Inspection on 04/06/07 for Dene Place Nursing Home

This inspection was carried out on 4th 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 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

Dene Place Nursing Home 24/10/05

Dene Place Nursing Home 04/07/05

Dene Place Nursing Home 25/11/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Dene Place Nursing Home Ripley Lane West Horsley Leatherhead Surrey KT24 6JW Lead Inspector Pauline Long Unannounced Inspection 4th June 2007 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000017607.V339239.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. DS0000017607.V339239.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dene Place Nursing Home Address Ripley Lane West Horsley Leatherhead Surrey KT24 6JW 01483 282733 01483 283360 walronda@bupa.com www.bupa.com BUPA Care Homes (BNH) Limited 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) To Be Confirmed Care Home 32 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (32) of places DS0000017607.V339239.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 32 beds providing nursing care for elderly people from the age of 60 years. One of the older people accommodated may be in the category DE(E) Date of last inspection 24th October 2005 Brief Description of the Service: Dene Place is owned and operated by BUPA who are the Registered Providers. The home is a large period-detached house situated in grounds owned by the National Trust, surrounded by farmland, in a village location in Leatherhead Surrey. The home benefits from a large well maintained garden with wheelchair accessible path that runs along the house. This establishment provides nursing care for up to 32 service users. There are good road links, but the home is not well served by public transport. Accommodation is generally provided in single rooms, a proportion of which has en-suite facilities. The home has five bedrooms which are available for double occupancy, or in the event of a couple wanting to share. The home is furnished and decorated to a high standard. The fees at the home range from £465 pounds per week to £1100.00 per week DS0000017607.V339239.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 09.00 and was in the service for 5 hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the services and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. Communication with some of the residents was limited, due to their communication difficulties, however body language and apperance indicated a sence of well being. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. The CSCI would like to thank the residents, the acting manager and staff for their hospitality, assistance and co-operation during the “Key Inspection” process. What the service does well: The acting manager and staff demonstrated an open and inclusive approach to the residents care. The resident’s benefit from a long standing staff team, some of whom who have worked in the home for several years, and this was reflected in the level of knowledge and understanding of the needs and preferences of the residents. The home promotes and encourages contact with family/friends and the local community. Residents spoken with were complimentary about the care and services provided by the home. The commented that, “that the care they received was good” and “that the staff are very good”. The standard of environment is good, providing the residents with a pleasant place to live. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. DS0000017607.V339239.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: All staff at the home must adhere to the homes medication policies and procedures to ensure the continued health and safety of residents. The home must review the training and development programme in order to ensure that staff training reflects the ongoing and changing needs of the residents. All of the staff at the home must undertake training in respect of safeguarding adults to ensure the continued health safety and well being of the residents. The staff supervision process must be formalised. All staff must receive the required number of one to one meetings with a manager and these meetings must be documented. Requirements have been made in respect of these areas. Please refer to pages 25 and 26 and of this report. DS0000017607.V339239.R01.S.doc Version 5.2 Page 7 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. DS0000017607.V339239.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 DS0000017607.V339239.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): 3,5,6 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Prospective residents are only admitted to the home following an assessment of their needs. The home does not provide an intermediate care service. EVIDENCE: The home provides a care service mainly for privately funded residents however some local authority services users may be admitted from time to time. The home has recently developed and implemented a new care needs assessment document, which when completed, would, provide a comprehensive and holistic view of a residents needs. The acting manager stated that following a referral and telephone discussion, the prospective resident/representative would be invited to the home for further discussion in order to make a decision as to whether or not the home could meet their needs. Following this visit the manager or deputy would then visit a DS0000017607.V339239.R01.S.doc Version 5.2 Page 10 prospective resident at their home or hospital to carry out the care needs assessment. This process could not be confirmed by any of the residents spoken with. The home would undertake a trial assessment to ensure that the resident’s needs could be properly met. The acting manager stated that if there were any areas of concern in that time then the placement would be reviewed. Three of the residents care needs assessments were sampled and were found to provide a comprehensive overview of the residents care needs, for example all daily living activities and their preferences in respect of their names, health and social care needs, spiritual needs and their likes and dislikes around activities. The home does not provide an intermediate care service. DS0000017607.V339239.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): 7,8,9,10 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s health and social care needs are well met. They are treated with respect and their privacy and dignity is promoted. Improvements are required in respect of the homes medication administration practices to ensure the continued health and safety of the residents. EVIDENCE: As discussed earlier in this report, the home has introduced a new care needs assessment and the new care plan document reflects this. This document is comprehensive, to include all daily living activities and goals and gives the reader a good insight into a residents holistic needs. All of the care plans sampled had been signed, dated and regularly reviewed by staff, however none of them had been signed by a resident or their representative. Residents commented, that, “the care they received at the home was good” and that they had access to their care plan if they wished to see them, however none could remember being involved in developing them. Discussions were had DS0000017607.V339239.R01.S.doc Version 5.2 Page 12 with the acting manager in respect of gaining a resident’s or representative’s signature on the care plan to indicate that they were in agreement with the plan or recording the reasons as to why their signatures had been omitted. Medication practices and procedures in respect of administration, recordkeeping, storage and training were sampled. Medication administration was observed and was found to be carried out in a sensitive manner. It was noted however, that the member of staff administering the medication left a tablet with a resident and did not observe it being taken. This was discussed with her and the acting manager and member of staff at the time. The storage of medication was found to be safe. General medication and controlled medication record sheets were sampled, and were found to be well documented, with no gaps in signatures noted. The staff commented that daily checks are carried on the medication record sheets and any issues noted would be addressed with the member of staff at the time. Discussions were had with the care staff about the homes medication policies and procedures. It was evident through these discussions, that the staff had a good understanding of the policies and procedures. The manager commented, that only the registered nurses who were competent were permitted to administer medications. Care staff confirmed this. Throughout the inspection process, staff were observed carrying out various aspects of personal care for the residents, this support was offered in a respectful, sensitive and dignified manner. Staff were observed knocking on doors and waiting to be invited in, before entering rooms. Bathroom doors were kept closed whilst staff were attending to residents personal care needs. Residents commented that, all of the staff were kind and treated them with respect. A requirement and a recommendation has been made in respect of these areas. Please refer to pages 25 and 26 of this report. DS0000017607.V339239.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): 12,13,14,15 People who use the service experience good quality outcomes in this area. The residents are encouraged and enabled to maintain fulfilling lifestyles in the home and contact with family, friends and the local community is promoted. Residents are encouraged and enabled to makes choices in their lives and meal times at the home were observed as being a positive and pleasant experience for the residents. EVIDENCE: The acting manager commented that the home was committed to ensuring that the residents maintain their relationships with their family and friends. Residents commented that they received visits from their families and friends. None were observed visiting the home during the site visit. There was evidence of various flyers on homes notice boards relating to activities and trips, for example residents are encouraged to take part in art and craft sessions, as was evidenced in some of the arts and crafts on display. Staff commented that they had recently taken some of the residents out on a ten pin-bowling trip, which they all enjoyed. There were various photographs of outings displayed through out the home, with evidence of smiling faces indicating enjoyment. On the day several residents were observed taking part in a word search. Others DS0000017607.V339239.R01.S.doc Version 5.2 Page 14 were observed watching the television, listening to music or reading. Staff commented that reading materials could be provided in large print for those residents with sensory impairment. The home encourages the residents to practice their faith and has arranged for regular “ Songs of Praise” mornings at the home. One resident regularly attends church with her relatives. Throughout the visit residents were observed moving freely around the home, making choices as to how they would spend their day. The meals are freshly cooked in the home and it was positive to note, the choice of food on offer was good. The manager and chef commented that there were two choices of main course for each meal, this was evidenced during the lunch time activity. The residents commented that if they did not like what was on offer then the Chef would cook something else and that for the most part the food was good. Discussions were had with the Chef in respect of resident’s likes and dislikes. He demonstrated a good understanding of each resident’s likes and dislikes, and specialist diets for example diabetic, vegetarian and soft diets. It was noted that some residents required a soft diet, this meal was nicely presented and looked appetizing One resident commented that could have all their meals in their rooms of they so wished. Some residents were observed eating their meal in their bedroom. Other residents required support with their meals, and this support was offered in a sensitive, dignified and unhurried manner. DS0000017607.V339239.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): 16, 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The residents are protected by the homes policies, procedures and practices around concerns, complaints and protection. EVIDENCE: No complainants have contacted the Commission with information concerning a complaint made to the service since the last inspection. The complaints records at the home evidenced that 5 complaints have been made directly to the home since the last inspection. Records evidenced that the complaints had been responded to according to the homes procedures and had been resolved. Residents spoken with, commented, that if they any reason to complain, they would speak with the manager. No referrals have been made under the local authority multi agency Safeguarding Adults procedures. Discussions were had with the staff on duty and scenarios put to them in respect of the home’s safeguarding adults and complaints procedures. Staff interviewed demonstrated a good understanding of the policies and procedures. It was noted that not all of the staff have undertaken training in respect of the protection of vulnerable adults. A requirement has been made in respect of these areas. Please refer to pages 25 and 26 of this report. DS0000017607.V339239.R01.S.doc Version 5.2 Page 16 DS0000017607.V339239.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): 19, 20, 26 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The environment is able to meet the changing needs of the resident’s, it is homely, clean safe and comfortable. EVIDENCE: The home is an older property and therefore presents the owners with challenges in respect of the constant need for updating and refurbishment. Considerable work has been undertaken in this respect since the last inspection. Improvements have made in the general decoration and fabric and furnishings of the building for example: curtains, carpets and decoration have been renewed in some areas, several new specialist beds, and moving and handling equipment have been bought. All of which provide a more pleasant environment for the residents and safer working environment for the residents and staff. DS0000017607.V339239.R01.S.doc Version 5.2 Page 18 Some work is underway in the garden area to provide the residents with a small sensory garden, which will provide raised beds to enable the residents to get involved in tending the plants. The home is clean and hygienic with good systems in place to prevent the spread of infection. DS0000017607.V339239.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): 27,28,29,30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff in the home are skilled and in sufficient numbers to support the people who use the service. Improvements must be made in the staff training and development programme to ensure that the staff are confident and competent in managing the changing needs of the residents. EVIDENCE: Staff files sampled and work based observations evidenced that the home employs a diverse staff group. On the day the staffing levels were adequate for the dependency levels and numbers of residents, however it was noted that there were 7 vacant beds. Staff commented that the home was very seldom short staffed and that there was no agency usage. They also commented that the needs of the residents were increasing and that when all of the beds were full, staffing levels would need to be reviewed and increased. It was noted during the site visit that a considerable number of the residents had high dependency needs and some had communication difficulties. Resident’s spoken with commented that all of the staff were kind, helpful, knew what they were doing and good at their jobs. The homes recruitment practices were sampled, and were found to be good. Three staff files were sampled and all had the required documentation in place, DS0000017607.V339239.R01.S.doc Version 5.2 Page 20 with evidence of CRB ( Criminal records) or POVA (Protection of Vulnerable Adults) checks. Discussions were had in respect of the retention of CRB disclosures and the need to refer to the guidelines in this respect. Discussions were had with staff, who, were quite clear about their job roles and responsibilities. Work based observations, evidenced competent and confident staff carrying out their various tasks. Training records demonstrated that basic statutory training had been undertaken since the last inspection for example: Health and safety, Food Hygiene, First Aid, Fire Safety, Manual Handling and COSHH( Control of Substances hazardous to health). There was no evidence to indicate any further good practice training had been undertaken for example: dementia care or challenging behaviours. Care staff commented that they would benefit from training in these areas. The home is proactive in promoting NVQ (National Vocation Qualifications), and is working towards the National Minimum Standard recommendation of having at least 50 of care staff with NVQ2 or above. The training records did not evidence any specific training in respect of Equality and Diversity, however the acting manager and staff commented that Diversity issues would be discussed during the staff induction training, on a day- to- day basis and in the NVQ modules. Care staff discussed various diversity issues in respect of the residents, for example resident’s rising and going to bed when they please, resident’s faith needs being addressed, and resident’s dietary needs being considered. A requirement has been made in respect of these areas. Please refer to pages 25 and 26 of this report. DS0000017607.V339239.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): 31,33,35,36,38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The resident’s benefit from an open and inclusive management approach to the running of the home and their views are listened to. Improvements are required in respect of the staff supervision process to ensure the continued health, safety and wellbeing of the residents EVIDENCE: The acting manager has worked at the home for eighteen months, she is a registered nurse and has recently completed the registered managers award. She submitted an application for registration with the commission but it was returned to her, as it was incomplete. She has assured the inspector that her application for registration will be submitted to the Commission as a matter of urgency. The Annual Quality Assurance Assessment sent to the home was not DS0000017607.V339239.R01.S.doc Version 5.2 Page 22 completed within the required timescales and has yet to be returned to the Commission, again the acting manager has stated that it will be returned as a matter of urgency. This document was returned to the Commission on the 7th of June. The home activity seeks the views of the residents and their representatives. Meetings are held where residents are encouraged and supported to express their views, the most recent meeting was held in May 2007 as evidenced in the minutes of the meeting. The organisation seeks the views of all stakeholders on a yearly basis. Surveys are sent to residents, relatives and staff and a report is compiled following feedback. Recommendations were made following this report and were in respect of the quality of the food and the cleaning regime at weekends. These areas have been addressed evidencing that the Quality Assurance process at the home is effective. Discussions were had with the acting manager around resident’s personal monies. She stated that home holds small amounts of monies for 14 residents in their own individual personal accounts. The procedures and records in this respect were sampled and were found to be good. Discussions were had with the acting manager and care staff in respect of staff supervision and team meetings. The acting manager commented that the deputy manager would undertake all of the care staff supervision meetings, however was unable to produce any records to evidence that these meetings had taken place. Care staff commented that on occasion they meet formally with a senior member of staff, but they work closely with senior staff all the time and can discuss any issues they may have them. The staff also commented that the home would benefit from more frequent full staff meetings. They did acknowledge however, that regular head of department meetings are held at the home. Records evidenced that health and safety checks are routinely carried out at the home. The Fire Service has recently carried out an assessment and recommendations were made in respect of fire door closures. These matters are in the process of being addressed. A requirement has been made in respect of these areas. Please refer to pages 25 and 26 of this report. DS0000017607.V339239.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 X 4 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 2 X 3 DS0000017607.V339239.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 OP9 Regulation 12(1)(a) 13(2) 12(1)(a) 13(5) Requirement Timescale for action 04/07/07 2. OP18 3. OP30 18(1)(c)(i ) 4. OP36 18(2)(a) All staff must adhere to the homes policies and procedures in respect of the administration of medications. In order to prevent service users 04/08/07 being harmed or suffering abuse or being placed at risk of harm or abuse, all staff must undertake training in respect of the homes Safeguarding Adults procedures. All staff must receive training to 04/09/07 reflect the changing and ongoing needs of the residents. Training must be provided in respect of Dementia Care and Challenging behaviours. All staff must receive the 04/08/07 required number of formal one to one supervision meetings with a manager. DS0000017607.V339239.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 OP7 Good Practice Recommendations The manager could consider documenting on the care plans the reasons for residents/representatives not providing their signatures. DS0000017607.V339239.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 DS0000017607.V339239.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!