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Inspection on 25/09/06 for Crown Meadow Care Centre

Also see our care home review for Crown Meadow Care Centre for more information

This inspection was carried out on 25th September 2006.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is very well presented to prospective clients both in general appearance and in the excellent sources of information provided. The reception area and staff are welcoming and this is noted to continue as noted in discussion with visitors who said they were made welcome and were comfortable to visit at any time and believe they were kept informed about important matters relating to their relative. The home provides a good range of activities but is also actively seeking ways to ensure all service users are included by identifying their likes and wishes. Service users were very complementary about the meals provided and they serve as high points of the day. The property is well maintained and kept in good decorative order and in a clean odour free state. Record keeping of the monitoring of the environment and services is of a good standard demonstrating that all reasonable precautions are taken to maintain a safe environment. The home is proactive in seeking service users and their relatives views through surveys, undertaken as part of the quality assurance programme.

What has improved since the last inspection?

Care planning continues to be better documented and the range of risk assessments and risk management plans developed. Menu`s have been the topic of surveys and service users ideas have been included. A programme of redecoration has been implemented and continues in a planned way.

What the care home could do better:

Arrangements to train carers to NVQ level 2 continue to be disrupted and require to be established as a priority to achieve the 50% target without delay. While overall care planning is of a very good standard and can be observed in practice by staff there is a need to follow through to all possible outcomes such as the service use at risk of choking has a very good preventative plan but does not progress to actions required if the preventative measures fail. Care plan reviews are undertaken at least monthly but could be more informative saying why the care plan continues to be appropriate. The case files include a document for summarizing weekly progress, this is not required by the standards but if included should be completed as required by the organisation. It was observed that some members of staff continue to dispose of used hypodermic needles unsafely by re-sheathing, placing themselves at risk of needle stick injury. The home provides very good menus that exceeds the requirements of the standard but further enhance this by including the content of the supper so improving service users choice of what and when to eat. Health and safety monitoring is of a very good standard with a well formatted record of all aspects. The record of hot water mixing valves has a section to add comments, this should be used to describe all adjustments made to provide a full life picture for each valve.

CARE HOMES FOR OLDER PEOPLE Crown Meadow Care Centre Bayleys Bridge Tipton West Midlands DY4 OHB Lead Inspector Mr Richard Eaves Key Unannounced Inspection 25th September 2006 09:00 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 Crown Meadow Care Centre DS0000042299.V312485.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. Crown Meadow Care Centre DS0000042299.V312485.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Crown Meadow Care Centre Address Bayleys Bridge Tipton West Midlands DY4 OHB 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) 0121 520 0700 0121 557 8279 Southern Cross Care Centres Limited Mrs Susan Joan Hall Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Crown Meadow Care Centre DS0000042299.V312485.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One service user identified in the variation report dated 23.3.05 may be accommodated at the home who is 64 years and over. This will remain until such time that the service users placement is terminated. One service user identified in the variation report dated 22.11.05 may be accommodated at the home who is aged 59 years and over. This will remain until such time that the service users placement is terminated. One service user identified in the variation report dated 21.2.2006 (female) may be accommodated at the home in the category PD. This will remain until such time that the identified service users placement is terminated. One service user identified in the variation report dated 21.2.2006 (male) may be accommodated at the home in the category OP aged 63 years and over. This will remain until such time that the identified service users placement is terminated. 27th February 2006 2. 3. 4. Date of last inspection Brief Description of the Service: Crown Meadow Nursing Home provides nursing care for up to 35 service users who are over 65 years. The home has this year transferred ownership to Southern Cross Healthcare Ltd. The home is situated on a main road close to Great Bridge and other local shops and amenities. The property is a purpose built three-storey building with parking at the front and garden at the rear. The home consists of 31 bedrooms, 4 of which are doubles. Other than their own rooms, service users have use of a large lounge/dining room on the ground floor, fronted by a conservatory entrance way and a small quiet lounge on the first floor. The second floor contains just 5 bedrooms, hairdressing salon and staff room. There are two passenger lifts and the home has two assisted bathrooms that are suitable for dependent residents; assisted showers are also available in most bedroom en-suites. Fees for this home are in the range £335 - £439 per week. Crown Meadow Care Centre DS0000042299.V312485.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is of the key unannounced inspection, the visit was undertaken by an Inspector from the Commission for Social Care Inspection using the following information: the action plan submitted by the home to the announced inspection in February 2006, reports from the organisation relating to the conduct of the home, the annual quality assurance self assessment and records held at the home. The inspection involved a full tour of the bedrooms, communal rooms and service areas and provided an opportunity to speak with most of the service users, a number of visitors and staff. What the service does well: What has improved since the last inspection? Care planning continues to be better documented and the range of risk assessments and risk management plans developed. Menu’s have been the topic of surveys and service users ideas have been included. A programme of redecoration has been implemented and continues in a planned way. Crown Meadow Care Centre DS0000042299.V312485.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. Crown Meadow Care Centre DS0000042299.V312485.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 Crown Meadow Care Centre DS0000042299.V312485.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1–6 The overall quality in this outcome area is good. Service users and prospective clients their supporters are provide with good sources of information about the home and are invited to spend time at the home prior to admission to enable them to make an informed decision about entering the home this is confirmed at admission by contract. The staff group are stable well established and collectively have the knowledge and skills to assess needs and to meet the needs of the current service users. Confirmation is given that the agreed needs can be met by the Home. EVIDENCE: The statement of purpose and service users guide were reviewed and updated following the change of ownership this year and provide current and prospective service users with a good source of information from which to make informed decisions about the suitability of the home and the services they offer. The revised service user guide was observed to have been reissued to each room. Crown Meadow Care Centre DS0000042299.V312485.R01.S.doc Version 5.2 Page 9 The assessment process is based on an activities of daily living model with additional specific risks of manual handling, pressure sore risk and bed rail need, falls, nutrition risk and continence assessments. Three case files were inspected and case tracked in detail, the assessments were extensive and kept under review and were thorough in documenting service users details, abilities and needs. All risk assessments were seen to have risk reduction care plans. The assessments are subject to monthly evaluations and the file shows a record of joint reviews with the care manager. Each case file includes a contract and a letter confirming that the agreed assessed needs can be met by the home, the letter also invites prospective service users to take the opportunity to visit and trial the services offered. The home does not offer an intermediate care service. Crown Meadow Care Centre DS0000042299.V312485.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 – 10 The overall quality in this outcome area is good. Care plans are derived from a comprehensive range of assessments and provide the basis for the delivery of care and detail the actions required of staff to meet the identified needs. Health care needs of service users are fully met. Administration of medication practice is robust and ensures service users medication needs will be safely met. Service users are treated with respect and their privacy upheld. EVIDENCE: A sample of three case files were selected at random to be inspected and case tracked. The care plans were drawn from the assessed needs process and were relevant and maintained to a good standard. The care plans reflect actual care requirements and the service users preferences of how it is to be given for the most part. Example was seen of a service user losing considerable weight over the year and becoming insulin dependent during a recent hospitalisation. The post discharge continued weight loss should be recognised as an issue that requires to be addressed either medically or dietary. In another file, risk and aims were identified for potential to choke but the derived plan failed to guide staff in the event of choking addressing the Crown Meadow Care Centre DS0000042299.V312485.R01.S.doc Version 5.2 Page 11 preventative factors only. The extensive range of care plans are subject to at least monthly review but many of these were thought to be uninformative limiting comment to care plan being continued. All service users are registered with a GP of their choice and other allied health care providers attend on a regular basis. Policies and procedures for the recording, handling, administration, storage and disposal of medicines were found to be generally satisfactory. All medicines are administered using the Boots monitored dosage system by qualified nurses who are responsible for the reordering of repeat medication, safekeeping and a contract for returns of unwanted medicines is in place. Records of administration were checked and found to be complete. Evidence was observed of re-sheathing of used hypodermic needles. There are no controlled drugs currently in use at the home, arrangements for storage and record keeping are satisfactory. Service users wear their own clothes at all times and on the day of inspection everyone appeared neatly attired. Service users rights, dignity and respect are given prominence during the induction of new staff and the interaction between staff and service users was observed to be easy, thoughtful and considerate, staff were also noted to use preferred names and clearly identified in the case file, meeting this element of the standard. In discussion with service users many were able to describe how they are assisted to make choices for themselves in such areas as rising and settling and where they wish to spend their time. Crown Meadow Care Centre DS0000042299.V312485.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 – 15 The overall quality in this outcome area is good. The home provides an appropriate and varied social and recreational activity programme that provides interest and pleasure for the service users. An open visiting policy assists service users to maintain contact with their family and friends. Service users exercise choice and control over their lives. Meals at the home are wholesome and meet the nutritional needs of service users while reflecting choice and taste. EVIDENCE: The home employs an Activity Organiser who plans and organises activities within the home on a daily basis during the afternoons and who is very popular with the service users who on the day were joining in and having fun together. The home has regular fortnightly professional entertainments with dates displayed until the end of the year. In conversation with service users they said that they generally enjoy the activities with bingo seemingly a favourite. The programme for each week is planned with the service users and displayed on the notice board. The sample of programmes viewed show good variety and during the visit a good proportion of service users were participating in a quiz and were enjoying it. Photographs were displayed in the home of service users enjoying a variety of social events. Individual records are maintained of participation in the activities. Crown Meadow Care Centre DS0000042299.V312485.R01.S.doc Version 5.2 Page 13 The home has an open visiting policy and a number of visitors were seen to come and go. Local churches provide visiting and occasional services and communion. The care plans identify service users individual likes and dislikes and choices about their individual routines and specific plan for individual needs of rest and sleep, these are carried out flexibly to provide for choice of the moment. Service users spoken with, as they were able said that they chose what they wanted to wear, when to get up and go to bed and how and where they liked to spend their day and a number spoken with enjoying time in their own room. The home provides a varied menu with a choice at each meal including choice of deserts, a cooked option is available at the 3 main meals of the day, snacks can be provided outside the main meal times, the manager should consider including the supper arrangements on the menu to allow service users to make an informed decision of what they eat and when. Birthday and celebratory buffet teas are also organised regularly and the cook maintains a list of birth dates. The cook confirmed that special diets are catered for when required. Staff were observed to assist or feed service users who were unable to feed themselves at the lunchtime meal. In conversation with service users, those expressing a view were very complementary about the meals and clearly consider them a high point of the day. Crown Meadow Care Centre DS0000042299.V312485.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 – 18 The home complaints and protection policies are robust providing a safe environment in which service users feel they can voice concerns and that these will be listened and responded to. Service users rights are protected and staff demonstrate excellent knowledge and understanding of adult protection issues which contributes in providing an environment safe from abuse. EVIDENCE: The complaints procedure is well promoted in the service user guide and in notices displayed in numerous places about the home. Records demonstrate that concerns raised are acted on and that the staff are receptive to personal wishes, no complaints have been received since the previous inspection. Advocacy services and pamphlets are also displayed in the main reception area. The manager identified that the electoral roll has been completed for the year and confirmed that postal votes has been arranged. The home has a robust adult protection policy and all staff have undertaken adult protection training. Crown Meadow Care Centre DS0000042299.V312485.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 The home provides a good standard of décor, furnishings and managed services providing a safe, disabled accessible environment and an attractive, and homely place to live. The home is clean, free from odours and hygienic. EVIDENCE: Entrance to the home is off the car park through a conservatory that fronts the home and provides a pleasant sitting area that is quiet but allows view of the comings and goings to the home. The small service user garden at the rear is an attractive and pleasant area with plentiful garden furniture. The home is well presented with a good standard of decoration and is comfortably furnished. It is clean and hygienic with no unpleasant smells. The bedrooms are comfortable with a domestic appearance making them pleasant and homely many having been extensively personalised with a selection of pictures and ornaments on display. Currently the bedrooms, all en-suite most with shower are used as single with no doubles being shared although 2 are available to be shared. Each bedroom is fitted with good Crown Meadow Care Centre DS0000042299.V312485.R01.S.doc Version 5.2 Page 16 quality furniture and each meets the standards for electrical sockets, window restrictors, staff call, door locks and lockable facility, lighting and the heating is under floor. A service user guide and individual record of bath temperatures is kept in each bedroom. A separate hairdressing salon is provided on the 2nd floor. The first floor provides a small quiet lounge. Two sluice rooms are available, one hopper and one sluice disinfector. Hand sanitizer is provided in both. A well-equipped laundry meets standards for sluicing and disinfection. Crown Meadow Care Centre DS0000042299.V312485.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 – 30 The home has a good mix of staff in sufficient numbers to provide consistency of care that meets service users needs. The home has been proactive in developing a skilled staff group with understanding of service users needs but has not met the target to demonstrate certificated competence. Recruitment and selection processes are to a good standard protecting vulnerable people. EVIDENCE: The home is consistently staffed with adequate numbers and skill mix of Nurses and carers over the 24 hour period, being 1 nurse and 5/6 carers in the morning, 1 nurse and 4/5 carers afternoon and 1 nurse and 2 carers at night. The home are experiencing difficulty in getting staff trained to NVQ level 2 since the change of ownership and those staff enrolled require to transfer to the new company system. The manager requires to provide an action plan for the Commission demonstrating how the standard of 50 of care staff holding this qualification is to be achieved and then maintained. Recruitment and selection is completed to a good standard and includes all necessary checks such as CRB, POVA and nursing registration. A sample of Crown Meadow Care Centre DS0000042299.V312485.R01.S.doc Version 5.2 Page 18 three staff files also show that two references are obtained and records kept of interviews. An inspection of a sample of training records shows that mandatory training is up to date. Each member of staff has their own training folder and a matrix is maintained for ease of monitoring completion of mandatory and development training. Induction and foundation training follows the Skills for Care requirements. Crown Meadow Care Centre DS0000042299.V312485.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 Leadership of this home is good and staff demonstrate an awareness of their roles and responsibilities and service users benefit from this consistency. The home regularly reviews its performance which includes consultation and seeking the views of service users and their families and evidenced that it is acted upon. The arrangements for safekeeping of service users money safeguards their interests personal and financial. Staff receive supervision and direction to ensure that the service users receive consistent quality care. The safety and welfare of service users is protected. EVIDENCE: The manager is a registered nurse with extensive experience in care home management and holds the NVQ level 4 award in care management. Many staff gave the view that morale at the home is high and the senior staff are Crown Meadow Care Centre DS0000042299.V312485.R01.S.doc Version 5.2 Page 20 very approachable and work closely with staff. Regular staff meetings also support this with good communication. The last full satisfaction survey of service users and relatives was undertaken during August covering meals, activities, care and laundry the results were seen and show a very positive view of the home and services. The area manager undertakes monthly, unannounced visits in line with regulation 26 requirements, the reports of which are copied to the Commission. The home is not appointee for any service users but do undertake to keep personal allowances the book keeping of which is undertaken with individual accounts giving details of income and expenditure and two signatories for each transaction. The area manager as part of the monthly visit undertakes auditing. Staff supervision is well established at the home, a sample of files show the supervision content to be relevant and taking account of work activities and policies within the homes. Health and Safety is given appropriate priority with an extensive range of monitoring and maintenance in place. During the tour of the building it was observed that all corridors and fire escape ways were clear. An inspection of the monitoring records shows these to have satisfactory results and kept in good order. It was noted that adjustments were made to hot water valves where required but not commented on in the comments section Staff training in health and safety, fire safety training is satisfactory. Crown Meadow Care Centre DS0000042299.V312485.R01.S.doc Version 5.2 Page 21 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Crown Meadow Care Centre DS0000042299.V312485.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP28 Regulation 18(1)(a) Requirement The registered person must prepare a report and action plan demonstrating how the standard of 50 of care staff will be qualified at NVQ level 2 in care. Previous timescale 31/12/05 not met. The registered person must prepare a plan of care to address actions required in the event that the preventative plan fails to avoid choking. The registered person must ensure that staff dispose of used hypodermic needles safely by stopping the practice of resheathing used hypodermic needles. Timescale for action 31/03/07 2. OP7 15(1) 31/10/06 3. OP9 13(2) 31/10/06 Crown Meadow Care Centre DS0000042299.V312485.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard OP7 OP7 OP15 OP38 Good Practice Recommendations The manager should ensure that the monthly care plan reviews are more informative. The manager should ensure that if a weekly progress report is include in the case file that it is completed on a weekly basis. The manager should include details of the supper provided on the menus. The manager should ensure that adjustments to hot water mixing valves are included in the comments section of the monitoring record. Crown Meadow Care Centre DS0000042299.V312485.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Crown Meadow Care Centre DS0000042299.V312485.R01.S.doc Version 5.2 Page 25 - 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. 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