Inspection on 24/07/06 for Clare House Nursing Home

This inspection was carried out on 24th July 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Clare House Nursing Home 30/08/07

Clare House Nursing Home 12/12/05

Clare House Nursing Home 30/08/05

Clare House Nursing Home 06/09/04

Clare House Nursing Home 22/04/04

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Clare House Nursing Home 36 Hersham Road Walton On Thames Surrey KT12 1JJ Lead Inspector Denise Debieux Key Unannounced Inspection 24th July 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Clare House Nursing Home DS0000017598.V298735.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Clare House Nursing Home DS0000017598.V298735.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Clare House Nursing Home Address 36 Hersham Road Walton On Thames Surrey KT12 1JJ 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) 01932 224881 01932 252539 skinnic@bupa.com www.bupa.com BUPA Care Homes (BNH) Limited Patsy Ann Maxwell Care Home 32 Category(ies) of Physical disability over 65 years of age (32) registration, with number of places Clare House Nursing Home DS0000017598.V298735.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 32 beds providing nursing care for elderly people from the age of 60 years. Up to 3 beds may be used for physically disabled people from the age of 50 years. 2 places for elderly day care (E) Date of last inspection 12th December 2005 Brief Description of the Service: Clare House is an attractive Tudor style home situated in a residential area of Walton-On-Thames. It enjoys the benefit of a pretty, secluded garden, which is accessible to all service users. There are three sitting rooms, a conservatory and a large dining room, all of which have a homely atmosphere. An activities room offers a variety of interests and personal hobbies are encouraged. The home is owned by BUPA who are the registered providers. The home offers nursing care to 32 older people. Fees range from £765 - £965 per week. This fee does not include newspapers, hairdressing, chiropody, manicures or physiotherapy. This information was provided on 25/07/06. Clare House Nursing Home DS0000017598.V298735.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place over 8.5 hours and was carried out by Denise Débieux, Regulation Inspector. Mrs Jacky Sylvester (Manager Wingham Court), Ms Elaine Farrer (Responsible Individual) and Mrs Valerie Eassom (Quality and Support Manager) were present as the representatives for the establishment. A tour of the premises took place. Fifteen of the twenty-three service users and four on-duty staff were spoken with during the visit. In addition, seven service user survey forms and two relatives’ survey forms were completed and handed in to the inspector on the day of this visit. Some of the comments made to the inspector and made on the survey forms are quoted in this report. The home had completed a pre-inspection questionnaire and service user care plans, staff recruitment records, complaint’s log, health and safety check lists, menus, activity schedule, medication records and storage were all sampled. The lunchtime meal and medication round was observed and the home was toured. The inspector would like to thank the service users and staff for their time, assistance and hospitality during this visit. What the service does well: What has improved since the last inspection? Clare House Nursing Home DS0000017598.V298735.R01.S.doc Version 5.2 Page 6 The ongoing maintenance, redecoration and refurbishment programme provides service users with a safe and comfortable environment in which to live. Since the last inspection the staff recruitment practises have improved and the home have worked hard to obtain all missing information and documentation for existing staff. 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. Clare House Nursing Home DS0000017598.V298735.R01.S.doc Version 5.2 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 Clare House Nursing Home DS0000017598.V298735.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each service user is only admitted to the home following a needs assessment to ensure that the home can meet the service user’s identified needs. The home does not offer intermediate care. EVIDENCE: Three care plans were sampled for the most recent admissions to the home. In each case full and comprehensive pre-admission assessments had been carried out prior to admission to ensure the home could meet the service users’ identified needs. All service users surveyed confirmed they had received enough information prior to deciding to move into the home and all confirmed they had received contracts. Clare House Nursing Home DS0000017598.V298735.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal care and healthcare support and assistance is planned and was seen to be provided, where needed, in a respectful and sensitive manner. Policies, procedures and practices are in place to ensure the safe administration of medication. EVIDENCE: Care plans sampled were comprehensive and clearly set out actions which need to be taken by care staff to ensure that all aspects of the health and personal care needs of the service users are met. In order for this standard to be fully met the home needs to include social care needs when drawing up the care plans and a recommendation has been made. The care plans were detailed and included the assistance required, with emphasis placed on the way the service users want their care to be provided. The activity co-ordinator also completes a ‘Life Plan’ document with the service users and uses this information when planning activities. However, the life plans seen were not signed or dated and a recommendation has been made. Clare House Nursing Home DS0000017598.V298735.R01.S.doc Version 5.2 Page 10 Care plans are regularly reviewed, with the service user signing to indicate their agreement. Up to date risk assessments relating to the risks of falls; skin breakdown and nutritional status were seen in all care plans. Daily notes are kept that reflect the care given and any changes or new concerns are recorded and acted upon. However, it has been recommended that the staff relate their daily records more specifically to the individual care plans to evidence that the service users needs are being met and that care is given in the way the service user wishes. During the tour of the home staff were observed to always knock before entering the service users’ bedrooms and all interactions observed between staff and service users were seen to be caring and respectful. Of the seven service users surveyed, five said they always receive the care and support they need, one answered ‘usually’ and another answered ‘sometimes’. The three service users spoken with at length during this visit all stated that they felt well cared for with one adding ‘they are very kind to me here.’ During the recent hot weather the home obtained and is following the Department of Health ‘Heatwave Guidance’. All service users had been risk assessed. During this visit staff were seen to offer extra fluids and fluid charts had been introduced for service users identified as at risk. Ice lollies were being handed out in the afternoon and salty snacks (such as crisps, peanuts) were available and offered. The medication administration records, medication storage, policies and procedures were all sampled and found to be in order. The lunchtime medication round was observed and seen to be in line with the home’s policies and procedures. Clare House Nursing Home DS0000017598.V298735.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The routines of daily living and activities are flexible and varied to suit individual service users’ wishes. Contacts with family and friends are encouraged and service users are encouraged and enabled to exercise choice and control over their lives. The meals in this home are good, offering both choice and variety and catering for special dietary needs. EVIDENCE: The routines of daily living are arranged to suit individual service users’ preferences and choices. The home employs two activity coordinators. The activity schedule seen was varied and included weekly exercises, board games, cards, reading, minibus outings, crafts and a summer garden party is being planned for August. Service users are able to choose which activities they attend and six of the seven service users surveyed said that there are always activities provided that they can take part in, with the seventh saying ‘usually’. The inspector was advised that the activity coordinators for the local BUPA homes have recently developed an ‘Activities Forum’ that meets quarterly and Clare House Nursing Home DS0000017598.V298735.R01.S.doc Version 5.2 Page 12 enables the activity coordinators from the different homes to pool their knowledge and further develop the activity provision. In addition BUPA have introduced new training to all care staff on activities. This was introduced last Autumn and is now included in new staff induction and is being rolled out to all pre-existing staff. Menus sampled showed that the home offers a varied and well-balanced menu, with service users able to choose alternatives if they do not want the dish that is on the menu on the day. The lunchtime meal took place during this visit and the food was well presented with ample staff available to offer help and assistance as needed. The service users spoken with during this visit were complimentary about the food at the home and confirmed that there were always alternatives offered. Clare House Nursing Home DS0000017598.V298735.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. All required policies and procedures are in place to ensure that service users and their relatives feel their views will be listened to. Policies are in place to protect service users from abuse but lack of consistently robust staff recruitment procedures are placing them at possible risk of harm or abuse. EVIDENCE: The home has a complaint’s procedure in place that is available to all service users and their relatives. Of the seven service users surveyed, four knew how to make a complaint and three answered that they did not know how to make a complaint. Four answered that they always knew who to speak to if they were not happy and three answered ‘usually’. Of the two relatives who returned comment cards, one stated that they were aware of the home’s complaint’s procedure and one answered that they were not. The complaint log was seen at this visit and was seen to be in order, with the home following the BUPA complaint’s procedure correctly. The home has recently introduced a system of documenting and recording actions taken on any concerns brought to the attention of the staff at the home, whether or not they are presented as complaints. Clare House Nursing Home DS0000017598.V298735.R01.S.doc Version 5.2 Page 14 The home has a ‘Whistle Blowing’ policy in place and basic awareness of the protection of vulnerable adults is included in the home’s induction training. A copy of the latest ‘Surrey Multi-agency Procedure for the Protection of Vulnerable Adults’ is available in the manager’s office for staff to refer to. All service users spoken with told the inspector that they felt safe at the home. Staff recruitment is addressed in the ‘Staffing’ section of this report. Clare House Nursing Home DS0000017598.V298735.R01.S.doc Version 5.2 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): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The location and layout of the home and gardens are suitable for their stated purpose. An ongoing maintenance and redecoration programme provides the service users with clean, pleasant and homely surroundings in which to live. EVIDENCE: All service users spoken with expressed their satisfaction with the accommodation provided at the home. Six of the seven service users surveyed stated that the home was always fresh and clean, with one answering ‘usually’. During the tour of the home the premises were seen to be well maintained with service users able to access all areas of the home and grounds. A small, continuous leak was noted from an overflow pipe on the patio. This had left an area of paving slippery just outside the dining room’s french doors. Mrs Sylvester took immediate action and made the area safe, advised the staff Clare House Nursing Home DS0000017598.V298735.R01.S.doc Version 5.2 Page 16 of the leak and advised the inspector that arrangements would be made for a maintenance man to investigate the leak the following day. Laundry facilities are sited on the ground floor with washing machines suitable for the needs of the service users at the home. On the day of this visit the home was found to be warm and bright with a homely atmosphere and a high standard of housekeeping apparent. The grounds were well maintained with additional, shaded seating areas provided for the service users and their visitors. All personal rooms seen were individualised to the service users’ wishes and were seen to contain many personal items and mementos. One of the service users commented on how much she liked her room and the view of the garden from her window. Clare House Nursing Home DS0000017598.V298735.R01.S.doc Version 5.2 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): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staffing numbers meet service users’ needs. The home has a staff training programme which is designed to ensure, as far as reasonably possible, that service users are in safe hands at all times but action needs to be taken to increase the percentage of staff qualified to NVQ level 2 in care from 25 to 50 . Staff recruitment procedures have improved but the home needs to ensure that all required information and checks have been obtained and verified for new employees before they commence employment. EVIDENCE: The staff rota evidenced that staff are provided in sufficient numbers to meet the needs of the service users at the home. Of the seven service users surveyed, four stated that staff are always available when needed and three answered ‘usually’. Of the sixteen care assistants, three are qualified to National Vocational Qualification (NVQ) level 2 in care and one has the level 3 qualification with one further care assistant currently on the course. This was discussed at this visit and the inspector was advised that a further three care assistants can be enrolled on the NVQ course for the September intake, thereby, eventually bringing the percentage of qualified staff up to the required 50 . Clare House Nursing Home DS0000017598.V298735.R01.S.doc Version 5.2 Page 18 Following requirements made at the last inspection in December 2005, all staff files were audited and the home worked hard to obtain all missing information and documents. The files re-sampled at this visit evidenced that this work has been completed and the majority of the requirements have been met. In addition, BUPA have now amended their application form for future applicants in line with the amended requirements of the Care Homes Regulations 2001. Files for two members of staff employed since the last inspection were also sampled during this visit. The files were seen to contain all required documentation and CRB checks had been carried out. However, the home must ensure that the information and documents provided by applicants is verified and explored further if indicated. On one application form there was a 2 year gap in employment and the applicant had only given the dates of employment as years (e.g. 2003-2004). The unexplained gap in employment had not been explored and, without having details of the month as well as the year that employment commenced and ceased, it was not possible to ascertain whether other gaps in employment were present. In one file the dates of employment stated by a referee on the reference did not match the dates of employment given by the applicant. In another file the home had failed to apply for a reference from the applicant’s last place of employment involving work with vulnerable adults. A copy of the CSCI recent publication ‘Safe and sound?: Checking the suitability of new care staff in regulated social care services’ was left at the home on this visit and requirements have been made. Staff spoken with at this visit confirmed that they had been given copies of the General Social Care Council (GSCC) code of conduct and practice. BUPA has a comprehensive induction and ongoing training programme which covers all areas required by the Skills for Care organisation (previously TOPSS). The training logs seen at this visit evidenced that all mandatory training and updates are provided promptly and the training records were well maintained and easy to follow. The inspector was advised that individual training needs are identified at the employee’s annual appraisal and additional training is provided that is relevant to the needs of the individual service users at the home. The BUPA training department have also recently developed new training initiatives, for example: training to all care staff in activity provision and an introduction to the care of dementia for all care staff, even if the home they work in does not provide accommodation for people with dementia. Clare House Nursing Home DS0000017598.V298735.R01.S.doc Version 5.2 Page 19 Service users spoken with and surveyed were all complimentary about the staff at the home and all stated that the staff always listen and act on what they say. Clare House Nursing Home DS0000017598.V298735.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home does not have a registered manager at the present time. The home has a quality assurance and monitoring system in place that is based on seeking the views of the service users. Service users’ financial interests are safeguarded by the policies and practices of the home. All required health and safety policies, procedures and checks are in place to ensure, so far as is reasonably practicable, the health safety and welfare of service users and staff. EVIDENCE: The home does not have a registered manager at the moment. The new manager is due to start work at the home on the 1st August 2006. In the interim, BUPA have arranged for other BUPA home managers, the responsible individual and the Quality and Support Manager to provide managerial cover. Clare House Nursing Home DS0000017598.V298735.R01.S.doc Version 5.2 Page 21 BUPA carry out an annual service user survey. When the results have been correlated a report is sent to the home and an action plan is developed to address any issues that are identified. The home had recently received the results of the last survey carried out in Autumn 2005. This survey involved the service users and their relatives. In order for this standard to be fully met the home will need to expand their quality assurance system to include seeking the views of stakeholders in the community (e.g. GPs, chiropodists, care managers and other health and social care professionals). A random sample of maintenance certificates and safety checks were seen at this inspection. All were found to be well-maintained and up to date. All interactions observed between the staff and service users were inclusive, caring and respectful. Clare House Nursing Home DS0000017598.V298735.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 3 Clare House Nursing Home DS0000017598.V298735.R01.S.doc Version 5.2 Page 23 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 OP28 Regulation 18(1)(a) (c)(i) Requirement Timescale for action 30/09/06 2 OP29 19(1)(ac)Schedul e2 3 OP29 19(1)(ac)Schedul e2 The registered person must develop and put into action a plan to increase the number of care assistants qualified to NVQ level 2 in care, to a minimum of 50 . The registered person must not 24/07/06 employ a person to work at the care home unless the person is fit to work at the care home and he/she has obtained, in respect of that person, the information and documents specified in paragraphs 1 to 9 of Schedule 2 of the Care Homes Regulations 2001, as amended by The Care Standards Act 2000 (Establishments and Agencies)(Miscellaneous Amendments) Regulations 2004. (Timescale of 12/12/05 not met) 24/07/06 The registered person must obtain the information and documents specified in paragraphs 1 to 9 of Schedule 2 of the Care Homes Regulations 2001, retrospectively for each member of staff employed by the company since the last DS0000017598.V298735.R01.S.doc Version 5.2 Clare House Nursing Home Page 24 inspection on 12/12/05 and before those employees work at the care home again. (Specifically, obtain a full employment history and explore any gaps in employment; obtain references from the person’s last period of employment in a position which involved contact with vulnerable adults; and be satisfied as to the authenticity of the references obtained.) 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 OP7.2 OP7 OP7 Good Practice Recommendations It is recommended that the home include social care/activity needs in each service user’s care plan. It is recommended that the staff sign and date all documents to evidence who obtained the information and when the information was obtained. It is recommended that staff relate their daily notes/records specifically to the actions set out in the care plans to evidence that service users’ needs are being met and that their wishes and preferences for personal care are being followed. It is recommended that the quality assurance system is expanded to include seeking the views of stakeholders in the community (e.g. GPs, chiropodists, care managers and other health and social care professionals). 4 OP33.7 Clare House Nursing Home DS0000017598.V298735.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Clare House Nursing Home DS0000017598.V298735.R01.S.doc Version 5.2 Page 26 - 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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