Inspection on 22/08/07 for Downs Cottage

This inspection was carried out on 22nd August 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

Downs Cottage 28/08/08

Downs Cottage 06/06/06

Downs Cottage 21/12/05

Downs Cottage 06/10/05

Downs Cottage 20/05/04

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

CARE HOMES FOR OLDER PEOPLE Downs Cottage 183 Great Tattenhams Epsom Downs Epsom Surrey KT18 5RA Lead Inspector Kenneth Dunn Unannounced Inspection 22nd August 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 Downs Cottage DS0000013315.V342289.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. Downs Cottage DS0000013315.V342289.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Downs Cottage Address 183 Great Tattenhams Epsom Downs Epsom Surrey KT18 5RA 01737 352632 01737 371068 care@downscottage.co.uk www.downscottage.co.uk. Mr D Thomas Mrs N Thomas Mrs Norma Thomas Care Home 23 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) Category(ies) of Dementia (23), Mental Disorder, excluding registration, with number learning disability or dementia - over 65 years of of places age (23), Old age, not falling within any other category (23) Downs Cottage DS0000013315.V342289.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Out of the 23 (twenty-three) registered , they maybe either within the categories mental disorder/older persons MD(E) or dementia older persons DE(E). Of the 23 registered users, one may be between 60 and 65 years of age, within the categories MD (mental disorder) or DE (dementia). 6th June 2006 Date of last inspection Brief Description of the Service: Downs Cottage is a care home with nursing for older people. S service provision includes care of older people with dementia and mental disorders. The registered providers are both qualified nurses and have relevant management qualifications. They are directly involved in the day-to-day management and administration of the home and its operation. This two-storey property has been converted and extended over the years, retaining the domestic style and character of the building. The home has car parking facilities to the front of the premises. A spacious, secluded, enclosed garden is provided to the rear. This has suitable ramped access and a furnished patio and affords an interesting outlook from the lounge and some bedroom windows. The garden has mature shrubs and trees and is set mainly to lawn. Bedroom accommodation is arranged on the ground and first floor and is part-accessible by chair lift. Whilst the bedroom accommodation is mostly for single occupancy, there are some twin rooms available, if preferred. Most bedrooms have en suite facilities and all have wash hand basins and emergency call bells. Communal areas are situated on the ground floor, comprising a combined lounge/dining room and a separate, small lounge. Assisted bathing facilities and hoisting equipment are available. The home is within walking distance of local shops in Tattenham Corner village and is served by public transport. The home’s location, near to the open countryside of Epsom Downs, affords a peaceful, semi-rural environment. It is, however, within a short distance of a number of towns and all community amenities. The home’s website address is www.downscottage.co.uk. Fees range from £550.00 to £650.00 per week. Downs Cottage DS0000013315.V342289.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit was conducted as part of a key inspection using the Commission’s ‘Inspecting for Better Lives’ (IBL) process. The site visit took place over 4 hours, commencing at 09:00am and ending at 13.00pm and was undertaken by Mr K Dunn, regulation inspector. The registered manager was on annual leave. However, two members of the nursing staff assisted the inspector. Three residents allowed their bedrooms to be viewed as part of the inspection process. The residents and staff were friendly, welcoming and helpful. An annual quality assurance assessment (AQAA) was supplied to the home by the CSCI, and this was completed and returned. Information from the AQAA will be referred to in this report. The AQAA states that the home has policies and procedures to promote equality and diversity and all staff have received training to increase their knowledge and awareness of these issues. In addition the home has a set of policies and procedures that have been designed to safeguard the rights of the residents in gender and lifestyle choices. The final report takes into account detailed information provided by the registered provider and the registered manager that included an Annual Quality Assurance Assessment (AQAA) and returned surveys (next of kin, medical professionals, care managers and any other interested representatives of the residents). In addition, any information that the CSCI has received about the service since the last inspection will also be used to complete this report. Six residents’ files were inspected including their person-centred plans, reviews, risk assessments, medical information and weekly schedules. The recruitment process of four staff members was reviewed and the staff training and development logs sampled. A full tour of the premises took place; staff relatives and residents were spoken to during the visit. Menus, staff rotas, health and safety certificates and the complaints and compliments log were sampled. The pre-inspection material supplied by the home and information received since the previous key site visit, as recorded on the inspection record, was also used in compiling this report. Downs Cottage DS0000013315.V342289.R01.S.doc Version 5.2 Page 6 The inspector would like to thank the management, nurse in charge, staff and service users for their contribution to the inspection. What the service does well: What has improved since the last inspection? Some of the previous requirements have been met. Generally the service is operating for the benefit of the residents. There were no issues raised by the residents and/or their representative and, on the whole, they were very complementary about Downs Cottage. Downs Cottage DS0000013315.V342289.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Downs Cottage DS0000013315.V342289.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 Downs Cottage DS0000013315.V342289.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 3 and 6 were assessed during this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The statement of purpose is informative but requires to be updated more frequently. The home is able to demonstrate that pre-admission assessments are completed prior to admission to the home. The home does not support residents for intermediate care. EVIDENCE: The statement of purpose in use at the time of the visit offered the reader some basic information about the home. It was discussed with the duty manager that the statement of purpose was not fully representative of the home and there were areas of good practice that were not included in the document. It was felt that the inclusion of every aspect of the home would benefit the reader to consider Downs Cottage as a possible home. Downs Cottage DS0000013315.V342289.R01.S.doc Version 5.2 Page 10 The statement of purpose must be updated and reviewed continually to ensure that prospective residents have the most accurate information to base their decision on prior to moving into the home. The home has clear admission criteria in accordance with its stated purpose. A process is in place to ensure that the needs of prospective residents are fully assessed. Prior to admission potential residents are fully assessed by the manager for their suitability and the suitability of Downs Cottage to meet their needs. Relatives are made aware of the specialist nature of the care provided and are invited to visit and look around the home as well as talking to staff and managers. The current residents have had their wishes taken into account when considering referrals for the home’s vacant place. A representative of the home confirmed that prospective residents have the opportunity to visit the home prior to admission and that the cultural and diversity needs of residents are considered as part of this assessment, such as sexual orientation and preferences in conjunction to their social and leisure needs. Downs Cottage DS0000013315.V342289.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 were assessed during this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for care planning still require to be strengthened. Resident’s healthcare needs are being met. The management of medications at the home is satisfactory, promoting good health. The arrangements for privacy and dignity ensure that the residents are treated with respect. EVIDENCE: The care plans are drawn up with the involvement of the residents and/or their representatives. The care plans sampled set out some details of the action which needs to be taken to ensure that the residents receive the care they require. The care plans indicated that there is clear information for the staff to follow to ensure that the needs of the individuals are met. However, this Downs Cottage DS0000013315.V342289.R01.S.doc Version 5.2 Page 12 system only works well because the service has a very stable staff team who clearly know and understand the residents. A review of the care files evidenced that there was a lack of system for the storage of information. It was discussed with the nurse on duty that to be able to offer care to a resident the reader would have to sift through a large amount of less important information. Therefore, the manager must ensure that the care plans and all relevant documentation are correctly collated and stored in a user friendly way. The inspector was informed that key workers and key nurses conduct a system for the monthly review on all care plans. Evidence seen during the visit supported that reviews are now regularly undertaken and care plans updated accordingly. The residents are registered with a GP and have access to hearing and sight tests, chiropody and dental services which are provided by the local primary care trust. The home has a policy on medications in line with the National Minimum Standards. Medications were appropriately stored and medication record sheets were dated and signed by staff. Staff have training in the administration of medications and attendance dates were in staff training files. The home has a policy for residents to self medicate (dated 02/06/07). However, at the time of the site visit no resident handled their own medications. It is essential that the manager compile risk assessments to ensure that the home practices for maintaining control over the residents’ medications are undertaken in their best interests. The home had a policy on privacy and dignity and the inspector noted that staff addressed the residents by their preferred names and knocked on doors before entering residents’ bedrooms. Downs Cottage DS0000013315.V342289.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): Standards12, 13, 14 and 15 were assessed during this visit. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who live in the home are provided with a variety of choices, which aim to satisfy their cultural, social, dietary and recreational interests. The home is able to demonstrate that residents have access to a range of recreational and leisure activities and maintain links with their family/friends and the local community. Residents are supported to make choices and individual preferences are respected. EVIDENCE: Residents are supported to access a range of recreational and social activities, which meet their needs and preferences. The social needs, hobbies and interests of individuals are recorded in their care plans. The home employs an activities co-ordinator and it was clear that a range of activities is available. The co-ordinator keeps records of all the activities that residents attend to ensure that their recreational, social and leisure needs are monitored. A review of records confirmed that the home had an activities diary which Downs Cottage DS0000013315.V342289.R01.S.doc Version 5.2 Page 14 reflected that service users were involved in soft ball exercises, skittles, general knowledge quizzes and dancing to music. However, relatives of two residents stated in their returned surveys that they would like to see a greater choice of activities because they are becoming very repetitive and not offering any new stimulus. One other family member also expressed concern that the home no longer offer the residents trips out, but instead bases all activities in-house. During this visit relatives were observed to be visiting the home and all relatives’ comment cards received indicated that they are able to visit at any time and are made to feel welcome. One relative commented, “There is a friendly, warm atmosphere”. The inspector was informed that a Roman Catholic sister visited the home on Saturdays to conduct Holy Communion to meet the religious needs of some of the residents, regardless of their faith. In addition, the local Church of England minister visits the home regularly to also conduct services. The inspector was informed that at the time of this visit all of the residents were either Roman Catholic or Church of England. However, in the event of a person moving into the home from another religious denomination, arrangements are in place to meet their needs. The inspector sampled the menu plans, which offered variety and choice, and observations confirmed that meals were nicely presented and the mealtime was relaxed and unhurried. A requirement is still outstanding from the previous inspection report requesting that a dietician ensures that menus are adequate to meet the nutritional needs of service users . Downs Cottage DS0000013315.V342289.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 were assessed during this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home responds appropriately to any complaints made, listens to the complainant and takes any actions necessary to ensure a positive outcome. Staff understand the process for reporting any incidence of suspected or actual abuse. EVIDENCE: The home has a comprehensive complaints procedure in place dated 08/05/07 and in addition the home has a policy on abuse dated 02/06/07. The procedure guarantees that all complaints are recorded and will be responded to within the time allocated. A log of complaints and any correspondence is kept by the home. The inspector, as part of this site visit, reviewed the log; the log would indicate that no complaints have been made since the last visit by the CSCI. There are no current safeguarding adults investigations within this home. The deputy manager confirmed that all staff have received protection of vulnerable adults training. Downs Cottage DS0000013315.V342289.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 & 26 were assessed during this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The premises are good ensuring that the residents live in a homely and comfortable environment. The arrangements for hygiene are good ensuring the home is clean and hygienic. EVIDENCE: On the day of this site visit the home was clean, nicely presented and well maintained. The communal lounge was large, spacious, airy and well furnished. Bedrooms were nicely decorated and personalised with adequate heating and ventilation. In addition there are well-maintained grounds for residents to access. Call bells are provided in every bedroom. However, the manager must review the ventilation of the bedroom situated directly above the kitchen. The bedroom windows were open for ventilation and unfortunately all of the cooking smells from the kitchen were coming into the room. Downs Cottage DS0000013315.V342289.R01.S.doc Version 5.2 Page 17 Observations confirmed that the home had adequate laundry facilities and staff practiced infection control measures by washing their hands regularly to prevent the spread of infection in the home. A review of staff training records confirmed that staff have training in infection control and the inspector noted that the home was clean, nicely presented and free from malodours A number of positive comments were received from visitors and relatives in respect of the décor and cleanliness of the home and included, “Spotless”, ‘‘The home is always clean and comfortable’’. Downs Cottage DS0000013315.V342289.R01.S.doc Version 5.2 Page 18 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): Standards 27, 28, 29 and 30 were assessed during this visit. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Generally the staff arrangements at Downs Cottage met the needs of the residents. Recruitment and vetting practices for safeguarding the welfare of the residents must be improved. The arrangements for induction training are good, ensuring that staff are trained to do their jobs. EVIDENCE: A review of the duty rotas evidenced that there are sufficient staff on duty to meet the needs of the residents. However, on four random dates - 15/07/07, 28/07/07, 17/08/07 and 19/08/07 - the male staff ratio to female residents was high. The home has 20 residents and 18 are female, but on these dates the duty rota had three male carers and only one female carer on duty. The manager must ensure that there is a sufficient gender mix to met the needs of all the residents. The home has a full set of policies for staff recruitment. The files reviewed on the day of the inspection indicated that these recruitment and selection procedures were being followed. A review of staff application forms did, Downs Cottage DS0000013315.V342289.R01.S.doc Version 5.2 Page 19 however, demonstrate that the home was not asking for a full and detailed history of past employers. The manager must ensure that a comprehensive list of all past employers be included on the application forms. In addition all current members of staff must supply a detailed list of their previous employers. There is sufficient evidence to indicate that the protection of vulnerable adults checks (POVA) were in place. The home had a policy on staff training and the inspector was informed that staff working at the home all receive induction and foundation training. The inspector sampled staff training records which reflected staff training in manual handling, food hygiene, fire safety, first aid, safeguarding adults and infection control and one staff member had a workbook on induction to work in social care which was completed, dated and signed by the employees. The home has a designated area for staff training with training aids and training materials available to promote staff training and development in the home, to ensure that staff are competent to do their jobs. Downs Cottage DS0000013315.V342289.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 37 & 38 were assessed. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The day-to-day management of the home is generally good. The systems for quality assurance are adequate, ensuring that the home is run in the best interests of the residents. The policies and procedures at the home safeguard the financial interests of the residents. The staff are appropriately supervised and feel supported. There are good arrangements for safe working practices to promote the safety of the residents and staff. Downs Cottage DS0000013315.V342289.R01.S.doc Version 5.2 Page 21 EVIDENCE: The home has a registered manager with an appropriate nursing qualification and an approved management qualification who provides management stability, leadership and direction to the staff team. A random review of the staff rotas, however, indicated that the management of the home is on limited hours - on one specific week the hours allocated to the management of the home was 17 hours. The manager must ensure that the home is effectively managed at all times. The home had a quality policy statement dated 08/05/07 and the nurse on duty during the site visit informed the inspector that the home had regular staff and resident meetings, and this was further supported by the residents’ regular reviews to monitor the quality of care in the home. The home has a comprehensive set of policies and procedures for the handling of residents’ monies, dated 02/06/07. These clearly set out the guidelines for the manager and staff to follow to ensure that the residents are safeguarded from any form of financial abuse. A number of health and safety procedures were in place. Policies and procures have been updated and evidence seen during the visit would indicate that they are now under continued management review. Substances hazardous to health were stored securely and appropriately updated (COSHH policy dated10/06/07). Accidents are recorded and, in addition to registered nurses on duty, there are also trained first aiders. The premises are secure with access to the building being through a number-locked door so that all visitors can be identified. The inspector noted that the kitchen appeared clean and hygienic and fridge and freezer temperatures sampled were within normal limits. The home has service inspection certificates for fire equipment dated 22/01/07, gas safety dated 19/06/07 and regular maintenance of general equipment hoist serviced 01/06/07. Downs Cottage DS0000013315.V342289.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X 2 3 Downs Cottage DS0000013315.V342289.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP37 Regulation 17 Schedules 3&4 Requirement The management of all documentation must be reviewed to ensure that relevant information is secure. In addition the care plans and all relevant documentation must be correctly collated and stored in a user friendly way. Risk assessments must be completed on the ability of residents to self medicate and the process of locking personal wardrobes and drawers. The registered person must ensure that the home’s menu plan has input from a dietician to adequately meet the nutritional needs of service users and promote health. (Not met from the previous report 01/09/06) The manager must review the ventilation of the bedroom situated directly above the kitchen. Timescale for action 01/10/07 2. OP9 13(2) 01/10/07 3. OP15 16(2)(i) 01/09/07 4. OP19 23(2)(o) 01/10/07 Downs Cottage DS0000013315.V342289.R01.S.doc Version 5.2 Page 24 5. OP27 18(1a) Schedules 4.6 & .7 19 Schedule 4.6 9(2)(b&I) The manager must ensure that there is a sufficient gender mix of staff on duty to meet the needs of all the residents. The manager must ensure that a comprehensive list of all past employers be included on the application forms. The home must be effectively managed at all times. 24/09/07 6. OP29 24/09/07 7. OP31 24/09/07 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 OP1 Good Practice Recommendations The statement of purpose must be updated and reviewed continually to ensure that prospective residents have the most accurate information to base their decision on prior to moving into the home. Downs Cottage DS0000013315.V342289.R01.S.doc Version 5.2 Page 25 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 Downs Cottage DS0000013315.V342289.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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