Inspection on 26/09/06 for Daisy Nook House

This inspection was carried out on 26th September 2006.

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

Daisy Nook House 30/11/07

Daisy Nook House 07/12/05

Daisy Nook House 10/05/05

Daisy Nook House 24/01/05

Daisy Nook House 03/09/04

Daisy Nook House 20/03/04

Similar services:

Chirnside House

Sunny Bank (P.R.S.) Ltd

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Ashwood Court Unit 1

Langrigg House

Parkside

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

CARE HOMES FOR OLDER PEOPLE Daisy Nook House Bamburgh Drive Ashton-under-Lyne Tameside OL7 9SX Lead Inspector Steve Chick Unannounced Inspection 11:00 26th and 28 September 2006 th 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 Daisy Nook House DS0000005566.V313257.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. Daisy Nook House DS0000005566.V313257.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Daisy Nook House Address Bamburgh Drive Ashton-under-Lyne Tameside OL7 9SX 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) 0161 343 1033 0161 343 8233 Tameside Care Limited Mr Ronald Henry Duke Care Home 40 Category(ies) of Dementia - over 65 years of age (40), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (10), Old age, not falling within any other category (39), Physical disability over 65 years of age (39) Daisy Nook House DS0000005566.V313257.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 40 DE (E) up to 10 MD (E) up to 39 OP and up to 39 PD (E) 10th May 2005 Date of last inspection Brief Description of the Service: Daisy Nook is a purpose built residential home offering accommodation to up to 40 older people in single rooms with en-suite facilities. The home is a detached property, all on one level. Day care is provided as part of Daisy Nooks service, but this report only focuses on the residential care facilities. Daisy Nook is based around three discreet lounges. There is additional communal space in the form of one quiet room and several pleasantly furnished areas around the building. Daisy Nook includes some gardens and an appropriately sized car park. It is located in a quiet residential area of Ashton under Lyne. The home is run by Meridian Healthcare Ltd, a not for profit organisation, which operates several other care homes. At the time of this site visit Daisy Nook charged £353.66 per week. such as outings, etc were not included. Extras Daisy Nook House DS0000005566.V313257.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. For the purpose of this inspection five service users were interviewed in private, as were two visitors to the home. Additionally discussions took place with the manager and three staff members were interviewed in private. Informal discussions also took place with other service users and staff. The inspector also undertook a tour of the building and looked at a selection of service user and staff records as well as other documentation, including staff rotas, medication records and the complaints log. This key inspection included an unannounced site visit to the home. All key standards were assessed. What the service does well: The physical environment of Daisy Nook is well maintained and kept clean and tidy. Service users have a choice of pleasantly appointed areas where they can spend their time. The manager and staff were described by visitors and service users as friendly and approachable. Prospective service users’ needs are thoroughly assessed to ensure Daisy Nook can meet their needs. Good working relationships are maintained with health care professionals to help ensure service users’ health needs are appropriately met. The provision of food is good and reflects the tastes of the service users. Staff recruitment procedures and staff training assist the home to offer safe and competent care. During the visit all service users and visitors spoken to were positive about the care offered by Daisy Nook. One visitor said that staff did not “stand on ceremony” and were “nice all the time”. The good quality of care previously identified has been maintained. Daisy Nook House DS0000005566.V313257.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Daisy Nook House DS0000005566.V313257.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 Daisy Nook House DS0000005566.V313257.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): 2, 3, 4, 5 and 6 Quality in this outcome area is good. Service users’ needs are appropriately assessed and they, or their representatives, are able to visit before a decision is made that the home is appropriate for them. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: A selection of service users files was looked at. All had a copy of an assessment undertaken by an appropriate professional. There was also documentary evidence that the home complemented external assessments with their own pre admission assessment to attempt to ensure that Daisy Nook could meet the needs of the prospective service user. One example was seen where the assessed language and dietary needs of a service user could not be fully met. The manager reported that the service user and family were aware of these limitations before the service user moved Daisy Nook House DS0000005566.V313257.R01.S.doc Version 5.2 Page 9 in and still made a positive choice to move to Daisy Nook. Daisy Nook had made arrangements to address these issues as best they could through support from an appropriate community centre, the advocacy service and family members. It was also reported by the manager that interpreters were arranged, if required. Staff who were asked, expressed the view that day to day communication with this service user, whilst limited verbally, was effective. Daisy Nook has a written policy of encouraging service users and their representatives to visit the home before making a decision as to its suitability. One visitor confirmed that they were able to visit the home before making a decision about moving in. There was documentary evidence on service users’ files of the home’s terms and conditions being issued. Those that were looked at had been signed by either the service user or a representative of theirs. Daisy Nook does not offer intermediate care. Daisy Nook House DS0000005566.V313257.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, 8, 9 and 10. Quality in this outcome area is good. Service users’ have individual plans of care which are regularly reviewed to ensure they reflect current physical needs. Service users have access to appropriate community based medial services to ensure their health needs are met. The home’s procedures in connection with administration of medication are implemented to the benefit of the service users. Service users are able to exercise their right to privacy and are treated with respect. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: A selection of service users’ files was inspected. All had a written copy of a care plan and there was documentary evidence that the plan was reviewed at appropriate intervals. Daisy Nook House DS0000005566.V313257.R01.S.doc Version 5.2 Page 11 Documented care planning had improved since the previous visit. None the less there were still areas where more detail would be helpful in clarifying the best ways to address assessed needs. Similarly the ‘daily records’ and other recording tools, did not present as recording all the work actually done with individuals. For example one care plan required daily monitoring of skin, and weekly weight checks, but no record of skin observation was seen and the service user’s weight had not been recorded each week. Discussion with the manager and staff, indicated that this was an administrative issue and, in practice, staff had a more detailed understanding of each individual’s needs and undertook more regular tasks than the records indicated. Staff who were interviewed confirmed that they did use the written care plans and referred to the daily records as a source of information. However they relied more heavily on the communication books, one kept for each of the lounges, and the verbal handover at each change of shift to ensure they had up to date knowledge of individual’s circumstances. There was little recorded evidence to indicate the degree to which service users, or representatives, were involved in consultation about the appropriateness of their care plan. Staff confirmed that some discussion did take place with service users, but it was not clear if this addressed all aspects of care. One service user expressed confidence that they could influence the way care was offered and said “if they [staff] do something and you don’t like it, and tell them, they are very nice.” Service users and visitors spoken to were all positive about the standard of care offered at Daisy Nook. One service user cited “not wanting for anything” as the best thing about the home. Another service user said Daisy Nook was like “a home from home” The home uses a pre dispensed monitored dosage system to administer service users’ medication. Medication was seen to be appropriately and securely stored. Medication administration records presented as being predominantly appropriately maintained. There was evidence that the manager undertook regular ‘audits’ of the medication administration records to identify any errors at an early stage. The temperature of the fridge used to store some medication had been consistently noted as 28o C, which was clearly a recording error. The fridge temperature at the time of this visit was within acceptable limits. There was documentary evidence that service users had appropriate access to the full range of medical and para medical services available in the community. A visiting professional reported positively on the staff’s communication with them, and the care offered to service users. Service users spoken to expressed confidence that medical support was sought if necessary. Daisy Nook House DS0000005566.V313257.R01.S.doc Version 5.2 Page 12 Observation and discussion with service users visitors and staff indicated that service users were treated with respect, and that their dignity was maintained. Service users confirmed that they were able to go to their rooms or use the communal facilities, as they chose. Daisy Nook House DS0000005566.V313257.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. The home attempts to provide an appropriate range of activities for service users to participate in if they wished, which enhance their fulfilment and social stimulation. Visitors are welcome in the home to maintain community and family links for the benefit of service users. Service users are able to maximise their autonomy within the context of community living. The provision of food to maintain service users’ health and well being is good. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: Service users at Daisy Nook are able to access the social activities available in the attached day care service. Discussion with service users in connection with activities gave a mixed picture. Some being satisfied and some reporting they would appreciate more Daisy Nook House DS0000005566.V313257.R01.S.doc Version 5.2 Page 14 activities. It was not clear from discussion what specific activities service users would like, which were not already possible to access. The home’s internal Quality Audit had identified ‘activities’ as a weaker aspect of the homes performance, and the issue was being addressed by Daisy Nook. A meeting with service users had tried to address the issue and the manager reported that he had identified a member of staff to lead on activities. At the time of this visit that member of staff was reported as being temporarily on night duty so was unable to have a positive impact in connection with structured activities. Staff spoken to reported that, in addition to the meeting, individuals are asked about their interests, but predominantly present as poorly motivated to participate in activities. Daisy Nook has a written policy of allowing visitors at any reasonable time. Service users, staff and visitors all confirmed that this policy is put into practice. Service users can see visitors in the privacy of their own room if they wish. The manager reported that service users’ families are encouraged to attend meetings in the home. Observation and discussion with service users and staff indicated that service users were able to exercise personal choice and autonomy within the context of communal living. The tour of the building confirmed that service users were able to bring their own personal possessions into the home. One meal was sampled during the site visit. This was tasty and pleasantly presented. All service users spoken to were positive about the provision of food at Daisy Nook, and those who were asked confirmed the availability of choice. Daisy Nook House DS0000005566.V313257.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. Service users are confident that any complaint they may have would be dealt with appropriately. Service users are protected from abuse or exploitation by the homes policies and practices. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: The home has an appropriate complaints procedure, which is available to service users and visitors. Service users, staff and visitors spoken to during the visit, expressed confidence that Daisy Nook staff were receptive to ‘complaints’ and endeavour to sort out any problems quickly. One relative had contacted the Commission for Social Care Inspection, before this visit, to express their frustration about a continuing difficulty in connection with staff undertaking a specific task for their relative. Discussion with the manager indicated that he had taken steps to ensure that sufficient staff now had the necessary training to undertake this task. The complaints log was looked at and the entries presented as being appropriately recorded. However it was evident from other records and discussions, that not all complaints were recorded in the specific complaints log. This issue appeared to be related to a distinction being made between Daisy Nook House DS0000005566.V313257.R01.S.doc Version 5.2 Page 16 ‘formal’ and ‘informal’ complaints and occasional failures in the internal communication processes. This was an administrative issue and not a failure to address complaints or concerns. All service users spoken to expressed the view that they were safe at Daisy Nook. Visitors and staff also expressed the view that service users were safe. One visitor commented, when asked if they thought service users were safe “absolutely, never heard or seen anyone being treated with anything other than respect.” Staff who were interviewed demonstrated an understanding of the need to be vigilant about the possibility of abuse, and of appropriate action to take. This included the ‘whistle blowing’ procedure. Daisy Nook House DS0000005566.V313257.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24, 25 and 26. Quality in this outcome area is good. The home is appropriately maintained, decorated and cleaned to enable service users to live in a pleasant, safe and hygienic environment. Suitable toilet and bathing facilities are available to enable service users to maintain their personal hygiene in a dignified manner. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: During the visit to the home a tour of the building was undertaken. This included communal areas and a selection of service users’ bedrooms. There were several communal areas where service users could spend their time, or they could access their rooms when they chose. Daisy Nook has one designated smoking area. Daisy Nook House DS0000005566.V313257.R01.S.doc Version 5.2 Page 18 The home presented as being appropriately maintained and decorated throughout. One visitor described the Daisy Nook as being a -“pleasant, light and airy building”. Service users had access to a pleasantly landscaped and secure patio area which had appropriate outdoor furniture. No remedial issues relating to the maintenance of the building were identified during this visit. All bedrooms were single and the manager reported that service users could have a key to their room if they wished. This was confirmed by one service user who did hold a key to their room. Service users’ bedrooms had an appropriate degree of personalisation. Appropriate bathing and toilet facilities are available. The home presented as being clean and tidy throughout. This was confirmed as the usual state of the home by service users, visitors and staff spoken to. One service user described Daisy Nook as “Always lovely, clean and tidy”. Daisy Nook House DS0000005566.V313257.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. The numbers and skill mix and number of staff on duty promotes the independence and well being of service users. Recruitment and vetting procedures are effectively applied to minimise the risk to service users of inappropriate staff being employed. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: The manager reported that the home aims to maintain staffing levels at a minimum of five care assistants and one senior care assistant in the morning and four care assistants and one senior care assistant in the afternoon. Examination of the staff rota for the week beginning 18th September 2006 indicated that these levels were maintained and exceeded on several occasions throughout that week. Additional to these staff are the manager, cooks and housekeeper. The manager reported that of the 29 care staff, 21 hold an NVQ II or higher (representing 72 ). A random selection of certificates was seen to confirm this. Daisy Nook House DS0000005566.V313257.R01.S.doc Version 5.2 Page 20 The manager maintains an effective record of training undertaken by staff on a chart in the office. Staff who were interviewed were able to confirm that new staff undergo a period of induction and that the organisation’s commitment to staff training was being maintained. A selection of records relating to the vetting of recently recruited staff was looked at. These demonstrated that with one relatively minor omission, appropriate vetting procedures were undertaken before any new member of staff started work at Daisy Nook. The omission related to one example where one written reference was received shortly after the commencement date. The manager reported that he had obtained a positive verbal reference from the referee before starting the worker, but had not recorded that conversation. Service users and visitors spoken to were positive about the attitude and approach of the staff team. One service user particularly valued the fact that night staff sometimes “stop in for a chat”, this service user also liked the banter with staff and that they shared information about their own families, children and grand children. Other service users described staff as “approachable and nice” – “carers are very good … can’t say anything wrong about them” , “staff treat me well” and they are “all very very nice with me”. Staff who were interviewed were also positive about their colleagues. One reported that her colleagues were a good staff team to work with and everyone “pulled together and do what they should do”. Daisy Nook House DS0000005566.V313257.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. The manager is appropriately experienced and qualified to run a care home for the benefit of service users. Quality Audit processes provide a framework to further improve services for the service users. Service users’ financial interests are protected by the home’s procedures and practices. Service users and staff are protected by the implementation of the home’s health and safety procedures. This judgement has been made using available evidence, including a visit to the service. Daisy Nook House DS0000005566.V313257.R01.S.doc Version 5.2 Page 22 EVIDENCE: The registered manager holds an appropriate qualification which has been confirmed on previous occasions and has several years experience of running care homes. Discussion with staff and service users indicated that the manager gives a clear sense of direction and an appropriate value base. Service users, visitors and staff confirmed that the manager’s style is to be open and approachable. Tameside Care Group undertake a range of Quality Audit and Quality Monitoring exercises. A report of the latest Quality Audit undertaken with service users earlier this year was available in Daisy Nook’s foyer. This included a hand written comment from the manager in connection with action which was to be taken as a consequence of the analysis of the questionnaire results. It was recommended that service users and visitors might find this easier to read if it were typed. A selection of records relating to money held by Daisy Nook on behalf of service users was scrutinised. They presented as being appropriately maintained and included receipts for items purchased on behalf of service users. The manager reported that all staff receive basic training regarding health and safety matters. Documentary evidence was seen in relation to this training, including moving and handling and regular fire training. Staff who were interviewed confirmed that the use of equipment such as disposable gloves and aprons, to minimise the risk of cross infection, was mandatory. Some staff reported that occasionally stocks of gloves run very low and accessing them on those occasions could be problematic. The manager reported this was only ever a problem if appropriate staff who could re order them, were not informed of stocks getting low. Previous site visits to Daisy Nook have confirmed good standards of the maintenance of equipment for health and safety purposes. Similarly there has been a regular routine of testing fire alarm and detection equipment. The manager reported that the company was maintaining all appropriate health and safety testing and compliance. A small sample of this documentation was looked at and indicated these standards were being maintained. Daisy Nook House DS0000005566.V313257.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 2 17 X 18 3 3 3 3 X 3 3 3 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 X 3 X 3 X X 3 Daisy Nook House DS0000005566.V313257.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. Standard Regulation Requirement Timescale for action 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 OP7 Good Practice Recommendations The registered person should ensure that service users personally sign to confirm that they are in agreement with their care plan unless there are documented reasons why this is not appropriate. If the service user does not have the capacity to understand their care plan, agreement should be sought from a representative of the service user. The registered person should ensure that effective records are kept of all actions and significant observations undertaken by staff in implementing the care plan. The registered person should ensure that an accurate record of the fridge used to store medication is maintained. The registered person should ensure that all; complaints are recorded in the complaints log to enable effective managerial oversight, accountability, and the early DS0000005566.V313257.R01.S.doc Version 5.2 Page 25 2. 3. 4. OP7 OP9 OP16 Daisy Nook House 5. OP33 identification of any patterns of complaints or concerns. The registered person should ensure that reports intended to inform service users or their representatives are typed to improve their accessibility. Daisy Nook House DS0000005566.V313257.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 Daisy Nook House DS0000005566.V313257.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!