Inspection on 09/11/07 for Culrose

This inspection was carried out on 9th November 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

Culrose 20/06/06

Culrose 23/11/05

Culrose 03/06/05

Culrose 11/01/05

Culrose 29/06/04

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 Culrose Norwich Road Dickleburgh Diss Norfolk IP21 4NS Lead Inspector Mrs Susan Golphin Unannounced Inspection 9th November 2007 09:15 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 Culrose DS0000059073.V354664.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. Culrose DS0000059073.V354664.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Culrose Address Norwich Road Dickleburgh Diss Norfolk IP21 4NS 01379 741369 01379 740186 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) Jean Whitten Care Ltd Miss Leanne Prest Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Culrose DS0000059073.V354664.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Twenty (20) Older People, not falling into any other category, may be accommodated. 20th June 2006 Date of last inspection Brief Description of the Service: Culrose is a converted and extended detached property in the village of Dickleburgh situated close to the Suffolk / Norfolk border. The home can accommodate up to twenty older people in sixteen single and two double bedrooms on the ground and first floors. Three single bedrooms have en suite facilities. There is ample parking space to the front of the property with gardens to the rear of the property. The weekly fees range from £289-to -£387 plus an additional £20charge for accommodation with en-suite facilities. Culrose DS0000059073.V354664.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care services are judged against outcome groups that assess how well a provider delivers the service to people. The key inspection has been carried out by using information from previous inspections, information from the providers, the residents and staff. This report gives a brief overview of the service and the current judgments for each outcome group. The inspection was carried out in one day. Four residents, the Manager of the service and three care staff were seen during the course of the day. The Annual Quality Assurance Assessment (AQAA) was completed and returned on time, the information is brief but gives a satisfactory review of the services and progress of the home throughout the last year. The home can accommodate twenty older people but currently has eighteen residents, as two of the double rooms are being used for single occupancy. The registered providers have obtained planning permission for a small extension to the property, this will maintain the registered numbers at twenty. The manager has been without the support of a deputy manager since April 2007. Two staff are being trained to act in a senior capacity and will undertake other responsibilities. As a small service the manager has also undertaken care staff duties and covered for absences during staff shortages. Whilst this ensures a continuity of service to residents it has detracted from some of the managerial tasks such as reviewing the care planning process and maintaining written records for staff supervision and appraisal, which have not been kept up to date. What the service does well: Culrose is a small home and offers a good level of care to all the residents. The home can support people with a range of healthcare needs. From the information available at the inspection eight of the eighteen residents have high dependency needs, with three being cared for in bed. The home maintains its good reputation for end of life care and monitoring skin tone and nutritional and fluid intake. Two of the residents seen said that they are very happy with the care they receive and are well supported by staff. One resident said they ‘feel safe and can rely on the staff for help at any time’. Another said that they found the manager very kind and always ‘very visible’ in the home. Culrose DS0000059073.V354664.R01.S.doc Version 5.2 Page 6 One resident spoke of the recent bonfire night fireworks and the visit to the home by birds of prey display team and how interesting it was. Another said there is always some kind of activity or entertainment offered on a regular basis. Residents said that they or their relatives received appropriate information about the service prior to coming into the home. An assessment of need for all new service users is carried out prior to admission, and pre admission visits are encouraged and welcomed by the staff. People visiting the home were observed being made welcome and able to access the manager to discuss their relatives, one relative said that they are very happy with the service and find the management and staff helpful and informative. Relevant training courses are available for all staff including NVQ training. What has improved since the last inspection? All requirements and recommendations made at the last inspection bar one recommendation have been met. The gradual improvements to the premises are being completed and the programme of redecoration and refurbishment is continuing as planned. Carpeting throughout the corridors and stairs and first floor landing will be replaced on 19th November 2007. From the information submitted in the Annual Quality Assurance Assessment document (AQAA) the requirements made at the last inspection have been met. Radiator covers are in place and the water temperatures are all controlled. Work on the main shower/ bathroom has been completed including new WC fittings and tiling. The three en-suite facilities have also been upgraded with new flooring and tiling. Non-slip floor covering has also been installed in the second bathroom. The storage for medication has been located and although still a small space it has improved the storage facility. CCTV has been installed to monitor the exterior areas and garden of the home. The waking night staff has been increased from one to two each night and additional time has been allocated to the cook so that care staff are not diverted from care tasks at meal times. Culrose DS0000059073.V354664.R01.S.doc Version 5.2 Page 7 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. Culrose DS0000059073.V354664.R01.S.doc Version 5.2 Page 8 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 Culrose DS0000059073.V354664.R01.S.doc Version 5.2 Page 9 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): Standards 1,3,6 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence, including a visit to the service. People using this service can currently access relevant information about the home that will assist them to make an informed choice about where they wish to live. Satisfactory assessment processes are in place, and more detailed risk assessments would assist staff in the promotion and safeguarding of residents independence. There is no separate rehabilitation service provision in this home. Culrose DS0000059073.V354664.R01.S.doc Version 5.2 Page 10 EVIDENCE: The home provides prospective residents with information about the service and the home. Prospective clients are encouraged to visit or contact prior to admission. Residents spoken to on the day said that they were given information about the home before they moved in, and it had met their expectations. The manager plus a second member of staff carry out pre-admission assessments. Four files were seen during the course of the inspection and the information about the healthcare needs for each person were stated and in place, although the original assessment of need is maintained separately from the plan of care. Each care plan contained an individual risk assessment. The assessments are brief and need be more detailed with regard to each identified risk if they are to be appropriately used by staff to safeguard and support the resident. The care plans are agreed and signed at each review. See requirement. The daily records for each resident reflect the physical support and care they receive from staff. The records would benefit from a review to give a more holistic view of each persons care. See recommendation. The home does not have a separate intermediate service, but does respite care as part of supporting people in the community and as an introduction to long term care. Culrose DS0000059073.V354664.R01.S.doc Version 5.2 Page 11 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): Standards 7,8,9,10 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence, including a visit to the service. Residents receive good standards of care based on their assessment of need and care planning processes. Residents are treated in a dignified way and their personal wishes and choices respected by the staff. There is a medication policy in place that promotes safe practices and procedures. EVIDENCE: From the information submitted in the Annual Quality Assurance Assessment document (AQAA) Residents have been offered improved bathing facilities with the opportunity to bathe or shower more frequently. A new stand-aid has been purchased this year that promotes and improves residents’ independence and safety. Culrose DS0000059073.V354664.R01.S.doc Version 5.2 Page 12 Four care plans were seen during the course of the day and each offered a brief picture of the person and their healthcare needs. Some of the reviews could be more detailed and express the view of the residents or their representatives. Both residents and relatives are involved in the care planning and review process and residents confirmed that the manager is readily available to discuss any concerns they might have about their care. Four residents were interviewed on the day and all were positive about the service stating that the staff are caring and supportive as is the manager too. Residents confirmed the staff respect their privacy and dignity and even though one resident chooses to leave her door ajar the staff always knock and wait for a response before entering. During the discussions with the three care staff they demonstrated a good understanding of resident’s needs and expectations. The current resident group is reasonably balanced with eight of the eighteen residents needing a higher input of care, and three of the eight confined to bed. The home has a good reputation for providing good quality end of life care. Advice and guidance is sought from other health care professionals with regard specialist or medical care. There is a written policy for the management and administration of medication and one resident currently manages their own medication. A separate risk assessment has been drawn up, but was not in the residents care plan at the time of the inspection. A copy of the risk assessment should be maintained on the residents file with a copy in the drugs and medication administration file so that staff can access the information as needed. See recommendation. The resident maintains their medication in a small personal safe in their room. The storage and management of the medication has been reviewed and moved to a larger storage space. Three of the residents medical administration records were checked on the day and found to be in good order and up to date. Culrose DS0000059073.V354664.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): Standards 12,13,14,15 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence, including a visit to the service. Residents are offered a varied and well balanced diet. The majority of social and recreational activities provided at this home meet the needs and expectations of the residents. Residents are encouraged to maintain family and community contacts as far as they are able. EVIDENCE: From the information submitted in the Annual Quality Assurance Assessment document (AQAA) it states that residents are encouraged to manage their daily lives as they wish. There is an activity / social interest in place every day and a list of activities or entertainments for the forthcoming month displayed on the notice board in the reception hall. Residents talked of interesting events recently which included a display of birds of prey and a firework/bonfire night party. In the coming weeks there is to be a Punch and Judy show followed by a short talk on the history of the puppet theatre. The manager explained that there is a musical entertainment every two months. Culrose DS0000059073.V354664.R01.S.doc Version 5.2 Page 14 One resident regularly attends a local club and another a day centre every fortnight. One resident attends church services each week. Residents spoken to on the day said that they enjoy the in-house entertainments most, especially the musical ones and of course the regular bingo sessions. The daily menu is displayed on a white- board in the dining room. Residents said that the meals are varied and plentiful, with lots of choices at breakfast and teatime. For those with special care needs the staff maintain a written record to monitor nutritional intake and especially fluids. Relatives and visitors were observed being welcomed into the home and were obviously at ease with both the staff and management. Culrose DS0000059073.V354664.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): Standards 16,18 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence, including a visit to the service. People who use the service are aware of the homes complaints procedure and are confident that any concerns about the service will be dealt with. The staff receive training which helps them to recognise and respond appropriately to allegations of abuse. EVIDENCE: No formal complaints about have been received about the service in the last year. The home maintains a complaints file, and all contacts or queries are recorded, including any action taken or outcome reached. The manager is reviewing how the information is recorded to include a clearer audit trail. Residents seen on the day said that they have no complaints and if they have any concerns they talk to the staff or the manager ‘who are very approachable’ and they are very good at ‘sorting things out’. Culrose DS0000059073.V354664.R01.S.doc Version 5.2 Page 16 The home uses an independent agency to deal with all their Criminal Records Bureau disclosures and Protecting Vulnerable Adults enquiries. The staff attend training sessions to promote their knowledge and understanding on safeguarding adults as part of the induction training. The manager confirmed that arrangements are in place for the staff group to attend a ‘safeguarding adults’ training session for those recently appointed and also as a refresher for long standing staff. See recommendation. Culrose DS0000059073.V354664.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): Standards 19, 20,22,26 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence, including a visit to the service. The home provides a comfortable, safe environment that suits the needs and wishes of the residents. Culrose DS0000059073.V354664.R01.S.doc Version 5.2 Page 18 EVIDENCE: A brief tour of the home was undertaken and it was noted that the long term plan to upgrade and refurbish the premises is continuing. A small number of residents’ rooms were seen on the day and all were decorated and furnished to a good standard and are individual and personalised in style and layout. All the areas seen were well maintained and in good order. Work on the bathroom and shower room has been completed providing improved bathing facilities for residents. Staff receive training in the management of infection control and the training is offered in-house by the manager who uses the NHS guidance and audit tool to demonstrate good practice. New carpets are to be fitted in the corridors and stairs and front hall on 19th November 2007, and replacement blinds to the windows on the first floor. The garden areas have been upgraded with safe walkways and secluded sitting areas. Wooden storage sheds have been replaced and screened from view. As a safety measure the external grounds and gardens are monitored by CCTV. The home is registered to accommodate twenty older people, but currently two of the double rooms are used for single occupancy. Planning permission has been agreed for a small extension of three single rooms en-suite, the extension will not increase the overall number of residents that can be accommodated. The management are to be commended for the continuous work on the home to improve and upgrade the environment standards. Culrose DS0000059073.V354664.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): Standards27,28 , 29,30 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence, including a visit to the service. Resident’s needs are met by staff with a range of skills and knowledge in the care of older people. There are good recruitment and selection processes in place. Staff training including NVQ is promoted. Formal staff EVIDENCE: From the information submitted in the Annual Quality Assurance Assessment document (AQAA) it states that the home employs caring staff who work to a high standard for the benefit of the residents. To maintain the good standards and practice duty rotas overlap ensuring that there is an opportunity for staff to share and pass on information between shifts. Only two out of ten comment cards from staff were returned to CSCI prior to the inspection. Both were complimentary about the management of the home and confirmed that they receive appropriate and relevant training and supervision in the care of older people. Culrose DS0000059073.V354664.R01.S.doc Version 5.2 Page 20 During the discussions the manager said that there have been some staff changes recently, and whilst this has not had an adverse affect on the service to the residents, it has meant that on occasions the manager has worked directly with clients to meet the shortfall. Staffing levels have improved and there are four care staff on duty throughout the day, with two staff during the evening and two waking night staff until 8am in the morning. The care staff are supported by one domestic each day and a cook. The care staff are responsible for all domestic tasks at weekends. During the discussions with staff, one said that the staff group are a ‘good team’ and work well together especially at busy times of the day or if they are short of staff, and always supportive. Residents seen on the day said that the staff ‘are very good and helpful’ and can be relied upon to come when called. Another resident gave good examples of individual kindness and help shown to them by staff and manager. Four staff files were seen on the day of the inspection and all contained evidence of good recruitment and selection procedures, including identity and Criminal Records Bureau checks. Information relating to staff Criminal Records Bureau disclosures is maintained in each staff file. Details relating to CRB checks and staff suitability for care work is obtained through an independent agency. The information is kept in loose- leaf folders and would benefit from being maintained in sectioned files that would provide secure storage and ease of reference. See recommendation. Staff spoken to on the day confirmed that they have received relevant and regular training including courses on Moving and Handling, Fire training, First aid, Basic food hygiene and Infection control. NVQ training is encouraged and promoted. Currently three staff have NVQ2 and one has NVQ3 and it is anticipated that a further four staff will commence their NVQ training in January 2008. Culrose DS0000059073.V354664.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): Standards 31,32,33,35,36,38 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence, including a visit to the service. The financial interests of the residents are safeguarded by good practices and procedures. Formal staff supervision procedures should be reinstated to promote consistency of care and maintain good standards. The health and safety of residents is protected by good procedures. Culrose DS0000059073.V354664.R01.S.doc Version 5.2 Page 22 EVIDENCE: The home has a stable manager who has been in post for a number of years and has a good well established rapport with both staff and residents. Staff seen on the day spoke of good support from the manager and clear direction and leadership. Residents also spoke highly of the support and easy access to the manager whenever needed. They also confirmed that they regularly meet with the manager for one to one supervision and discussion about their work. However, the manager is not keeping a written account of staff supervision or on the development and progress of the staff group. The manager stated that it was their intention to review and revise the format for supervision some time ago but it has not been carried out, and whilst the meetings and reviews with staff are taking place the administration and recording is not. It was agreed that the need for a formal record of staff supervision is essential to monitor and audit good practice and promote personal and professional development. See requirement. The manager has been without the support of a deputy manager since April 2007. There have also been other changes in personnel in the last few months which has involved supporting care staff to take on more senior roles senior whilst the manager has been required to cover some of the care staff duties herself. It is acknowledged that priority has been given to essential care work and as a result some of the managerial tasks and administration have not been kept up to date. It is essential that the management review the roles and responsibilities of the senior staff to ensure that there is a professional balance established and management duties can be prioritised appropriately. See recommendation. The last quality assurance survey for the home was undertaken at the end of 2006. The outcome has been collated but not shared with residents or relatives. The survey should be extended to the staff and other health care professionals attending the home. The results and any planned action should be published and displayed in the home, and a copy submitted to CSCI as part of the information submitted in the Annual Quality Assurance Assessment document (AQAA) See recommendation. The management do not involve themselves in resident’s financial affairs however they do hold and administer small amounts of personal allowance on behalf of residents. A separate record for each person is maintained. Building, equipment and safety records are in place and well maintained. A maintenance file is kept in date order. Aids and adaptations have been serviced and safety checks carried out on the equipment. Heating and water systems are serviced on a regular basis and records maintained. Culrose DS0000059073.V354664.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 3 x 2 x x x 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 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 x 3 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 2 x 3 Culrose DS0000059073.V354664.R01.S.doc Version 5.2 Page 24 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 OP3 Regulation 13 Requirement The registered providers are required to review and revise the risk assessment procedures which form part of the assessment of need process to ensure they clearly define and identify any risk and that appropriate safeguards are in place and explain how they will promote independence and protect residents The registered providers are required to re-establish a formal and documented process of supervision for all staff. Timescale for action 31/03/08 2 OP36 18 31/03/08 Culrose DS0000059073.V354664.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 OP9 Good Practice Recommendations It is recommended that the risk assessment for the management of self medication be kept with the clients care plan and also a copy maintained with the medication records. It is recommended that all newly appointed staff complete the training in safeguarding adults as soon as possible. It is recommended that all staff files be changed from loose leaf folders to files that can be sectioned off to retain all staff details including training and development achievements and supervision records. It is recommended that the roles and responsibilities of the manager and senior staff be reviewed to ensure that the manager can relieved of care duties to give priority time to outstanding managerial tasks and administration It is recommended that a copy of the outcome of the QA survey for the service but submitted to the CSCI and a copy of the results are also made available to those who use and visit the service. 2 3 OP18 OP29 4. OP32 5. OP33 Culrose DS0000059073.V354664.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Culrose DS0000059073.V354664.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!