Inspection on 20/06/07 for Delaware House

This inspection was carried out on 20th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Delaware House 20/06/06

Delaware House 14/03/06

Delaware House 24/08/05

Delaware House 24/02/05

Delaware House 09/07/04

Similar services:

Claremont House

Chesham House

Oak Ridge

Argyll House

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

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

CARE HOMES FOR OLDER PEOPLE Delaware House Maplin Way North Shoeburyness Essex SS3 9PS Lead Inspector Sharon Lacey Unannounced Inspection 10:15 20th June 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 Delaware House DS0000059047.V341935.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. Delaware House DS0000059047.V341935.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Delaware House Address Maplin Way North Shoeburyness Essex SS3 9PS 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) 01702 588501 johnhase@southend.gov.uk www.southend.gov.uk Southend on Sea Borough Council Mr John Hase Care Home 24 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (24), Mental disorder, excluding learning of places disability or dementia (6), Mental Disorder, excluding learning disability or dementia - over 65 years of age (6), Old age, not falling within any other category (24) Delaware House DS0000059047.V341935.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Personal care and accommodation to be provided to no more than six (6) service users with mental disorder (MD) (6) Personal care and accommodation to be provided to no more than twenty four (24) service users over the age of 65 (OP) Personal care and accommodation to be provided to no more than twenty four (24) service users with dementia - DE(E) Personal care and accommodation to be provided to no more than one (1) service user under the age of 65 (DE) Number of service users to whom personal care and accommodation is to be provided shall not exceed twenty four (24) 20th June 2006 Date of last inspection Brief Description of the Service: Delaware House is owned by Southend on Sea Borough Council, and provides residential care for up to 24 older people. In addition the category of registration enables the home to accept those older people who have a formal diagnosis of dementia. The care home is situated within a residential area of Shoeburyness. The area benefits from good public transport links. Shops and other local amenities are a short distance away. The home has large grounds surrounding the property and there is on site visitors parking. The Registered Person has copies of recent CSCI inspection reports available in the home for prospective service users and/or their relatives. Enquirers can also down load copies of the inspection reports from the CSCI Internet web sight. Delaware House DS0000059047.V341935.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine Unannounced Inspection, which took place over six and a half hours. This was a full inspection covering most of the National Minimum Standards. A tour of the home was completed and also an inspection of relevant records and documentation took place. Areas looked at included information given to residents before being admitted to Delaware House, information gained when residents first come into the home; how information is given to staff on the care required; the facilities and environment of the home; and any complaints that may have been received since the last inspection. Also staffing and management of the home were inspected. During the Inspection the team leader on duty was the person in charge due to the manager being on annual leave. During a tour of the home residents and a relative were spoken to about their life and experiences at Delaware House. Some of the other residents approached were unable to express their thoughts and feelings, but were observed during the day interacting with staff. Most staff members were spoken with informally during the Inspection and any feedback has been included as part of the report. Questionnaires were also left at the home for relatives, to gain feedback on their experiences of the home, two were returned. Feedback from the questionnaires has been included in this report. At the end of the day the Inspection was discussed and advice and guidance was given regarding the findings. What the service does well: What has improved since the last inspection? Delaware House DS0000059047.V341935.R01.S.doc Version 5.2 Page 6 Care Plans have continued to be developed and include relatives and residents views were possible. The manager and team have worked hard at achieving the requirements from the last report. 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. Delaware House DS0000059047.V341935.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 Delaware House DS0000059047.V341935.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): 1, 2, 3, 4, 5 and 6. Quality of this outcome area is good. The home provides prospective residents with enough information about the home to help them choose. There is an appropriate admission and assessment process. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Delaware House has detailed operational policies to help with the day-to-day running of the home. The Statement of Purpose and Service User Guide contains details of the home and also the services provided. A copy of these documents could be found in the home’s foyer. New and prospective residents are given copies during the assessment process, and this is recorded on resident files. Both relatives who returned the questionnaires confirmed that they received enough information abut the are home to help them make a choice. Delaware House has a written contract/terms and conditions of the home, but as they are in the process of updating these documents. Evidence was not sought on resident files. Delaware House DS0000059047.V341935.R01.S.doc Version 5.2 Page 9 The home has a thorough admission process and all new residents are visited to ensure the home are able to meet their needs. An assessment form is completed for all new residents and this contains all the areas listed in Standard three of the National Minimum Standards (NMS). Three resident files were inspected and all contained a fully completed form. Anyone being admitted to the home is invited to visit with his or her relatives or friends. The home has a collective group of staff that has been at the home for a number of years and has the skills and knowledge for the present residents care needs. Delaware House does not provide intermediate care. Delaware House DS0000059047.V341935.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11. Quality of this outcome area is excellent. Each resident has a care plan which contains relevant information on the care required and how this is to be provided. Referrals are made to appropriate professionals to ensure that the resident’s health care needs are being met. Policies and procedures for medication are being routinely followed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three residents files were inspected; all contained a copy of a care plan, which had been developed around the care needs of the individual. Some information was better than others, but they are developing well and there was clear evidence that they had been reviewed regularly. There was clear evidence that residents and relatives had been involved in their plan of care. The files contained clear evidence to indicate that Residents are supported and have access to a variety of healthcare resources (GP, District Nurse, Hospital appointments, CPNs etc). Appropriate referrals had been made to other health care professionals when required. The home was also using specialist equipment to help in the prevention pressure sores. Visits from the optician and dentist are arranged as required. Delaware House DS0000059047.V341935.R01.S.doc Version 5.2 Page 11 The home benefits from the support of a Dementia Link Nurse who visits every 2 to 4 weeks. This supports staff by being an advisory and sharing of information and also gives the consultant’s involved regular updates on individuals and their present situation. Regular Regulation 37 forms are submitted by the home to the CSCI advising of any falls, deaths or injuries to residents. Other forms used within the home to assist in the care of it’s residents included turning charts, falls records and nutritional assessments. The home tries to ensure Residents are able to stay at the home in familiar surroundings for as long as possible. There is a written policy on managing death and dying within the home and all three files contained details of the Residents wishes in relation to this. A few staff had received training on care of the dying, but this was limited. Delaware House has a policy on the Administration of Medicines, but this was not viewed during this inspection. A Senior Care was observed during the lunchtime medication round. The home has audit systems in place to ‘double and triple’ check that medication is correct and there are no ‘missed’ medication. It was noted that bottles of medication had been dated when opened and residents on PRN medication had written guidance to staff on when this may be required. Other areas of good practice included staff providing eye drops and inhalers after lunch and not whist residents were sitting at the table. Some files did not contain a photograph of the resident. During the day it was noted that staff treated residents with dignity and respect. Observation during the inspection showed residents to be well cared for, clean and properly looked after. Those who were unable to converse or had ‘special needs’ were included in the day-to-day activities and appropriate care provided. One relative who had joined his wife for lunch spoke positively regarding the care provided and another reported that ‘staff are very patient and kind’. Staff were observed encouraging residents to eat and drink and the care was provided was relevant to the individual. Residents were advised by staff on what care was to be provided before it commenced, to ensure they knew what was happening. It was also noted that confidentiality was respected in relation to one resident when a staff member was asked to provide details to a visitor about a resident, she proceeded to go to a quiet room so others could not hear. Feedback from the questionnaires confirmed that the home met the needs of the residents and gave support that was needed. Delaware House DS0000059047.V341935.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, and 15. Quality of this outcome area is good. The home has a flexible routine, and promotes resident’s independence and choice. Visiting arrangements are open and relaxed. Residents are not at present given sufficient leisure and recreational activities in and outside the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home does not at present have a dedicated ‘Activities Co-ordinator’. Staff organise day-to-day activities within the home and evidence of activities included hair dressers, manicure and hand massage, music DVD night, arts and crafts, sing a long, ten pin bowling and dominos. There were also photographs of an Easter bonnet parade and a 100th birthday. This is an area that needs to be developed to ensure residents receive stimulation and interesting activities within the home; these should be relevant to those with dementia. The home has already requested funding to try and develop this. Routines within the home were fairly flexible and choice is provided in meals, times to get up and go to bed, clothes, bathing times, etc. On the day of the inspection three residents were still in bed, two due to health reason and the third was their choice. Delaware House DS0000059047.V341935.R01.S.doc Version 5.2 Page 13 The home has an open visiting policy, although they would prefer that visitors missed meal times to ensure the dignity and privacy of other residents is respected. There is a separate visitors room available if privacy is required and also other areas around the home, including a room upstairs with tea making facilities. Meal times are unhurried and residents are given enough time to eat. Staff were observed offering assistance in eating where necessary and this was done discreetly and sensitively. They assisted residents in holding their cups to drink or placing food on a spoon so the person could keep some independence when trying to feed themselves. There was a choice of juice at lunchtime and also a choice of two hot meals. Tea consisted of a hot choice or sandwiches and hot drinks and snacks are available outside meal times if required. One relative stated the ‘food was very good’ and a resident was observed calling to the cook and shouting ‘chef – that was very nice thank you’ The kitchen was inspected and noted to be clean, tidy and well stocked. There was a good supply of fresh vegetables and fruit. The Cook was an agency member of staff who was very positive regarding the home and stated she had found the kitchen clean and sufficient food available. Delaware House DS0000059047.V341935.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): 16 and 18. Quality of this outcome area is good. The home provides good information on making complaints. Systems are in place to assist in protecting residents from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is clear written guidance in the Home’s Service Users Guide and Statement of Purpose on how relatives and residents can make complaints. The home holds 3 monthly relative meetings and this can be a forum for people to bring any issues to his attention. On viewing the homes complaint folder no complaints had been received since the last inspection or received by the CSCI. The Home does have policies and procedures in place to ensure the protection of service users, but these were not fully inspected. Some staff had received training on the recognition of abuse and what action should be taken, but twelve staff still needed to attend. No Protection of Vulnerable Adults issues have been received since the last inspection and no staff had been referred to the Protection of Vulnerable Adults list. Delaware House DS0000059047.V341935.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): 19, 20, 21, 22, 23, 24, 25 and 26. Quality of this outcome area is good. Residents live in a safe and wellmaintained environment. They have access to safe and comfortable indoor and outdoor facilities and bedrooms are nicely decorated and individually personalised. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of inspection the home was observed to be clean, tidy and odour free. Overall the home environment presents no health and safety issues. The environment was homely, comfortable and practical for the use of residents at Delaware House. The home is mainly decorated in the same colour paint and carpets, which may be confusing for those residents at Delaware house who have dementia. This was highlighted in the last inspection and the home has been pro-active in trying to address this situation. The manager has been looking to develop appropriate signage and introduce pictures or some visual aid, which may support residents to recognise their own bedroom door. Toilets and bathrooms doors have been painted ‘light blue’ to help residents maintain some Delaware House DS0000059047.V341935.R01.S.doc Version 5.2 Page 16 independence around the home. Other options were discussed to help the home develop this further. There is a small garden area, which is fenced off and provides a pleasant area for residents to use. Lighting in the lounges is bright and provides sufficient lighting. There are also wall lights around the home to facilitate reading and other activities. Furnishings within the home are new, domestic in character and of a good quality. The home also has ‘security pads’ to ensure residents do not gain access to areas which may cause them harm. There are also ‘call bells’ in each bedroom and in the lounges, which were being tested by the maintenance man on the day of the inspection. The home has sufficient toilets around the home, which as stated earlier have been painted a different colour assist with orientation. All bathrooms are a good size and were well laid out to assist with any equipment that may be needed. All were clean, tidy and had appropriate hand washing facilities. Delaware House offers accommodation to residents with a variety of walking abilities. There were grab rails around the corridors of the home and wide doorframes for wheelchairs. There was sufficient equipment for present residents. During a tour of the home it was noted that some residents had chosen to bring in personal belongings and many of the rooms looked ‘homely’. Some bedrooms had ensuite facilities. Windows have restrictors fitted and each resident’s bedrooms is centrally heated with a radiator and thermostatic control. The homes Maintenance man makes regular checks to the water temperatures and there were clear records. Two washbasins were checked and found to be within the recommended temperature. Delaware House has its own laundry facilities and this was well organised. All those residents seen during the Inspection were noted to be clean and well presented. Delaware House DS0000059047.V341935.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): 27, 28 and 30. Quality of this outcome area is good. Resident’s needs are met by the numbers and skill mix of the staff. Staff are trained and competent to do their jobs, although some updates are needed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection there were five staff plus one shift leader on duty in the morning and the afternoon. Some of the residents have very high needs, but staff were always available. There is a core group of staff that have been employed at Delaware House for some time and they were aware of the residents needs. The Manager is supernumery to staffing numbers, but was on annual leave on the day of the inspection. The home’s Team Leader was very helpful and assisted in gaining sufficient information for the inspection. The home had four housekeeping staff on duty and also a cook. The home was clean and tidy and odour free. Six staff have achieved their NVQ 2 and two their NVQ 3. Four more staff had registered to start their NVQ 2 in September. Regular training is offered to staff and consists of infection control, moving and handling, dementia, challenging behaviours, violence and conflict and Protection of Vulnerable Adults (POVA). On viewing the training record most Delaware House DS0000059047.V341935.R01.S.doc Version 5.2 Page 18 staff had attended these course, although it was noted twelve still needed to attend POVA. Other training that had been offered to staff included food hygiene, first aid, fire safety, risk assessment, pressure care, mental health, pressure care, nutrition and falls prevention. Generally staff have sufficient knowledge and understanding to provide the care required. It was also recommended that staff have some training in care of the dying. Delaware House had a set Induction for new staff. It was stated that this was in line with the Skills for Care requirements. Recruitment was not looked at during this inspection, but at the last inspection it was reported that there was a good recruitment and selection policy in place and all necessary checks had been completed. All staff had enhanced CRB checks and POVA checks, before being offered a contract of employment. Delaware House DS0000059047.V341935.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): 31, 32, 33, 34, 37 and 38. Quality of this outcome area is good. The Manager is very experienced and has a good understanding of the residents needs. Southend Borough Council have policies and procedures in place to safeguard both staff and residents. There are clear lines of accountability and support is offered. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Delaware House DS0000059047.V341935.R01.S.doc Version 5.2 Page 20 The Manager has considerable experience in managing residential care homes and has gained appropriate qualifications. There are clear lines of accountability within the home. During the Inspection there was clear evidence of staff discussing care issues or concerns with the Team Manager and appropriate advice and action being taken. One staff member stated she was ‘happy with the running of the home’. There was clear evidence that both resident and relatives meetings had been held since the last inspection. This was an opportunity for both residents and relatives to raise any concerns they may have. Policies and procedures used by Delaware House cover the health and safety and welfare of staff and residents Under Regulation 26 of the NMS, Delaware House receive regular visits from a Development Manager and a report is written highlighting any action or good practice that has been highlighted. Delaware House have a Quality Assurance system, which approaches both relatives and residents for their views on the care received. There is also a set form for District Nurses or other professionals to feedback their experiences of the home. The CSCI have been provided with a copy of the home’s Quality report. A recent regulation 26 report was gained and this contained clear evidence that regular checks on gas appliances, fire alarm system, lift, emergency lighting, water temperatures, nurse call system and electrics had been completed. Appropriate insurance certificates were seen and in order. Staff and resident files are kept secure and Delaware House are registered with the Data Protection Act. Residents can have access to their files if requested. The accident book was viewed and in order. Delaware House DS0000059047.V341935.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X X 3 3 Delaware House DS0000059047.V341935.R01.S.doc Version 5.2 Page 22 Yes Are there any outstanding requirements from the last inspection? 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 OP12 Regulation 16(2)(m) and (n) Requirement The registered person shall having regard to the size of the home and the number of service users consult service users about the programme of activities arranged by on behalf of the care home, and provide facilities for recreation having regard to the needs of the service users, activities in relation to recreation, fitness an training This is in connection to developing your present activities programme and provide service users with a varied programme of `in house` and community based activities. Previous timescale of 01/02/06, 14/05/6 and 1/9/06 not met. Timescale for action 30/09/07 Delaware House DS0000059047.V341935.R01.S.doc Version 5.2 Page 23 2. OP18 13(6) The registered person shall make 30/10/07 arrangements, by training, staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. This is in connection to ensuring all staff have received Protection of Vulnerable Adults training. 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 Recommend a review sheet is introduced at the back of the care plan rather than crossing out and putting new dates on the front of the form, which becomes can become confusing. Recommend the medication folder is checked as some residents photos were missing. Recommend staff are provided with care of the dying training. Recommend you continue to look at appropriate systems to introduce to the home to aid orientation for those residents with dementia. 50 of care staff should achieve NVQ Level 2 2. 3. 4. OP9 OP11 OP19 1. OP28 Delaware House DS0000059047.V341935.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Delaware House DS0000059047.V341935.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. 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