Inspection on 10/09/07 for Cranhill

This inspection was carried out on 10th September 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Cranhill 09/10/06

Cranhill 07/11/05

Cranhill 22/06/05

Cranhill 27/01/05

Cranhill 18/05/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Cranhill Weston Road Bath Bath & N E Somerset BA1 2YA Lead Inspector Andrew Pollard Key Unannounced Inspection 10th September 2007 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 Cranhill DS0000020276.V345225.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. Cranhill DS0000020276.V345225.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cranhill Address Weston Road Bath Bath & N E Somerset BA1 2YA 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) 01225 422321 01225 482637 Mr Charles Otter Mrs Virginia Hughes Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Cranhill DS0000020276.V345225.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. May accommodate 31 Persons over 50 years of age requiring nursing care Staffing Notice dated 09/11/2001 applies Manager must be a RN on parts 1 or 12 of the NMC register May accommodate one named person aged 49 years: the registration will revert when this person leaves the Home 9th October 2006 Date of last inspection Brief Description of the Service: Cranhill Care Home is situated in a suburban area of Bath and provides nursing care for up to 31 residents. There is easy access to Victoria Park nearby, also to other local venues and shops by car. The building is an older converted property providing single rooms on three floors with lift access. Communal space is in three areas and residents also enjoy the forecourt/terrace area in front of the home. Currently the maximum charge for a room is £795 per week. Cranhill DS0000020276.V345225.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection conducted as part of the annual inspection process. The inspection lasted one day. Following the previous inspection several requirements were made concerning the environment and issues related to the health and safety of residents, there are no outstanding requirements. The following methods of evidence gathering has been used in the production of this report; observation, discussion with residents, relatives and staff, tour of the home and sampling policies, records and care plans. 23 surveys were returned from residents and relatives and 2 from health professionals. Information from these has been collated and is detailed throughout the report. Staff and resident interactions were seen to be friendly and caring upholding the dignity of the residents. Members of staff were observed on duty and several were consulted individually. General feedback was given to the manager on the day of inspection. What the service does well: Residents, relatives, visitors and health professionals consulted on the services evidenced a good quality of life for residents. The residents/relatives consider the quality of food to be good. The impression of the home is that it is a friendly comfortable and safe place to live and the staff respectful and caring. The environment is of a good standard and clean. The residents are calm and cheerful and the staff assists them to look smart and well kempt. All of the residents and visitors spoken with during the inspection commented positively on all aspects of the home. Cranhill DS0000020276.V345225.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Cranhill DS0000020276.V345225.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 Cranhill DS0000020276.V345225.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective clients and their families are given relevant information in written or verbal form about the home. Contracts and terms and conditions of services are provided to all clients. The assessment procedure is well managed and a thorough assessment of prospective residents needs is carried out. EVIDENCE: A statement of purpose and a service user guide plus additional helpful information is made available at the initial stage of enquiry to prospective Cranhill DS0000020276.V345225.R01.S.doc Version 5.2 Page 9 residents/families. This provides information about the services and facilities available and includes the terms and conditions. The manager is due to carry out a review of the service user guide in the coming weeks following a revision of the conditions of registration. All the residents/relative surveys returned stated that they had received adequate information to help them decide if Cranhill was somewhere they would like to live. They also confirmed that they or family member had received a contract on admission to the home. The home operates a robust admission procedure for residents, in the form of a checklist to ensure the smooth running of this first initial period within their new home. New residents are admitted following a full pre-admission assessment, which is carried out by the manager. The manager stated that visits to service users homes or the hospital are arranged. The Inspector looked at the pre-admission assessments, which covered the activities of daily living. The prospective resident, family and carers are involved in the pre-assessment and all information is used to determine the suitability of the placement. Where possible the manager had also obtained assessments and care plans from other professionals involved for example, social workers and hospital staff. Prospective residents are encouraged to visit the home either for the day or for lunch if they wish. A month’s trial period on both sides is usually undertaken to ensure that everyone is happy with the arrangements and to ensure that the placement is suitable. Residents are referred to the Primary Care Trust for assessment for funding under the Registered Nurse contribution or Continuing Health Care (CHC). Cranhill DS0000020276.V345225.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good care plans are in place but the scope could be improved. The staff provide a high standard of personal and nursing care to maintains residents’ health and well-being and dignity. Proper arrangements are in place for residents to access primary healthcare services. The staff properly store, administer and record medication on behalf of residents. Storage of drugs for disposal needs to be improved. Cranhill DS0000020276.V345225.R01.S.doc Version 5.2 Page 11 EVIDENCE: Residents care plans were examined to assess how they are being supported and their needs met. Care plans addressed residents’ physical, psychological and health needs. There are elements relating to social needs and activities. The development of thumbnail biographies by care staff in liaison with the resident/relatives was discussed as a way to enhance a person centred approach to the care regime. In general the case files give good information stating how best to meet the residents needs and demonstrating that health care needs were being monitored and kept under review. It was suggested that annual reviews are planned to take place and if possible to coincide with RNCC or social services reviews. The value of night staff being delegated responsibility for writing detailed night care plans was discussed and about the possibility of carers being delegated responsibility for recording the personal care elements in care plans. It was suggested that named RN’s take responsibility for writing and maintaining the clinical elements of care plan. Risk assessments were in place with detailed information to ensure safe procedures for example, manual handling, the correct use of bed rails and how to reduce the risk of falls. The use of bedrails had been discussed with the individual or their representative and written consent had been sought. Each resident is referred to a General Practitioner (GP) on admission to the home and an initial first visit was then set up. Currently nine different practices support the home. Records of the GP and paramedical visits to residents are recorded. Specialist referrals to dentists were discussed in relation to regular examinations being offered to all residents. A GP who submitted a comment card said he was happy with the standard of care in the home. The manager knowledgeable about the care needs of the individuals living in the home and felt well supported by the staff team. Residents surveys stated that “staff were helpful” and “looked after them well” and were available when they needed them. The atmosphere in the home on the day of the inspection was relaxed. Staff, the manager and residents were observed to have good relationships. Staff responded to residents in a sensitive and professional manner. Staff were witnessed knocking on resident’s doors before entering confirming respect for the residents’ individual privacy and dignity at all times. Cranhill DS0000020276.V345225.R01.S.doc Version 5.2 Page 12 The manager and deputy are link nurses with the Dorothy House Hospice and oversee end of life care planning. The staff make every effort to establish resident’s wishes concerning palliative care and any provision residents and their families would wish for when developing end of life plans. Medication procedures and practices in the Home were reviewed, and the Home operates a safe system of storage, administration and recording of medication. Disposal arrangements are in line with current legislation, however the disposal bin does not provide secure storage of drugs awaiting disposal as the lid cannot be put on until the bin is full. The home has drug fridge drug fridge and suction equipment. A ridged catheter is required for the suction machine. Cranhill DS0000020276.V345225.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,14.15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A range of social and recreational activities is arranged that seek to enhance the quality of life for the residents. Resident’s families are involved and informed of issues related to their relatives and are able to maintain close contact with families and friends. The food is of a good standard and provides a balanced diet for residents although choice is not always offered. EVIDENCE: The activities coordinator provides a varied programme of activities for the residents. She is a well-established member of staff who is knowledgeable of the residents’ needs and wishes. Cranhill DS0000020276.V345225.R01.S.doc Version 5.2 Page 14 In conjunction with the residents the activities coordinator develops a monthly timetable of activities and forthcoming events. A copy of this is placed in communal areas throughout the home, to ensure that all residents and visitors are aware of the planned activities. Individuals have records of their social and activity choices and record of participation in their files. Activities planned include trips and outings musical entertainment, card making, exercise classes and aromatherapy. Relative’s comments in surveys stated that they are satisfied with the home and the services provided, “staff are very welcoming”. The aroma therapist made many positive comments regarding her observations of staff attitudes and manner. The manager stated that the residents benefit from services run by the local church including Holy Communion for residents each monthly. A residents spoken with very much enjoys the service. One resident said, “I always enjoy the service and the different hymns we sing”. There are no residents with other faith backgrounds. The grounds and gardens are extensive at Cranhill and the residents take advantage of sitting on the terrace and new lower patio where people can enjoy the views when the weather permits. There is a very pleasant dining room where individuals can enjoy dining together. Other residents through choice or being frail receive their meals in their rooms. Residents that required assistance with eating their meals were supported by staff members, this was performed in a respectful, sensitive way, for example without rushing the residents and staff were sat at the same level as the resident. The 3-week menu rota displayed traditional meals and choice was available at each setting. The menus are reviewed to reflect seasonal trends and availability of produce. Three residents reported no always being offered a choice of main meal and the manager admitted that on occasions this has failed to take place but will ensure that it does so in future. Special food is ordered on request for birthdays and special occasions. Fresh fruit and vegetables are delivered twice weekly and bowls of fruit are on offer throughout the day. Residents’ surveys expressed that “The food is always very good” Cranhill DS0000020276.V345225.R01.S.doc Version 5.2 Page 15 The kitchen was clean, spacious and stores exhibited a good range of foods. The required temperature checks were being carried out on fridges and freezers and that food was also being probed after being cooked before serving. Risk assessments were in place and up to date. An EHO visited last year and found all in good order. Cranhill DS0000020276.V345225.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are robust and comprehensive policies in place to protect residents investigate complaints. Proper arrangements and policies are in place to protect residents from abuse. There are arrangements in place for staff training and awareness of Protection Of Vulnerable Adults matters. EVIDENCE: The Home has appropriate procedures in place for the management of complaints. The complaints procedure was on display in the hallway at the entrance. The document contains contact details for the Commission for Social Care Inspection There had been no recorded complaints since the last inspection. The Manager stated that the home has an open door policy and has resolved any concerns before they became a complaint. Cranhill DS0000020276.V345225.R01.S.doc Version 5.2 Page 17 All residents who completed a survey indicated that they knew who to talk if they were not happy and how to make a complaint. Comments included, “I’ve never had cause to complain “. Residents also said they would speak to the manager or a nurse to discuss any concerns they may have. The home has clear policies and procedures for Adult Protection and Whistle Blowing, staffs receive training on Adult Protection during their induction and qualified staff is aware of the procedures to follow. The majority of staff received adult protection training in January 07 a small number of staff are awaiting places for training. The home does not handle residents’ money. Some valuables were stored in the safe and were properly logged. Cranhill DS0000020276.V345225.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,22,24,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The rooms are large and the standard of furnishing and décor in bedrooms and communal areas is good. The Home is safe, well maintained internally and externally. The standard of cleanliness is high. Cranhill DS0000020276.V345225.R01.S.doc Version 5.2 Page 19 EVIDENCE: The home was found clean, warm, well lit and free from unpleasant odours. Residents had been supported to personalise their bedrooms with pictures and ornaments. Residents are able to bring items of furniture should they wish to. Suitable dining room seating and table facilities are provided so that residents can enjoy their meal times comfortably and in a congenial setting. The home offers a variety of communal areas looking onto the well-tended garden. The garden is large and recent hard landscaping has provided residents with the option of using larger areas of the gardens. There are sufficient bathrooms and toilets. However, there is ongoing discussion between the manager and the proprietor to have these upgraded. A grant has been obtained to create a walk in shower room to offer choice and enhance the bathing experience for residents’. Baths have thermostatic mixer valves and the monitoring hot water temperatures take place, however the temperatures recorded varying outlet temperatures, often quite cool. The manager will make arrangements for the maintenance man to check all the outlet temperatures and adjust as required to provide comfortably hot but safe water. When surveyed residents said the home was always clean and fresh. All verbal comments were in praise of the cleanliness of the environment and its upkeep. Resident areas are fitted with appropriate aids such as grab rails and all rooms have a nurse call system with audible alarm facility. Mobile and fixed hoists and stand aids are provided. There is a shaft lift and stair lift, which give level access to all parts of the home. Pressure relieving equipment is available as required. The home employs housekeeping and laundry staff on a daily basis. Sluice areas included one washer disinfector. The laundry has sufficient washing machines and tumble dryers. Two residents praised the quality of the laundry service. There are appropriate infection control, policy and procedures in place. The clinical waste is correctly disposed of to prevent the spread of infections. Cranhill DS0000020276.V345225.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The recruitment procedures and records are in good order. The home is well staffed with appropriately trained and experienced staff for the number of residents. Proper training arrangements and clinical updating for RN’s are in place. Progress is being made training care staff for the benefit of residents. EVIDENCE: The staffing levels are in accord with or exceed the staffing notice. The staffing levels are indicative of the needs and level of care required by the residents. Surveys agreed that staff were always available when they needed and always listened and acted upon what the residents had to say. Cranhill DS0000020276.V345225.R01.S.doc Version 5.2 Page 21 At present there are no Nurse vacancies and one carer vacancy. The home has a small bank of staff and agency use is minimal. The domestic, catering, admin and laundry staffing levels are satisfactory. The induction programme is and based on the Skills for Care standards. After completion of the foundation training care staff enrol on the National Vocational Qualification (NVQ) programme level 2 A recruitment policy and procedure is in place. The staff files checked showed all the appropriate documents and checks were in evidence. In future CRB’s will be retained until the inspector has signed them off or an appropriate confirmation is received from the umbrella organisation. Registered Nurse verification of registrations have been validated with the Nursing and Midwifery Council (NMC). The manager is going to develop a training matrix to plan and evidence that all mandatory training including fire safety, food hygiene, first aid, load handling and adult protection training has been completed in the required intervals. Training objectives will be set through the appraisal system. The manager and other Registered nurses are conscientious in attending clinical updating and training relevant to the care needs of the residents. Residents’ surveys stated that, “the staff work hard and are very pleasant” Relatives’ comments included, “The staff are caring and approachable” and “Staff are friendly and respectful”. Cranhill DS0000020276.V345225.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31.33.34.35.36.37.38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run taking into account the views and wishes of the relatives and residents and as they are able. There are good arrangements in place to maintain and service the equipment and facilities in the home. Staff supervision is taking place. The Home protects the health and safety of residents and staff. Cranhill DS0000020276.V345225.R01.S.doc Version 5.2 Page 23 EVIDENCE: The manager and deputy are registered nurses who was able to demonstrate an understanding of the needs of the individuals living in the home and have a good team who work with them to ensure that high standards of care are achieved and maintained. The atmosphere in the home was positive and calm. Staff were noted interacting with residents in a caring and friendly manner. During the inspection the inspector spoke to residents who said they were” very happy at Cranhill”. There was satisfaction expressed by all of the residents spoken with. Based on the comments made in surveys and through the inspector’s discussions it is evident that the home is run in their best interests and their needs are being met. Resident/relative meetings are held periodically throughout the year and records are maintained of people’s views. The home has been awarded the ISO9001 for management next due for review in 2008. The home carries out surveys of resident satisfaction periodically and the manager is considering developing thematic surveys in the future. Staff appraisal and supervision was reviewed. Some staff had received supervision on a one to one basis, however it has been ad-hoc and some nurses may require training to feel confident in delivering the process before it can be properly established. It was agreed that due to the size of the home that there would be a combination of supervision and appraisal for nursing and care staff four times a year. Staff have carried out residents risk assessments and made appropriate provision to protect residents from injury. Padded bed rails are used to reduce the risk of falls where there is an assessed need and consent in place. There are restricted openings on windows. There are radiator covers in areas of identified risk. Accident records and regulation 37 notices are properly completed. The home employs a maintenance man for routine upkeep of the home. Records showed that relevant inspections and maintenance has been carried out at the required intervals for the fire alarms and equipment, gas and electrical services, hoists and lift. Mr King is in the process of updating the fire safety risk assessment and plan. Cranhill DS0000020276.V345225.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 X 3 2 3 STAFFING Standard No Score 27 3 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 3 2 3 3 Cranhill DS0000020276.V345225.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? None 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. Standard Regulation Requirement Timescale for action 2. OP9 13.3 The disposal bin for discarded 01/11/07 drugs should have a tamperproof lid to ensure the content are secure. That there will be a system in 30/11/07 place to provide a combination of supervision and appraisal for all nursing and care staff four times a year. 2. OP36 18.2 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. Refer to Standard OP25 Good Practice Recommendations Hot water temperatures need to be monitored at the outlet to ensure they are hot but do not exceed 45 degrees. Extend care plans to include night care plans. OP8 Cranhill DS0000020276.V345225.R01.S.doc Version 5.2 Page 26 3. 4. OP30 OP36 To develop a training matrix to plan and evidence that all mandatory training is booked and completed. That the supervision arrangements are delegated amongst the RN’s Cranhill DS0000020276.V345225.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South West Regional Office 4th floor, Colston 33 33 Colston Avenue Bristol BS1 4UA 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. Extracts may not be used or reproduced without the express permission of CSCI Cranhill DS0000020276.V345225.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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