Inspection on 20/06/07 for Crouched Friars Residential Home

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 (sorry - unknown). 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

Crouched Friars Residential Home 17/07/08

Crouched Friars Residential Home 14/07/06

Crouched Friars Residential Home 27/11/05

Crouched Friars Residential Home 28/05/05

Crouched Friars Residential Home 11/11/04

Crouched Friars Residential Home 30/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Crouched Friars Residential Home 103-107 Crouch Street Colchester Essex CO3 3HA Lead Inspector Sara Naylor-Wild Key Unannounced Inspection 20th June 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 Crouched Friars Residential Home DS0000017799.V343814.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. Crouched Friars Residential Home DS0000017799.V343814.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Crouched Friars Residential Home Address 103-107 Crouch Street Colchester Essex CO3 3HA 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) 01206 572647 01206 763622 Weldglobe Limited Mrs Lutchmee Engutsamy Care Home 56 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (56) of places Crouched Friars Residential Home DS0000017799.V343814.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 56 persons) One person, who name was made known to the Commission in December 2006, who requires care by reason of dementia The total number of service users accommodated in the home must not exceed 56 persons 14th July 2006 Date of last inspection Brief Description of the Service: Crouched Friars is a period property that has been extended to offer care to 56 older people on three floors. The upper floors are accessed via a passenger lift. Most of the bedrooms are single occupancy and all have en-suite facilities. There are several communal areas offering a choice for service users, and a large pleasant garden at the rear of the property with a summerhouse for service users use. The property is situated close to Colchester town centre and has access to local amenities, including libraries, shops, post office and public transport. The fees charged by the home range from £367 to £570 per week. In addition to the weekly fee, service users pay £4 for hairdressing and £12 for the chiropodist where those services are used. Crouched Friars Residential Home DS0000017799.V343814.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The evidence contained in this report was gathered from discussion with service users and staff at the home, questionnaires completed by service users, relatives and professionals visiting the home, information provided to the Commission for Social Care Inspection (CSCI) including the Annual Quality Assurance Assessment, since the last report and an unannounced visit to the home on 20th June 2007. Mrs Lutchmee Engutsamy, the Registered Manager assisted the inspector at the site visit. Feedback on findings was given to her during the visit with the opportunity for discussion or clarification. The inspector would like to thank the Mrs Engutsamy, the staff team, residents, relatives and visiting professionals for their help throughout the inspection process. What the service does well: What has improved since the last inspection? In general the service continues to develop in its understanding of providing a service to meet the Care Homes Regulations 2001 and the National Minimum Standards for Older People. They are moving forward in providing residents with a voice in how the service is operating and developing to meet these expectations. Crouched Friars Residential Home DS0000017799.V343814.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Crouched Friars Residential Home DS0000017799.V343814.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 Crouched Friars Residential Home DS0000017799.V343814.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): 3 and 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents can be assured that the service will understand their needs prior to their moving into the home. Although the level of information gathered could be improved to ensure they are fully prepared to meet the individuals’ wishes and aspirations. EVIDENCE: The assessment information in respect of four residents was considered again at this inspection. The information is gathered using both a social services assessment where provided and a form developed by the service. This form asks for information in all areas of daily living normally associated with assessments, such as mobility, nutrition and personal care needs. Those assessments seen were completed and would provide the basis for developing a plan of care and understanding how suitable the proposed admission would Crouched Friars Residential Home DS0000017799.V343814.R01.S.doc Version 5.2 Page 9 be. As the format was a tick box style with space given for additional comments where required the detail and therefore the relevance of the information varied across the plans. The service does not provide intermediate care. Crouched Friars Residential Home DS0000017799.V343814.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 Adequate. This judgement has been made using available evidence including a visit to this service. Residents can expect their basic needs to be included in their plan of care. However, they cannot be confident that their individual preferences and choices are in sufficient detail to meet their needs. Residents can expect to receive their medication as prescribed, however they cannot be assured that all staff adhere to the home’s safe medication procedures. EVIDENCE: The files of four residents were examined to assess the quality of the information contained in the document The care planning documents had not been altered significantly from previous inspection visits and in each section of the plan gave a brief general description of the individuals needs and abilities and how staff should respond to them. Crouched Friars Residential Home DS0000017799.V343814.R01.S.doc Version 5.2 Page 11 Examples of the entries made in one plan of care are • Personal Care Needs - a cheerful person who is talkative, very well motivated, needs assistance with personal care as they have arthritis in their upper body. • Emotional care Needs - family visits are enjoyable…. • Spiritual Needs – C of E. This plan was not detailed enough to provide sufficient information to staff in supporting the residents independence in all aspects of their lives Another said • Communication Needs - X has no problems communicating…the story constantly changes depending on whom they are talking to… • Personal Care needs -. Well-motivated needs encouragement, at times they are very impatient. Very pleasant person, cheerful but also can be prone to mood swings and can get argumentative and may be manipulative at times, • Spirituality needs - C of E. • Emotional needs - can be agitated at times, encourage them to calm down, when extremely agitated or angry staff to walk away and inform senior on duty, do not engage in conversation. Ensure that any limitations are explained and justified for any decision to be made. • Eating - At times x is fed, at times they are supervised and sometimes they insist on being independent, all depends on their mood. The language and terms used to describe the resident in this plan were demeaning and lacked respect for the individual. There was also confusing messages about the individual and how staff should support them. When the inspector referred back to the original assessment they found the care plan record of the individuals religion was completely wrong. In both cases the records require greater elaboration in the detail of how staff should address the issues raised. i.e. to what level do they support the individuals personal care, do they encourage or walk away when someone is agitated. What attempts are made to understand the triggers in behaviour? Care staff are responsible for recording in the daily log how they are supporting individual residents. The records examined by the inspector did not indicate how the individuals care plan was being provided and to what degree the plan had been successful, so for example there were statements such as helped to wash and dress, seems in fair mood. It would not be possible from this information to understand whether the documented plan of care met the individuals’ needs and aspirations. Crouched Friars Residential Home DS0000017799.V343814.R01.S.doc Version 5.2 Page 12 Overall the care plans are present and provide a degree of information that would support staff in meeting residents basic needs, but in order for the service to provide a person centred support that respects the individual and aims to enhance their lives the documents require further consideration. In addition the staffs understanding of dignity, respect and person centred care planning must be developed. At the site visit the practice in medication administration was observed over the lunch time period. A member of the senior care staff was responsible for this dispensing and overall the practice observed was very poor. Issues included the dispensing of drugs without reference to the individuals MAR sheet and all the drugs dispensed being signed for en masse at the end of the activity. When asked why they did not refer to the dispensing instructions on the MAR sheet, the member of staff told the inspector that as this was a routine dispensing of drugs they were familiar with the quantities and did not need to be reminded. In addition a number of sheets of tablets, identified by the staff member as painkillers were carried in a kidney tray and dispensed to residents. These drugs were not identified by a pharmacist label as being prescribed for the individuals or their dosage and frequency. Finally the staff member administered. Eye drops to a resident at the dining table, and did not wash their hands before and after the administration or wear gloves. Overall the staff member failed to adhere to safe working practices in drugs dispensing as set out by the Royal Pharmaceutical Society of Great Britain. This practice does not protect residents from harm and was raised with the manager at the time of the visit. The training records for this individual identified that appropriate training had recently been provided and the manager was unable to account for their behaviour. The manager agreed to keep the CSCI informed of the action taken in respect of this issue. Following the inspection the CSCI was informed of the action taken in respect of the staff member and how the quality of medication administration will be monitored in future. Crouched Friars Residential Home DS0000017799.V343814.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, 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 majority of residents can be assured that they will be provided with a range of activities to suit their preferences. However development is required to provide opportunities to residents with more specialist needs. EVIDENCE: The service employs an activity co-ordinator who works in addition to the general care staffing hours. Although as previously stated the residents care plans did not refer in any detail how their social and emotional needs were being met. However, the co-ordinator has collated an assessment of each residents’ interests and choices in activities and aims to provide a flexible programme that includes these. On the day of the inspection a range of quizzes and a game of indoor ten-pin bowling were taking place. The co-ordinator has a number of resources they have purchased themselves such as the skittles, games etc. Crouched Friars Residential Home DS0000017799.V343814.R01.S.doc Version 5.2 Page 14 The activity diary sheets in residents care plans indicated a daily offering of some kind of activity with a mixture of one to one, group and family outings. Additionally the coordinator maintains a daily file to record what activities have been on offer, who took part and how successful these have been. There is not evidence of the rest of the staff group participating in either organised or informal activities, and the lack of definition in care plans about the individuals social, emotional and spiritual needs and how these will be met suggests that staff do not engage in this area of care. Specific issues raised to the Commission in relation to the care of one resident included the opportunities for activity on offer in the home, specifically in relation to sensory disabilities. The care plan of the resident did not indicate a full assessment of the interests they had and how this would be addressed, although subsequent to the concerns raised an action plan had been devised that included provision for the individual. The services visiting policy is provided in the service users guide and relatives, advocates and others were seen visiting residents throughout the inspectors visit. A resident spoken with during the visit commented on how welcome staff made visitors and that they felt able to offer hospitality as in their own home. During the inspectors visit to the home the main meal of the day was served in the two dining rooms. The meal was served in an unhurried manner when everyone was seated and the atmosphere was relaxed and pleasant. There was a choice of food available, and residents spoken with were aware of the choices of menu on offer that day. One resident said they were confident that even if you didn’t like what was on the menu there would be an alternative offered. Others said “You cannot fault the food, they even offer meals to people who visit” Crouched Friars Residential Home DS0000017799.V343814.R01.S.doc Version 5.2 Page 15 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that they will be listened to and that their concerns will be actioned. Residents can be assured that they are protected from abuse by the staffs understanding of safeguarding adults. EVIDENCE: The services complaints policy has been previously viewed at inspections and meets the criteria set out by the Care Homes Regulations 2001, with appropriate descriptions of how to make a complaints and timescales to which the service responds. As part of this policy the service maintains a complaints log, which held good records including action taken in response to complaints. There was one complaint letter held on file with a from recording the concern, the services investigation into the issue and the outcomes reached. The letter actually mentioned one significant issue and a further list of concerns raised as a result of the main issue, where as the services recording tool only refers to the one issue and how this was dealt with. The manager was able to describe to the inspector the full work undertaken in respect of the total complaint and how this had been dealt with, and was advised that this needed to be recorded in future. Crouched Friars Residential Home DS0000017799.V343814.R01.S.doc Version 5.2 Page 16 The Commission was also made aware of a resident’s complaint raised immediately prior to the inspectors visit to the home. This was supported by their social worker, who arranged meetings with the resident and the manager. The response to this issue was very positive and both the resident and the social worker reported that they were very satisfied with the responses made. The manager was able to detail work that was being undertaken as part of this response. There was also a complaints record maintained by staff in response to verbal complaints received. This provides good evidence of the way in which concerns are tracked and dealt with, however some of the staffs entries indicate they do not understand what the record is setting out to achieve, so for example there is not always clear evidence of what action had been taken and how the issue has been resolved. Service users spoken with were clear and confident about their rights to complain, and how the manager would deal with the complaint. The home’s recruitment practice, induction of new staff, supervision of staff, and commitment to training were good. These practices help to protect service users from abuse. There had been no protection of vulnerable adults issues raised in connection with this service since the previous inspection. Crouched Friars Residential Home DS0000017799.V343814.R01.S.doc Version 5.2 Page 17 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 and 26 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents can expect to be encouraged to use all areas of the environment. However those residents with specialist needs cannot be confident that they could access areas independently. EVIDENCE: Crouched Friars provides accommodation for up to 56 people. Although it is a fairly large home, the layout of the building gives an impression of smaller units and is not institutional. Accommodation is largely, but not wholly, in single rooms. There is some variation in the quality of accommodation provided to individuals, however it is felt that overall the accommodation is good. Some single rooms in the oldest part of the building are small with ensuite facilities that do not necessarily meet the needs of people living at the Crouched Friars Residential Home DS0000017799.V343814.R01.S.doc Version 5.2 Page 18 home. The home is on a number of levels but there is a lift in place to ensure people can move about the building. The front garden was tidy and well presented with a variety of flowering plants. The home has a generous sized rear garden. The rear garden was maintained to an adequate standard, and gazebos were provided to give some shade to residents. Independent accessibility for residents with walking aids and in wheelchairs to the garden is an issue that requires ongoing attention. The home is situated in the centre of Colchester making it easy for service users, where suitable assistance is available, to access the town centre. Records relating to health and safety, including the routine maintenance and servicing of equipment were clear and up to date. The main lift had been replaced and adaptations to the changing floor levels had been made in an upstairs corridor. The home employs domestic staff and at the site visit the home was clean, free from odour and well maintained. Staff had undertaken training in respect of infection control. Staff were observed wearing gloves and aprons when appropriate. None of the practices carried out by staff, and observed by the inspector gave rise to concerns about infection control measures. Crouched Friars Residential Home DS0000017799.V343814.R01.S.doc Version 5.2 Page 19 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, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect to be cared for by a group of staff that are supported and trained to meet their needs. EVIDENCE: The staff rota demonstrated that there was 6 care staff working in the waking day and 4 staff at night. This number is derived from the figures provided by the National calculation tool and is based on the assessed needs of residents. There are supporting staff for domestic, cooking and activities. It was evident through observation, that staff were able to carry out tasks in an unhurried manner and to engage with people living at the home in a meaningful, albeit limited, way. Staff were also observed responding promptly to service users calling for assistance from their rooms. Although visitors raised concerns to the inspector and residents that the staff were not always present in the communal areas were residents were. In one case a visitor had difficulty locating staff when a resident had fallen. The visitor has raised this with the manager and considerations were being made in respect of staff allocation. Crouched Friars Residential Home DS0000017799.V343814.R01.S.doc Version 5.2 Page 20 The service operates a staff training profile that identifies the training each member of staff has completed and when they will need refresher training ie moving and handling and medication training. Staff were due to complete an update to the POVA training and a session in sensory loss awareness provided by the Deaf Blind Association. All training is provided by a variety of external consultants. The manager explained how they assessed changes following training in the staffs conduct and devleopment to understand the impact of the training. Staff files contained documentation requifred to understand suitability of applicants to work with vulnerable adults ie references, CRB etc. This will provide a robust system of protection to residents wellbeing when recruiting Crouched Friars Residential Home DS0000017799.V343814.R01.S.doc Version 5.2 Page 21 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, 32, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and stakeholders can be assured that a competent manager who listens to their views and takes action leads the home. EVIDENCE: The registered manager of the home has several years experience as a manager and senior carer and is qualified to National Vocational Qualification Level 4. The manager and provider have also attended training courses and seminars to develop and update their knowledge. The registered manager and provider work in an open manner with the Commission and this was evident in the manner of staff during the visit to the home and in the supervision and Crouched Friars Residential Home DS0000017799.V343814.R01.S.doc Version 5.2 Page 22 meeting notes held by the home. The home meets regularly with the District Nurse team to ensure that communication between the two bodies is of a good level, which further supports this atmosphere. The Practitioner nurse attending the home on the day of the site visit made an express point of speaking with the inspector in order to inform them of the high regard in which the service was considered by the GP practice. The results of the quality assurance surveys are promoted in the home with results and the action plans developed in response to the comments posted in the communal lounge. The home ensures that staff are trained in respect of areas affecting the health and safety of service users. Good records are kept of the servicing and maintenance of equipment and services to the home. Crouched Friars Residential Home DS0000017799.V343814.R01.S.doc Version 5.2 Page 23 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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 2 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 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Crouched Friars Residential Home DS0000017799.V343814.R01.S.doc Version 5.2 Page 24 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 OP7 OP8 OP10 Regulation 15 Requirement Residents’ plans of care must contain all the information gathered about them and is updated when additional information is provided. This will assist staff to support residents consistently in a way that provides the best benefits to the individual. Residents’ choices and preferences in relation to daily living, activity, social emotional and spiritual needs must be recorded and care staff as well as the activities co-ordinator must have sufficient skills to be able to provide opportunities to exercise these choices Residents must be protected by the homes systems for the safe administration of medication. Timescale for action 30/09/07 2. OP12 15 30/09/07 3 OP9 13(2) 30/07/07 Crouched Friars Residential Home DS0000017799.V343814.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP3 Good Practice Recommendations The service should develop the format used for recording the assessed needs of prospective service users, so that it contains a fuller pen picture of the individual. Crouched Friars Residential Home DS0000017799.V343814.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Crouched Friars Residential Home DS0000017799.V343814.R01.S.doc Version 5.2 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!