Inspection on 20/06/07 for Cottage Farm

This inspection was carried out on 20th June 2007.

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 no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cottage Farm 19/12/08

Cottage Farm 20/06/08

Cottage Farm 18/04/06

Cottage Farm 25/11/05

Cottage Farm 04/05/05

Cottage Farm 07/12/04

Cottage Farm 20/07/04

Cottage Farm 07/01/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Cottage Farm Southampton Road Hythe Hampshire SO45 5TA Lead Inspector Mrs Michelle Presdee Unannounced Inspection 20thJune 2007 10:00 Cottage Farm DS0000012379.V338766.R01.S.doc Version 5.2 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 Cottage Farm DS0000012379.V338766.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 Adults 18-65. 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. Cottage Farm DS0000012379.V338766.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cottage Farm Address Southampton Road Hythe Hampshire SO45 5TA 023 8084 0661 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) www.macintyrecharity.org MacIntyre Care Bridget Prescott Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Cottage Farm DS0000012379.V338766.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 3 named service users may be accomodated in the LD (E) category Date of last inspection 14th September 2006 Brief Description of the Service: Cottage Farm is registered to provide accommodation to five younger adults with a learning disability, physical disability or sensory impairment, although the home currently accommodates three residents over the age of 65. The home is a large spacious bungalow in a semi-rural setting, on the outskirts of Hythe town centre and the New Forest. Accommodation is provided within individual rooms, with communal facilities including a large, comfortable sitting room, spacious kitchen / dining room, one assisted bathroom, walk in shower room, separate WC and utility room. At the front of the property is a large parking area, with the garden area at the rear mainly laid to lawn, with small shrubs, a patio area and an adjacent fruit orchard. MacIntyre Care provides a Day Support Service to service users living in the home, enabling 1:1 support to access community facilities, and individual activities. The Home has a copy of the statement of purpose and recent inspection report Home to inform prospective service users. Weekly fees are £1100. 00, there are additional charges for hairdressing/chiropody/toiletries/holidays/activities and magazines. Cottage Farm DS0000012379.V338766.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During this five hour unannounced inspection all residents and three members of staff and the manager of the home were spoken with. A tour of the home and all residents’ bedrooms were seen. The annual quality assurance document was received before the inspection and this and other paperwork on the day has been used to help form judgements in this report. Five surveys were received from residents, which had been filled out with the help of their key workers. What the service does well: What has improved since the last inspection? What they could do better: Care plans need to be improved to ensure all current information is accessible, relevant and reviewed on a regular basis. All activities each resident takes part in need to be recorded on the care plan. Clarification is needed on the role of the agency workers who provide one to one support with each resident. The manager needs to ensure all residents have regular to access to all community health professionals. All evidence relating to the recruitment of staff need to be available in the home. Cottage Farm DS0000012379.V338766.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Cottage Farm DS0000012379.V338766.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cottage Farm DS0000012379.V338766.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a good pre-admission process ensuring all new residents would fit into the home and have their needs met. EVIDENCE: The home has had no new admissions in the last three years. The manager discussed how the pre-admission assessment process would work and had extensive paperwork, which would be used. The manager explained the potential new resident would be invited to spend time in the home taking into account the views of the other residents living in the home. A range of professionals, family members and friends would be used to gain information on the service user. The manager had a copy of the service user guide, which she explained she was hoping to improve on, and put more photographs in and make it more personal to the home. Cottage Farm DS0000012379.V338766.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Plans for each resident need to be current, detail all relevant information and be reviewed on a regular basis to ensure their needs are being met. Appropriate support is given to ensure that residents’ have choices and make decisions about their lives. EVIDENCE: The plans of two residents were viewed, the manager and staff explained these are person centred plans and try to put the resident at the centre of the plan. It was noted both these had extensive information recorded, which made it difficult to know what the current plan was. In one residents plan, half the information recorded related to risk assessments and it was agreed this was not current and unnecessary. Information recorded included a personal profile, morning and evening routines, likes/dislikes, and a communication profile. For one client who had been admitted to hospital a profile had been made to ensure hospital staff were aware of the clients communication barriers. Whilst Cottage Farm DS0000012379.V338766.R01.S.doc Version 5.2 Page 10 it was clear from discussions with staff and observations on the day a lot of activity was taking place, it was not possible to ascertain this from residents’ plans. Plans did not give enough detail on how care and support should be provided and also did not record how identified social needs were being met. For one resident it stated they had enjoyed going to church, however it was not possible to establish why this had stopped. Staff stated the resident enjoyed watching religious programmes on television now, but again this was not recorded. It was not possible to establish how residents spent their day and what social and community activities they took part in. In one plan reviews had taken place on a regular basis and in the other seen, no review had taken place for six months. On the day of the inspection a care manager from social services had come to do an annual review on all five residents. It was noted these were being carried out in the kitchen/dining room with two residents present. From observations on the day it appeared residents are able with support to make decisions about their lives. Staff spoken to stated it was important all residents had choices and talked about the way they tried to promote this, in terms of personal care, dressing, meal times and social activities that are tried. Not all residents are able to understand and verbalise their wishes, but staff explained the strategies they used to overcome these obstacles. The manager explained the home and the philosophy of MacIntyre would support residents taking risks. Resident’s files had extensive risk assessments, which also talked about the way the risk could be minimised. It was agreed these need to be weeded to ensure they only refer to current risks. All residents now have individual risk assessments relating to fire issues in the home. Cottage Farm DS0000012379.V338766.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities are well-managed and contact with family and friends is encouraged. Routines in the home reflect individual rights and responsibilities. Meal times are relaxed and provide residents with an enjoyable and healthy meal. EVIDENCE: Residents are encouraged to try new leisure activities in the community. Each resident receives funding for seven hours each week for one to one support in the community. One resident enjoys going to see a family member, whilst others enjoy going out to the new forest, swimming, going to garden centres and to the pub. Three residents attend a music workshop at a local college. Recent organised trips include trips to the theatre, a boat trip and going bowling. Two residents and two members of staff are gong to a holiday camp in the summer for a few days. None of this information was recorded on care plans and was all expressed verbally. Routines observed around the home appeared flexible, with residents seen to come and go with community support Cottage Farm DS0000012379.V338766.R01.S.doc Version 5.2 Page 12 workers, throughout the inspection. The home has it’s own transport and can take residents out; the inspector was advised this is usually on an informal basis taking two or three residents out at a time. Not many of the residents in the home have regular visitors but visitors are always made welcome and can visit at any time. The inspector was advised staff can recognise the signs if a resident does not want a visitor or is uncomfortable with them. Arrangements are being made for one resident to visit a friend who they used to visit, which he was looking forward to. On the day of the inspection two representatives from an advocacy service came to the home for the first time and will continue to visit on a regular basis. It was clear from observation residents rights are respected and they encouraged to take part in meaningful activities and are encouraged no matter how small their achievement may appear, which includes being involved in household chores. Meals are planned on a weekly basis with the residents and reflect their individual choices. Pictures have now been included in menus to make it easier for the residents to choose. On the day of the inspection no pictures had been added to the menu board but they were available in the kitchen. The menu board demonstrated meals were well balanced and a variety of meals were available. Meal times are flexible to suit resident’s choices and assistance is given in a discrete manner. Staff spoken to were aware two residents could not have lumpy food and what each resident’s favourite food was. Cottage Farm DS0000012379.V338766.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are supported to maintain good health and receive personal care but there needs to be more clarification when residents are out with agency workers to ensure their needs are met in a manner suitable to residents. Medication procedures are mainly well managed in the home. EVIDENCE: From observations on the day it was clear personal care is provided in a dignified manner whilst retaining a residents privacy and dignity. Care plans need to clearly record what level of personal care is needed and how this is to be provided. Clearer guidance and clarification also needs to be worked out with the agency, which currently take out service users on a one to one basis. No one was clear in some circumstances how personal care would be delivered. Health needs are generally well met in the home. Clients are supported to health visits in the community and the home has good links with the local Doctors surgery. Occupational therapist and speech and language referrals have been made in the past. One resident has mental health needs and is monitored under the care programme approach. A chiropodist visits the home on a regular basis. At the time of the inspection it was not possible to establish Cottage Farm DS0000012379.V338766.R01.S.doc Version 5.2 Page 14 when each resident had last seen an optician or a dentist, it was agreed this would be looked into and records would be maintained. None of the residents are able to manage their own medication. The home had an appropriate drugs procedure, which staff were aware of and stated they followed. Staff undertake a medication course and only become involved with the medication once they feel competent and have undertaken the training. The medication is kept in a locked drugs cupboard, and the home uses a nomad system. The medication and records were checked and it was found all records were accurate. Whilst walking around the home, it was noted pots of cream are kept in each residents room, it was agreed these should be kept locked away. In one resident’s room it was noted the pot of cream had expired over a year ago, this was immediately put in the bin. Cottage Farm DS0000012379.V338766.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are given information on who to complain to. Staff have a good knowledge on the protection of residents from abuse or self harm. EVIDENCE: Each resident in their room has a copy of the complaints procedure in a format that is appropriate for each of them. The manager stated the ethos of the home is to welcome complaints and use them as a positive learning tool. A log is kept of all complaints and it was noted three had been recorded since the last inspection; all had been upheld and appropriate action taken. A recent complaint had been passed to social services who at a planning meeting closed the case with proposed action for the worker it related to. Staff spoken to were aware of adult protection procedures and knew what agencies to contact if they had concerns. Appropriate policies and procedures were in the home, which staff could access. All staff have to complete modules on abuse and protection through MacIntyre e-learning. This is an interactive certificated course, which staff can work through at their own pace. Cottage Farm DS0000012379.V338766.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a clean and comfortable environment to ensure residents are provided with pleasant and hygienic surroundings. EVIDENCE: All areas of the home including residents bedrooms were seen. All areas were clean and decorated to a reasonable standard. Resident’s bedrooms had been personalised and all seemed happy with their rooms. Staff spoken to were thinking of ways to improve the bedrooms and make them more personal. For one resident it had been decided they were going to have their room decorated in a football fashion. It was noted in one bedroom there was a huge amount of incontinent pads stored, so many they had filled under the bed and there was still over ten packs visible. It was agreed these and the two wheelchairs stored in another bedroom should be stored elsewhere. On the day of the inspection the bathrooms and toilets were being painted from a lavender colour to a bright blue. Residents are encouraged to be part of the process and were taken Cottage Farm DS0000012379.V338766.R01.S.doc Version 5.2 Page 17 to a local shop to help choose the colour. The home has a comfortable lounge, which opens up onto the garden and a colourful kitchen dining room. The garden has raised flowerbeds to accommodate people in wheel chairs and residents are supported to buy plants and flowers for the garden. The garden fence is being painted in brighter colours and residents are being encouraged to participate in this. During the site visit the environmental health officer carried out an inspection. No obvious hazards around the home were noticed. Most areas were clean; two bedrooms needed dusting. No unpleasant odours were detected. The inspector was advised it is hoped the kitchen will soon be re-furbished and smaller eating areas will be created to give residents more choice. The home has a laundry, which was well equipped with all cleaning materials locked away. Cottage Farm DS0000012379.V338766.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a supported, trained and caring staff group. Recruitment records do still not demonstrate all checks have been made to ensure the safety of residents. EVIDENCE: The home currently employs six members of full time staff and one part time staff plus the registered manager. The home has vacancies for two full time staff. Staff in the home have managed to cover the current vacant hours and felt this had worked well. More staff are being recruited but the manager was clear staff had to have the correct skills for the job. A minimum of two staff are on duty during the day and night to be able to meet the needs of the people in the home. The staff in the home on the day of the inspection showed a good knowledge of the diverse needs of the people in the home and had a good level of communication with each resident. Four staff have achieved National Vocational Qualification (NVQ) Level 2 and 50 of the staff team are qualified to NVQ Level 3. Cottage Farm DS0000012379.V338766.R01.S.doc Version 5.2 Page 19 The staffing records of the last two members of staff to be employed in the home were viewed. The organisation has an agreement that original staff records can be held centrally at MacIntyre Care, but a pro forma with all relevant information should be kept in the home. All information was recorded except evidence of a criminal records bureau (CRB) check for one staff member. The manager explained a CRB check would have been completed and it was down to an administrative error that the check had not been recorded. Staff spoken to felt they received a wide and diverse training programme. One staff member was just completing a six month induction training programme, which she had felt was very beneficial and explained how she had been through each section with her manager. Training undertaken, which had been recorded on staff files, included first aid, basic food hygiene, manual handling, infection control, person centred planning, epilepsy, autism, continence, fire training and health and safety. The home has regular staff meetings, which are well attended and minutes maintained. Staff confirmed they had monthly supervision sessions, which they felt were beneficial. Cottage Farm DS0000012379.V338766.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally well managed. Resident’s views are considered when decisions are made in the home. Health and safety procedures in the home are adequate. Issues relating to residents finances need to be organised for the protection of each resident. EVIDENCE: It was clear from discussions with staff members they felt the home was well managed and their manager supported them. The manager is currently undertaking her Registered Managers Award. The manager showed a great awareness of the diverse needs of the residents in the home and was keen to improve practices to improve their quality of life. Cottage Farm DS0000012379.V338766.R01.S.doc Version 5.2 Page 21 The home helps all residents with their finances. At the current time the way the residents monies is handled is changing and the organisation is trying to set up new bank accounts. Currently all money is accessed via MacIntyre petty cash. The records of two residents were checked and it was agreed the recording of the accounts was confusing and the totals at times were not correct. It was difficult from conversations with residents to establish if residents felt their views were used regarding future developments of the home. All residents had done a ‘Listen to me’ session with their key workers, which had tried to find ways in which their lives could be improved. The garden is an area, which is being developed from feedback from residents. A full quality audit has not been undertaken, except for the Provider’s monthly visits to the home as required under Regulation 26 of the Care Homes Regulations 2001. Staff are provided with plastic gloves and aprons, which were worn appropriately on the day. COSHH (Control of Substances Harmful to Health) assessments have been carried out. Cleaning fluids were kept locked away. A range of policies and procedures were in the home. Fridge and freezer temperatures were maintained. All food in the fridge was appropriately stored and being covered and dated. Prescribed creams should not be left in resident’s rooms and should only be used if they are in date. Fire equipment in the home is being regularly serviced. And checks on fire fighting equipment and fire drills are being recorded in the home. It was noticed during one fire drill one resident had refused to leave the home. Advice had been sought from the fire officer and this information had been written into the person’s fire risk assessment. It was not possible to establish what training takes place and how often staff had received fire training. Cottage Farm DS0000012379.V338766.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 Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 2 X 2 X 3 X X X 3 Cottage Farm DS0000012379.V338766.R01.S.doc Version 5.2 Page 23 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 YA34 Regulation 19 Requirement The proforma detailing all the checks that have been undertaken for staff as part of the recruitment process must be kept updated and current. Timescale for action 30/07/07 2. YA6 15 Service user plans must be 30/07/07 current, reflect all current needs and issues for individuals, and be reviewed on a regular basis. The registered person must ensure that all service users’ healthcare needs are monitored and that they are able to receive treatment and other services from any health care professional. Official accounts must be opened for each resident. Records must demonstrate all monies in and out and a running total must be maintained. Staff must receive adequate training in fire safety, with records kept to evidence this. Prescribed creams should only be used if they are in date. DS0000012379.V338766.R01.S.doc 3. YA19 13 30/07/07 4. YA37 16 30/08/07 5. YA35 18 30/08/07 6. YA20 13 30/07/07 Cottage Farm Version 5.2 Page 24 Creams should be stored safely. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cottage Farm DS0000012379.V338766.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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