Inspection on 09/07/07 for Culliford House

This inspection was carried out on 9th July 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

Culliford House 08/07/09

Culliford House 24/07/06

Culliford House 04/10/05

Culliford House 01/06/05

Culliford House 25/02/05

Culliford House 17/08/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

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 Culliford House Icen Way Dorchester Dorset DT1 1ET Lead Inspector Val Hope Unannounced Inspection 10:10 9th July 2007 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 Culliford House DS0000026789.V339479.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. Culliford House DS0000026789.V339479.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Culliford House Address Icen Way Dorchester Dorset DT1 1ET 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) 01305 266054 01305 266259 Mrs R F Moors Mrs Suzanne Jackson Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Culliford House DS0000026789.V339479.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th July 2006 Brief Description of the Service: Culliford House is situated close to the town centre of Dorchester and within easy proximity of shops and other amenities. The property is a large elegant Victorian house retaining many period features. The house has been sympathetically extended and is set in its own attractive landscaped gardens with a large car park to the front of the property. This is a well established family-run home, in the ownership of Mrs R Moors (proprietor) since 1985. Suzanne Jackson is Mrs Moors’ daughter and the registered manager. Mrs Jackson is assisted by Mrs Ann Moors who is deputy manager. Culliford House is registered to accommodate a maximum of 25 elderly people. Accommodation is provided at ground, first and second floor levels of the home. A passenger lift affords level access throughout the home. Fees range from £390 to £675 per week. Culliford House DS0000026789.V339479.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken on Monday 9th July 2007. The total time spent on this inspection was 6 hours. This included preparation time consisting of examination of the Annual Quality Assurance Assessment and Data information supplied by the home. In addition, examination of the Commission’s service history for the home, planning a timetable for the day, a tour of the premises, inspection of records and discussion with Suzanne Jackson registered manager and her deputy Ann Moors, 2 members of staff and 11 residents. On the day of the inspection there were 19 people accommodated in the home [including 1 in hospital]. The main purpose of this inspection was to review the home’s progression in implementing the one requirement and 4 recommendations made as a result of the previous inspection and to assess the home’s compliance with key National Minimum Standards for Older People. What the service does well: It was evident from observation, records and lengthy discussions with residents in private, that their experience of living within Culliford House is very good and that the management and staff make every effort to provide satisfactory services tailored to meet individual needs. Residents said that the management consults with them on a range of subjects in relation to their quality of life within the home. This is done by:• Mrs Jackson [Registered Manager] speaking with each individual privately on a weekly basis; • Questionnaires are used every six months to inform the management about residents views; • Residents meetings are held; • A complaints, compliments and suggestions form is made available in the hallway of the home for use by residents or visitors to the home. Culliford House is a Victorian period property that offers elegant, comfortable and attractive accommodation. The bright and spacious communal areas comprising large lounge, conservatory and dining room provide pleasant and relaxing surroundings. The décor and presentation of all areas of the home remain of a very high standard; there are 22 en suite rooms in the home with three registered as doubles. These are mostly used as singles and are generous in size; four rooms measure at least 20 square meters. It is the policy of the home to redecorate/refurbish each room upon vacation. Culliford House DS0000026789.V339479.R01.S.doc Version 5.2 Page 6 A passenger lift provides access to all floors and all bedrooms have en suite toilets; there are assisted use bathrooms for service users with impaired mobility. An exceptionally high standard of cleanliness continues to be maintained throughout all areas of the home; residents spoken with said this was always the case. This service has a good track record of responding positively to meeting requirements made as a result of the inspection process. 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. Culliford House DS0000026789.V339479.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 Culliford House DS0000026789.V339479.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): Standard 3 was assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prior to admission, the needs of each prospective resident are assessed to ensure the home will be able to properly meet them. The home does not provide intermediate care. EVIDENCE: The care records of 3 recently admitted residents were examined. There was evidence that prospective residents care needs are assessed prior to admission and they are assured that the home is able to meet their identified care needs. There is good information readily available in the main hallway of the home, copies of the home’s service user guide including the Statement of Purpose is always available. Culliford House DS0000026789.V339479.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Every resident has a care plan however, care plans do not accurately reflect the care delivered; staff should receive more comprehensive instruction as to how they are to meet residents individual care needs through the care planning process. The health needs of residents are well met and good multi disciplinary working takes place on a regular basis promoting and maintaining (where possible) good health. Residents are treated with respect and their privacy and dignity is promoted enhancing their quality of life. There are satisfactory arrangements for managing medication in the best interests of residents. EVIDENCE: The care plans of 4 residents were examined. Since the last inspection care workers who are named ‘key workers’ have undertaken the role of being responsible for evaluating care plans. As the persons actually carrying out the day-to-day care tasks they are more knowledgeable as to the requirements of Culliford House DS0000026789.V339479.R01.S.doc Version 5.2 Page 10 residents. However whilst the care records did indicate that reviews/evaluations had taken place care plans had not been amended accordingly to reflect any changes where appropriate. Discussion with both staff and residents demonstrated that care plans did not accurately reflect the actual care delivered. The instruction to staff detailing how an individual’s specific care needs were to be met was insufficient to ensure and/or evidence exactly how meeting their assessed needs was to be achieved. The plans of care relating to specific care needs contain input from specialist health professionals where appropriate. Care plans, case notes, accident records and risk assessments cross-reference satisfactorily. Health professionals’ visits are satisfactorily recorded. Residents said they feel respected and that care tasks are undertaken in a way that ensures they are able to retain dignity. There are policies and procedures in place relating to medicines. Care plans did not always contain information in relation to the medication needs of residents. The vast majority staff have received formal training in the management of medicines, only those who have completed the training are permitted to administer medication. The ordering, storage and administration of medicines is well managed and records were found to be completed and up to date. Residents retain control of their medication where they so wish subject to the risk assessment process, currently only one resident chooses to do so. The records demonstrated that satisfactory arrangements are in place. Talking with residents found that they feel well cared for and that staff are helpful and kind and undertake their duties in a willing and respectful manner. They also said that it is rare that they have to wait long for a response in the event they use the call bell to summon assistance. Comments received from residents included: • “I have not been here long, but I have been made to feel welcome by everyone. I am able to stay in my room if I want or join in the things arranged for us to do. I generally like to keep myself to myself and they let me do so”; “The staff are cheerful and helpful, the food is very good – excellent in fact although not everyone likes everything – they do very well to keep us happy really”; “They do everything that needs to be done I have no complaints”; “No complaints it is nice here and I am settled”. • • • Culliford House DS0000026789.V339479.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): All the above standards were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social, cultural and recreational activities are dependent on individual preferences and the resident’s capacity for involvement. The activities provided by the home meets the expectations of residents. Residents are supported in maintaining contact with their friends, family and the community and they are helped to exercise choice and control over their lives promoting independence. A good wholesome varied diet is provided, meals are appetising and of good quantity and quality, assisting with the promotion and maintenance of health. EVIDENCE: Residents said that they have choice in all the routines of daily living. Several of the residents continue to go out regularly whenever they feel like it. Individual assessments for social needs have been recorded and a record of entertainment/activities is held. Residents said that there have been more activities on offer recently and that staff always try to encourage or talk them into joining in. A large number of those spoken to said they do not always want to participate and if they do not, they choose to spend time privately in their rooms instead. Mrs Jackson assured the inspector that whilst residents are encouraged to participate, staff are careful not to pressurise residents and Culliford House DS0000026789.V339479.R01.S.doc Version 5.2 Page 12 make them feel they must join in. There was evidence from residents that staff seek to offer alternative social activities, but that this is not always wanted. Comments from residents were mixed and included:• • • • • “There are things to do if I want to – if I don’t then I don’t, although they do like you to join in. They do make an effort but it is not always wanted”; “I prefer to keep myself to myself”; “There are things to do and enjoy, I like musical entertainers myself although some of the others don’t. I am satisfied it suits me”; “There are things to do if you want to, it depends what I feel like on the day, what they do is interesting but I am in my nineties and don’t always feel up to it”; “I would like different things to do sometimes” when asked like what? The resident had no suggestions to make. Residents said that their visitors are always made welcome and are offered refreshments; arrangements can be made for relatives from outside the area to stay overnight in the separate apartment on the top floor of the home. This is also available for use by relatives if a resident is seriously ill and/or dying. There was evidence that a good varied and wholesome menu is provided and that alternatives are provided upon request. All the residents spoken with gave high praise for the food provision and said they are consulted about menus through discussion at residents meetings. Their likes and dislikes appear to be well known to the cook who is currently working towards NVQ level 4. Comments received relating to the food provision included: • • • • • • “The meals are very good here and you do get plenty to eat; they know what I like and don’t like and offer me other things instead”; “The food is excellent, there is always plenty and you can have more is you wish – grand really”; “There is always plenty of fresh fruit about, they just want to please”; “I have absolutely no complaints about the food here – or anything else for that matter! It is always fresh cooked it is nice to have cooking smells just before lunch it gets you ready!”; “Excellent, a very high standard indeed, never had a duff meal yet”; “You could not fault the food, there is always a change and it is good home cooking”. Menus and food stocks were viewed, there was plenty of fresh fruit and vegetables, fresh meat is delivered regularly and staple food stocks were of reputable brands. Stock rotation is clearly routinely practiced. The home has recently achieved a Four Star Rating from the local authority Environmental Health Department for food safety. Lunch was observed being taken by residents who clearly see this as a social event. Tables are attractively set out Culliford House DS0000026789.V339479.R01.S.doc Version 5.2 Page 13 and meals are served in a respectful and unhurried manner; those who wish to take meals in their rooms said that they are also served well. Culliford House DS0000026789.V339479.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 16 and 18 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints system, which is properly managed; residents are confident their concerns are listened to and taken seriously. Policies, procedures and staff training contribute to providing a safe environment for residents. EVIDENCE: The home had appropriate complaint policy and procedures in place; a copy is available in the main hallway of the home and within copies of the homes information packs that are always available in the hallway of the home. All complaints, no matter how minor in nature, are taken seriously and investigated; this was evidenced by examination of the complaints log. All the residents spoken with confirmed that they felt able to bring any matter to the attention of the management and were confident their concerns would be listened to, fairly dealt with and any action to rectify matters implemented. Care workers have received training in adult protection and policies and procedures are in place. Culliford House DS0000026789.V339479.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. JUDGEMENT – we looked at outcomes for the following standard(s): All the above standards were assessed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. On-going investment in both interior and exterior of the property continues to ensure that residents live in a safe, well-maintained environment. There is ample indoor and landscaped outdoor space with level access creating a relaxing, peaceful environment for residents. Adequate toilet, washing and bathing facilities are in place to meet the needs of residents. Residents have the specialist equipment they require to maximise their independence. Residents live in attractive, elegant, comfortable clean and hygienic surroundings suited to their needs and with their own belongings around them for their comfort. A very high standard of cleanliness is maintained for the comfort and safety of residents. EVIDENCE: The home meets with the requirements of Dorset Fire and Rescue Service and Environmental Health Department. Fire precautionary measures were satisfactory and the home’s fire risk assessment is routinely reviewed. Culliford House DS0000026789.V339479.R01.S.doc Version 5.2 Page 16 An Occupational Therapist assessment of the premises has been carried out. Regulators have been fitted to baths to reduce risk of scalding and the rolling programme to install radiator guards to reduce risk of injury has been completed. A very high standard of cleanliness is maintained and the laundry room has been subject to refurbishment and upgrade. Policies and procedures are in place in relation to infection control and the management of laundry. Residents looked very well groomed in wellpresented clothing and commented positively upon laundry services. There is now one designated named person each day responsible for laundry duties to try to minimise instances of unnamed items being delayed in the return to the appropriate resident; this aspect of the service is under constant review to try to ensure and maintain residents satisfaction. Culliford House DS0000026789.V339479.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. JUDGEMENT – we looked at outcomes for the following standard(s): All the above were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home employs enough staff to meet the needs of residents and to ensure their safety and comfort and the good condition of the premises. Procedures for the recruitment of staff are robust and designed to minimise the risk of unsuitable staff being employed. EVIDENCE: There remains a strong and stable staff team at Culliford House, a large number of staff have worked there for some years. In addition to the registered manager and her deputy there are 16 care workers, 1 cook, 1 care worker/cook, 1 cleaner, 1 relief and a volunteer ‘handyman’. Staff rotas demonstrated that there are 4 carers on duty in the mornings 3 afternoon and evenings and 2 awake at night. Staff rotas viewed were considered sufficient to meet the assessed needs of residents accommodated. There was evidence that Criminal Records Bureau checks had been obtained for all workers and the volunteer. The records of the most recent recruits to the staff team were examined; all the necessary checks had taken place and files contained copies of all the documents required by regulation. It was recommended at the last inspection that when references are received the date is recorded to accurately demonstrate they were received prior to commencement of work; this recommendation had not been met and is therefore repeated. Culliford House DS0000026789.V339479.R01.S.doc Version 5.2 Page 18 Residents hold management and staff in high regard; the inspector received many comments relating to the kindness and effectiveness of staff. Comments received from residents included: • • • “I feel there are enough staff, although at times it can be busy and you may possibly have to wait a little but in my experience this has not been an unreasonable wait”; “The girls are lovely, they do things in a proper way and I know they get loads of training which is good”; “Staff are always very prompt and get the doctor when you need one, they help you in a way that does not make you feel a burden”. The home has a staff training programme developed to ensure that staff of the home are well equipped to deliver a good standard of care to residents. There is an appropriate induction programme in place. Staff training during the last 12 months included Manual Handling, Health and Safety, Protection of Vulnerable Adults, Fire Protection, Challenging Behaviour, Food Hygiene and ongoing NVQ training. This forms the basis of the home’s staff training programme it is intended that training relating to pressure areas, continence management and oral care is planned. 10 of 16 care staff have NVQ level 2 or above which equates to 62.5 , which is in excess of the National Minimum Standard. 14 hold a current first aid certificate. Staff spoken with said that they feel well supported by the management and training they are provided with. Culliford House DS0000026789.V339479.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 33, 35, 36 and 38 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team is led by an experienced and competent manager; this assures residents that they are well cared for. The manager is supported well by senior staff in providing clear leadership and effective management, giving residents confidence that their best interests are being served. Organisation of administrative tasks and quality monitoring systems are in place to ensure residents benefit from an efficient administration. Management practices, records and policies and procedures are in place to promote and safeguard the health, safety and welfare of residents. EVIDENCE: Culliford House DS0000026789.V339479.R01.S.doc Version 5.2 Page 20 Mrs Jackson, registered manager has extensive experience in running a care home and has achieved NVQ level 4 in Management and Care. The Deputy Manager of the home also holds the same qualification. Mrs Jackson attends the home at least two full days in addition to other occasional shorter visits. She is constantly available by telephone and able to get to the home in a very short period of time. She undertakes a range of organisational and management tasks off the premises. The staffing structure within the home is very clear with all staff demonstrating an awareness of their roles and responsibilities. Residents said that Mrs Jackson visits each person on a Wednesday each week to discuss their views upon how the home meets with their satisfaction. A quality assurance project is undertaken twice yearly assisted by the use of questionnaires. The service has also provided the Commission with a completed Annual Quality Assurance Assessment as required by legislation. For the most part records required by regulation were found to be in place, notification of significant events and monthly registered provider reports have been submitted as required. The home manages petty cash for 8 residents, appropriate records are kept with a running total of the cash in their credit. All monies are safely locked away. Individual staff supervision sessions are planned and carried out, records were in place able to demonstrate this; it was recommended that all persons undertaking supervision should receive training in this topic. Mrs Jackson is still trying to source training for staff who carry out individual supervision duties; it was suggested that the home contact Partners for Care and/or Skills for Care organisations for assistance. A wide range of risk assessments have been carried out in relation to individuals and aspects of the premises, these have been recorded. There are a range of health and safety policies and procedures in place all of which are subject to annual review. Discussion with staff found that they are familiar with and knowledgeable about health and safety issues. Periodical testing of the home’s systems and equipment is consistently undertaken. Routine servicing, maintenance and staff training is ongoing. The fire records were satisfactory and training for staff in what to do in the event of fire is up to date. Culliford House DS0000026789.V339479.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 x X 3 X x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 4 3 4 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 Culliford House DS0000026789.V339479.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO 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 Regulation 15[1] Timescale for action The registered person shall, after 30/07/07 consultation with the service user, or a representative of his/hers, prepare a written plan as to how the service user’s needs in respect of his health and welfare are to be met. [This means that:1. Sufficient information must be included in the care plan to specify exactly how all assessed care needs are to be comprehensively met. 2. Care plans must be amended/updated as a result of review/evaluation. 3. A care plan relating to medication must be in place for each resident prescribed medication.] Requirement Culliford House DS0000026789.V339479.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 Refer to Standard OP29 Good Practice Recommendations When references are received the date should be recorded in order to be able to ensure the home can demonstrate. they were received prior to commencement of work. Persons undertaking supervision sessions should receive training in this topic. 2 OP36 Culliford House DS0000026789.V339479.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Culliford House DS0000026789.V339479.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. 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