Inspection on 06/06/06 for Downs Cottage

This inspection was carried out on 6th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Downs Cottage 28/08/08

Downs Cottage 22/08/07

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 Deavanand Ramdas Unannounced Inspection 6th June 2006 10:00 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.V299229.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.V299229.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.V299229.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). 21st December 2005 Date of last inspection Brief Description of the Service: Downs Cottage is a care home with nursing for older people. 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 carparking 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 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 of a combined lounge / dining room and a separate, small lounge. Assisted bathing facilities and hoisting equipment is 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 Downs Cottage DS0000013315.V299229.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by one inspector over a period of six hours and a full tour of the premises took place, staff and service users were spoken to, and documents and records were examined. 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? The manager stated she is committed to staff training and development and staff have access to a designated area for staff training with training aids and materials provided by the management. During discussions the manager remarked ‘‘I am very pleased with staff’’ and staff commented they are ‘‘generally satisfied with training’’. The management has invested in the home and purchased a number of new chairs for the lounge area to make it nice and comfortable for service users and one service user has a specialist chair to promote health. The home has met the previous requirements and Downs Cottage DS0000013315.V299229.R01.S.doc Version 5.2 Page 6 recommendations which have resulted in improvements in infection control measures to prevent the spread of infection and promote health. Recruitment and vetting practices have improved to protect service users from harm and abuse and pre-assessment procedures have been strengthened to ensure service users’ needs are assessed and identified prior to admission to the home. The home has employed a part-time assistant to support the manager with administrative tasks to do with the running of the home to ensure service users benefit from a well run home. 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. Downs Cottage DS0000013315.V299229.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 Downs Cottage DS0000013315.V299229.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes statement of purpose and service user guide is good ensuring prospective service users have information to make informed decisions about admission to the home. The arrangements for needs assessment are adequate ensuring the needs of prospective service users are assessed and identified before admission to the home. EVIDENCE: The nurse in charge stated the home had a statement of purpose and service user guide which was written in plain English, nicely presented and available in the hallway to make it accessible to relatives, visitors and service users. The statement of purpose had information about the aims, objectives, philosophy of care, services and facilities offered by the home and the service user guide was reviewed and updated by the management. The home had a policy on the assessment of needs of a service user and a policy on the admission of a service user dated 01/04/04. The manager stated service users are admitted to the home following an assessment of needs and Downs Cottage DS0000013315.V299229.R01.S.doc Version 5.2 Page 9 the inspector sampled individual care plans which included a joint needs assessment dated 12/05/06. The inspector noted the management had acted on requirements made and improved the assessment of needs process to include a falls risk assessment tool to promote the safety of service users. The nurse in charge stated the home did not offer intermediate care and this standard was not assessed. Downs Cottage DS0000013315.V299229.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9&10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The arrangements for care planning are satisfactory ensuring service users health, personal and social care needs are recorded in an individual care plan. However, care plans must be reviewed at least monthly to promote the welfare of service users. Access to health care is adequate ensuring service users health care needs are promoted and maintained. Medication arrangements at the home are satisfactory. However, records and practice at the home need improving to promote health. Privacy and dignity is maintained ensuring service users are treated with respect and their right to privacy is upheld. EVIDENCE: The nurse in charge stated the home had individual care plans which were kept in the office to promote security and confidentiality of information. The inspector sampled care plans and noted they were drawn up following an assessment of needs and had input from relatives and professionals involved in the service users care. The inspector noted some care plans were in need of reviewing and action has been required in respect of this matter to promote Downs Cottage DS0000013315.V299229.R01.S.doc Version 5.2 Page 11 good nursing practice. The nurse in charge stated the home employed qualified nursing staff to promote the health of service users and the inspector noted service users had access to health care services including the GP, dentist, physiotherapist, dietician and other health care professionals to meet the assessed needs of service users. It is recorded in a visitor’s questionaire dated January 2006 ‘‘I am very grateful for the care my sister has received in the many years of her residence’’. The home had a number of policies on medications dated 01/04/04 and the manager stated the home had a service level agreement with a local chemist to supply medications to the home. The inspector noted medications were adequately stored in a locked metal cabinet secured to the wall and the home kept a record of medications returned to the pharmacy which was signed by the pharmacist to prevent mishandling of medications. Medication record sheets had a recent photograph of the service user and were dated and signed by staff and the controlled drugs register was up to date and accurate. The inspector noted liquid preparations were not dated on opening, hand written prescriptions were not witnessed and signed by a second member of staff and the list of staff specimen signatures was in need of updating and action has been required to address these shortfalls. The home had a policy on service users rights and observations confirmed staff addressed service users by their preferred names and the nurse in charge knocking on doors before entering service users bedrooms, toilets and bathrooms. Downs Cottage DS0000013315.V299229.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14&15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The routines of the home promote social contact and activities. However, information about activities needs strengthening to make the information understandable to service users. The policies and facilities at the home ensure service users maintain links with their family, friends and local community. The arrangements for autonomy and choice are satisfactory ensuring service users are able to exercise choice over their lives. Meals at the home are adequate offering variety, choice and catering for the dietary needs of service users. However, the menu plans need to be assessed by a dietician to ensure it is adequate to meet the needs of service users. EVIDENCE: The nurse in charge stated service users have opportunities for social contact and activities and the inspector noted the home employed an activities coordinator to promote social activities and recreational interests. A review of records confirmed the home had an activities diary which reflected service users were involved in soft ball exercises, skittles, general knowledge quiz and dancing to music and the nurse in charge stated a ‘sister visited the home on Saturdays to do holy communion’ to meet the religious needs of service users. Downs Cottage DS0000013315.V299229.R01.S.doc Version 5.2 Page 13 The inspector noted information about activities was in need of strengthening to ensure the information is in a format suited to the capacities of service users. The home had a visitor’s policy, did not impose restrictions on visitors and provided a lounge where service users are able to receive visitors in private. The inspector sampled individual care plans and noted service users were visited regularly to promote family contact and during discussions a service user stated ‘‘ I have regular telephone contact with my daughter who is abroad’’. The nurse in charge stated service users were supported to make choices and entitled to bring personal possessions to the home which was reflected in service users bedrooms. The home had a policy on menu planning, a written menu plan and during an interview the cook stated she ‘‘planned the menu with service users which was approved by the manager’’. The inspector sampled the menu plans which offered variety, choice and observations confirmed meals were nicely presented and mealtime was relaxed and unhurried. The inspector noted a service user had a special diet due to her medical condition and one service user had his weight regularly monitored to promote health. Following discussions a requirement has been made for the menu plans to be sampled by a dietician to ensure it is adequate to meet the nutritional needs of service users. Downs Cottage DS0000013315.V299229.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16&18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints process is satisfactory with complaints information available to staff, service users and relatives. However, the complaints procedure is in need of updating. Policies and procedures are adequate and protect service users from harm or abuse. EVIDENCE: The home had a complaints procedure dated January 2005 which was displayed in the hallway for information and the nurse in charge stated the home kept a record of complaints made about the home. No complaints were received by the CSCI (commission for social care inspection) since the last inspection. During a meeting staff stated ‘‘they were aware of the complaints policy’’ and a service user remarked ‘‘it is very nice here I have no complaints’’. The inspector noted the complaints procedure was in need of updating to reflect a complaint could be made to the CSCI (commission for social care) at any stage should the complainant wish to do so and a requirement has been made in this area. The home had a policy on abuse, whistle blowing and the local authority (surrey county council) procedures on safeguarding adults. During a meeting staff stated they ‘‘had training in safeguarding adults which was very good’’. The nurse in charge commented staff have experience to deal with verbal aggression by service users and the home did not use any physical intervention techniques to manage or control service users. During discussions a service user commented ‘‘ touch wood, I have no complaints’’. Downs Cottage DS0000013315.V299229.R01.S.doc Version 5.2 Page 15 Downs Cottage DS0000013315.V299229.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19&26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for the premises are satisfactory ensuring service users live in a safe comfortable environment. However, the fence in the back garden must be repaired and the garden cleared of debris to promote the safety of service users. The systems for control of infection are adequate ensuring the home is clean and hygienic for service users. EVIDENCE: The home had a policy on buildings and grounds of the home dated 01/04/04 and employed a handyman who kept a record of routine maintenance to the home. The manager stated the home had purchased new furnishings for the lounge and one service user had a specialist chair to make it nice and comfortable for service users. The inspector noted the home operated a code lock system to the front door to promote the safety of service users and the gardens were nice, attractive, secure and accessible to service users. A requirement has been made for the back garden to be cleared of debris to Downs Cottage DS0000013315.V299229.R01.S.doc Version 5.2 Page 17 promote the welfare of service users and the fence to be repaired to promote the safety of service users. The home had a policy on general precautions for infection control dated 01/04/04 and staff have training in infection control. The home had laundry facilities with two washing machines and two dryers and observations confirmed staff practiced infection control measures by wearing disposable aprons and washing their hands regularly. The home had a service level agreement with an approved contractor for the disposal of clinical waste and the inspector noted the home was clean, well ventilated and free from mal odour on the day of the inspection. Downs Cottage DS0000013315.V299229.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29&30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for staffing are adequate ensuring sufficient numbers of staff on duty to meet the needs of service users. NVQ (national vocational qualification) training is satisfactory ensuring service users are in safe hands at all times. Recruitment and vetting practices are adequate and protect service users from harm and abuse. However, a recent photograph of employees must be available in staff recruitment files. Induction training is satisfactory ensuring staff are competent to their jobs. EVIDENCE: The home had a policy on staffing levels dated 01/04/04 and the home had written duty rosters which reflected the numbers of staff on duty. On the day of the inspection the manager, a registered nurse, four care assistants, a cleaner and cook was on duty to meet the needs of service users. During discussions staff stated ‘‘the staffing levels have improved with an extra care assistant on duty in the afternoon shift’’ and a service user stated ‘‘staff are pretty good, they listen to your problems’’. The home is committed to staff training and development and five care assistants have the NVQ (national vocational qualification), three are working towards the qualification and the nurse in charge stated training is planned for the remaining four care assistants. The home had a policy on selection and recruitment of staff dated 01/04/04 and recruitment records were confidentially stored in a locked cupboard in the administrator’s office. The inspector sampled recruitment files Downs Cottage DS0000013315.V299229.R01.S.doc Version 5.2 Page 19 which had completed application forms, references, CRB (criminal record bureau) disclosure information and statement of terms and conditions. A requirement has been made for recruitment files to have a recent photograph of employees to safeguard the welfare of service users. The home had a policy on staff training dated 01/04/06 and the nurse in charge stated staff working at the home have induction training and foundation training. The inspector sampled staff training records which reflected staff have training in manual handling, food hygiene, fire safety, first aid, safeguarding adults and infection control and one staff had a workbook on induction to work in social care which was completed, dated and signed by the employee on 19/07/05. 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 staff are competent to do their jobs. Downs Cottage DS0000013315.V299229.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for day to day management of the home are adequate ensuring service users live in a home which is run by a person fit to be in charge. Policies and procedures are good and safeguard the financial interests of service users. The systems for quality assurance are satisfactory ensuring the home is run in the best interests of service users. The home promotes safe working practices ensuring the health, safety and welfare of service users are protected. 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. There are clear lines of Downs Cottage DS0000013315.V299229.R01.S.doc Version 5.2 Page 21 communication and accountability within the home and during discussions staff stated the ‘‘manager is approachable, helpful and reacts to staff and service users if they have any difficulties’’. The home had a quality policy statement dated 01/04/04 and the nurse in charge remarked the home had regular staff meetings and service user reviews to monitor the quality of care in the home. The inspector noted the home used visitor’s questionaire dated January 2006 to obtain feedback about the home which were sampled. It is recorded, ‘‘I am very grateful and impressed with the care you take of my relative’’. The home had a policy on service users money dated 01/04/04 and service users living at the home were subject to power of attorney and guardianship. The home had a policy on health and safety and health and safety posters were displayed in the home for information. COSHH (control of substances hazardous to health) products were stored in a locked cupboard and the home had a policy on safe storage of cleaning materials which included data sheets and risk assessments. The inspector noted the kitchen appeared clean and hygienic and fridge and freezer temperatures sampled were within normal limits. The home had service inspection certificates for fire equipment dated 21/02/06, gas safety dated 31/05/06 and a fire officer visit was booked for the 08/06/06 to promote the safety of service users. Downs Cottage DS0000013315.V299229.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 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Downs Cottage DS0000013315.V299229.R01.S.doc Version 5.2 Page 23 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 Regulation 15(2) Requirement The registered person must ensure care plans are reviewed and updated at least monthly to promote the health and personal care of service users. The registered person must ensure medications in the form of solutions and suspensions are dated on opening to promote the health of service users. 01/07/06 3. 13(2) The registered person must ensure specimen signatures of qualified nurses working at the home are updated to safeguard the welfare of service users. 01/08/06 4. 16(2)(m) (n) The registered person must ensure information about activities is circulated to service users in formats suited to their capacities. The registered person must DS0000013315.V299229.R01.S.doc Timescale for action 01/07/06 01/07/06 2. 13(2) 5. Downs Cottage 16(2)(i) 01/09/06 Version 5.2 Page 24 ensure the homes menu plan have input from a dietician to adequately meet the nutritional needs of service users and promote health. 6. 22(1) The registered person must ensure the complaint policy is updated to reflect a complaint can be made to the CSCI at any stage should the complainant wish to do so. The registered person must ensure the safety of service users by clearing the back garden of all debris and either repairing or replacing the fence to safeguard the welfare of service users. 01/07/06 8. 7 (Schedule 2) The registered person must ensure recruitment files have a recent photograph of the employee to safeguard the welfare of service users. 01/07/06 01/09/06 7. 12(1)(a) 23(2)(o) 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. 2 Refer to Standard Good Practice Recommendations The registered person shall ensure handwritten prescriptions on medication record sheets are witnessed, signed and dated by a second member of staff. The registered person shall send a copy of the fire officer’s report (08/06/06) to the CSCI (commission for social care inspection) for information and action. Downs Cottage DS0000013315.V299229.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Downs Cottage DS0000013315.V299229.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. 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. 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