Inspection on 06/12/05 for Fessey House

This inspection was carried out on 6th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Fessey House 06/11/07

Fessey House 01/05/07

Fessey House 13/11/06

Fessey House 05/09/05

Fessey House 14/12/04

Fessey House 28/04/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Fessey House Brookdene Haydon Wick Swindon Wiltshire SN25 1RY Lead Inspector Stuart Barnes Announced Inspection 6th and 7th December 2005 02:30 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 Fessey House DS0000035422.V262545.R01.S.doc Version 5.0 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. Fessey House DS0000035422.V262545.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Fessey House Address Brookdene Haydon Wick Swindon Wiltshire SN25 1RY 01793 725844 01793 706104 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) Swindon Borough Council Mrs Doreen Ann Nicholls Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43) of places Fessey House DS0000035422.V262545.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th September 2005 Brief Description of the Service: Fessey House is a large 43 bed care home owned and managed by Swindon Borough Council. It is located in a quiet cul de sac in the Haydon Wick area of Swindon. There is easy access to local shops and a community centre. The home is on 2 floors and is sub divided in to 4 living areas. Three of these living areas provide long term social care and accommodation. The other area provides respite and crisis care on a short term basis. Each living area has its own separate lounge and dining room with a kitchenette where drinks and snacks can be prepared. Main meals are cooked on the premises in a central kitchen and delivered to the living areas in heated trolleys. The home provides several communal rooms, including a smoking lounge. All bedrooms are single rooms and can be decorated to the occupant’s choice. Service users are encouraged to personalise their rooms and may furnish them with their own furniture. Typically there are 7 or 8 care staff on duty plus a shift leader or manager. At night 3 care staff work in the home. Additionally the home deploys a housekeeper at busy times in each living area as well as cleaning staff. Designated staff are employed to carry out administrative and cooking duties. If the home is short of permanent staff it relies on staff working extra hours or agency staff. In an emergency on-call staff are available should the need arise. On the same site there is a local day centre that is run by Age Concern. Some service users can attend the day centre if there is a vacancy and they meet the criteria. The Commission does not inspect the day centre, as its remit is out side its powers. Fessey House DS0000035422.V262545.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection, which was by appointment, was carried out over 2 days covering approximately 10¾ hours. Before the inspection commenced the home supplied the Commission with various pre-inspection documentation. The Commission also canvassed the views of a representative sample of service users and their relatives and the staff who work at the home. The first day of the inspection was mostly spent progressing the requirements and recommendations made at the previous inspection and talking to staff. The second day was mostly spent meeting service users, examining case documentation and viewing parts of the accommodation as well as talking to more staff. Of the 14 requirements made at the previous inspection 13 were found to have been met and the other one partly met. Preliminary findings of the inspection were fed back to the manager at the end of the inspection. In total 17 National Minimum Standards were inspected out of a total of 43. What the service does well: What has improved since the last inspection? What they could do better: The accommodation is in need of partial refurbishment, (this is planned for 2006) and some remedial snagging is needed. The amenity fund needs auditing. Recording staff inventions and especially those associated with agreed care plans needs to be more consistent and clearer as to its meaning. Management need to keep a watchful eye on the deployment and number of staff on duty. Where relevant, health care staff need to contribute to care Fessey House DS0000035422.V262545.R01.S.doc Version 5.0 Page 6 planning for people who use the home for respite/short term care. Management needs to ensure that monthly unannounced visits are carried out in line with statutory requirements. Those obtaining the views of service users about the quality of the service ideally should not be paid care staff. 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. Fessey House DS0000035422.V262545.R01.S.doc Version 5.0 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 Fessey House DS0000035422.V262545.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3 The service is getting better at ensuring service users are provided with stated terms and condition of residency. EVIDENCE: Five case files were examined and each had a copy of the person’s stated terms and conditions. In two cases these had been recently updated and amended. All files seen provided detailed assessments including attention to relevant health care issues. Service users praised the home for the range and type of care provided. For example one person said; “I am getting good care the staff are very caring here”. Another said, “ The staff treat me kindly.” All who completed a survey form, except for one person, said they were well cared for and all said they liked living in the home. Another said, “the home is helping their recovery” [from illness]. Since the last inspection the manager has worked hard to produce a revised assessment template which, when implemented fully, will further improve the assessment process. Fessey House DS0000035422.V262545.R01.S.doc Version 5.0 Page 9 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 and 8 The arrangement for delivering personal care to residents’ has improved since the last inspection. EVIDENCE: Five case files were examined. Each had a written care plan and a written assessment of risk. There was evidence to show that when circumstances changed written risk assessments were periodically reviewed and that they cross referenced to the care plan. Some of the daily case documentation did not always state clearly enough what interventions staff make. Three case files did not seem to outline the person preferred routine in respect of washing/bathing/showering. However their daily record did show these interventions were intermittently provided. Another case file stated that, “assistance with personal care given” but it did not specify what type of care. This could mean that staff working the following shift may not know if the written care plan was being carried out, especially if the staff member was not at the handover meeting between shifts. While some care plans are specific about the care needed the daily notes do not always specify if such care is provided? For example where a plan says, “teeth must be left to soak overnight” it is not evident whether this is done on some nights. In another Fessey House DS0000035422.V262545.R01.S.doc Version 5.0 Page 10 example where a care plan states, “monitor diet and fluid intake” it appears details are recorded about food intake but not about the fluid intake. A third example is where a care plan specifies, “carry out nightly checks” or “ carry out 2 hour checks at night” are only being recorded as having been done on some nights and not others. Similarly another written example stated, “encouraged to use the commode at night” but it is not stated whether the commode was used or not. There were also some good examples of recording care inventions. One carer wrote, “completed bed change - gave a shower (water temp 38 degrees) with full personal care given; hair washed and set.” Discussion with the manager suggests that the variation in the way care plan interventions are detailed reflect a recording deficit rather than a lack of required care and attention. However one service user in their review feedback their concern that, “they do not see so much of the carers when compared to living in a previous local authority care home.” The manager confirmed that more service users could take a bath in the morning if they want one, as changes have been made to morning routines to facilitate this practice. No service user complained about not getting a bath when needed. Discussion also took place regarding the part health care professionals take in determining care plans for those on short term care, since one service user said that in taking up a respite care bed he was missing out on his exercise programme. The home is good at supporting residents to access local medical services and appears to benefit from good working relationships with local GP’s and district nursing services. Case files show that service users are supported to access the dentist, optician and other specialists such as dieticians and chiropodists. Fessey House DS0000035422.V262545.R01.S.doc Version 5.0 Page 11 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 and 14 Since the last inspection improvements have been made in providing different and better in-house activities. The home is quite good at giving people choice and helping them to make decisions. EVIDENCE: The home has increased the number of social activities including meetings with the staff. A seasonal newsletter has been produced alongside providing various seasonal activities, such as a bazaar and raffle. Other recent activities provided include beauty care, quiz, a fish and chip supper (in newspaper!) and for some a trip to the theatre. Generally service users report satisfaction with the way they are involved in the running of the home. Seven out of 9 respondents who returned their comment card said that they did not wish to be more involved in the running of the home. Two people reported that they would like more varied activities. All said their privacy was respected. Comments about the food were favourable with only one negative comment. The service users interviewed by the inspector also made favourable comments about the service. One said; “ here there is lots of choice about where I can go. I am benefiting from all the socialising [here].” Another service user was able to verify that the staff were considerate and helpful and that they can make choices about how they spend their day. Another person confirmed there were, “lots of choices – including a choice of residents smoking. “ Fessey House DS0000035422.V262545.R01.S.doc Version 5.0 Page 12 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, 17 and 18 While the home has a detailed complaints procedure it fails to fully encompass expression of dissatisfaction. The failure to keep clear records of complaints at the home means some issues get lost and protocols for reporting incident under the vulnerable adults procedure are not being followed. The home is striving to ensure service users legal rights are upheld. EVIDENCE: The council has a detailed complaints policy that includes 3 different stages. The service user guide details how a person can complain and outlines the policy. Information about how to complain is also posted throughout the home on notice boards. The record of complaints shows there were 4 complaints in the previous 12 months. One of the complaints was about not having access to a television during a period of short term care; another was about the way care was being delivered and two concerned difficulties between 2 residents. There was no evidence to show that the difficulties between 2 residents were referred under the local Protection of Vulnerable Adults protocols for further consideration. One particular expression of dissatisfaction made by a service user was discussed with the manager. It is evident that this matter was not captured as part of the council’s complaint process and that the complainant did not receive a letter acknowledging their complaint. The home does not keep its own record of complaints or expressions of dissatisfaction relying on the Council’s own complaints department to do so. In the opinion of the inspector this results in some issues getting lost. Notices are displayed throughout the home advising families that if they want the assistance of an advocate to discuss this with the manager. There is also Fessey House DS0000035422.V262545.R01.S.doc Version 5.0 Page 13 evidence to show that several residents have a nominated power of attorney. Others have access to an ‘age concern’ advocate. Form AHW3 confirms that current residents apply to be put on the electoral roll. According to the manager no staff member has been dismissed in the previous 12 months and no staff member has subjected to any formal disciplinary hearing. Fessey House DS0000035422.V262545.R01.S.doc Version 5.0 Page 14 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 and 26 The standard of accommodation is improving and service users report being satisfied with it but some areas of the home are in need of remedial work and refurbishment. There were some minor snags evident. e.g. light bulbs not working. EVIDENCE: The home is located in a residential area on the edge of Swindon with good access to local shops. Following a review of its care home services the Council have plans to complete a refurbishment of the home in the next 12 months. Some of this work has already started. Certain cosmetic decoration and improvements are on hold pending the commencement of this programme. Overall the accommodation is adequately maintained and kept secure and safe. The grounds were found to be tidier and better maintained that at the previous inspection. Service users report general satisfaction with their accommodation. It was noted that temperatures varied in different parts of the accommodation. It was said this was due to a fault with the thermostat. The manager confirmed that Fessey House DS0000035422.V262545.R01.S.doc Version 5.0 Page 15 an engineer had called to fix it and was awaiting the part. Radiators in rooms used by residents are covered so as to prevent any accidental scalding. Certain bathrooms have been partly upgraded as part of the refurbishment programme. There are no outstanding issues of concern regarding fire safety or environmental health. The manager has progressed the issue of fitting magnetic hold open devices or similar equipment on bedroom and corridor doors and it is expected this will be carried out as part of the refurbishment programme subject to costs. No fire doors were found wedged open. Service users who want to smoke have the option to do so in a designated smoking room. The home provides a well-equipped hairdressing saloon. There is a working vertical passenger lift between floors, which provides a smooth ride. Records confirm this lift is routinely serviced. It was noticed that some light pendants did not have light bulbs that work and some toilets did not provide curtains over the obscure glazing in these areas; thus making them look rather institutional. The home provides a designated area for sluicing. One bedroom is in need of an alternative floor covering to meet the specific needs of the occupant. One bathroom did not have a working lock on the door. Staff are expected to follow detailed infection control protocols. Overall the home was found to be clean and pleasant except for one room. The laundry facilities have recently been upgraded. Staff report that protective clothing is available to them. Service users said they found the home to be comfortable and to their liking, though one person indicated that the design of one of the toilets make it difficult for him to access in his wheelchair. Fessey House DS0000035422.V262545.R01.S.doc Version 5.0 Page 16 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 Some concerns remain over the deployment of sufficient staff. EVIDENCE: A feature of the design of the building is that the staff workstations are not in close proximity to the reception hall and staff are not always visual. It is apparent that visitors are finding it difficult to track down staff on occasions. The majority of relatives and friends that sent back a comment card stated that on occasions they felt there were not always enough care staff on duty. Rotas show that there are typically 7 or 8 care staff on during the busy morning period and 5 or 6 staff on during the late afternoon and evening; plus supporting staff such as cooks, housekeepers, office staff and supervising staff i.e. shift leaders or managers. No service user and no staff member on duty raised any concerns during the inspection about staff shortages. A comment was made that having an extra ‘floater’ was helping the staffing situation in the morning. The evidence points to a slightly improving situation re staff numbers when taking into account the use of agency staff. Examination of the rota confirms that the home is dependant on the use of agency staff though the number used is reducing over time. On the first day of the inspection 2 care shifts were covered by agency staff and on the second day one shift was covered by agency staff. Since the last inspection more attention has been given to providing extra training in conditions associated with old age. There is evidence to show that relevant training material is at hand. Work has taken place to plan a training programme for the year commencing April 2006 and staff have been updated Fessey House DS0000035422.V262545.R01.S.doc Version 5.0 Page 17 on the guiding principles of care such as ensuring privacy, dignity, promoting independence and the importance of care planning and recording. Since the last inspection 4 staff have attended a course on visual impairment as well as a course on deaf awareness. National Vocational Qualification training continues to progress. Fessey House DS0000035422.V262545.R01.S.doc Version 5.0 Page 18 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, 36 and 37 There appears to be a robust and effective system for managing residents finances and the charges levied. Arrangements for supervising staff are improving. Some efforts have been made to further develop quality assurance but this work is not yet complete. EVIDENCE: The manager is deemed a fit person by the Commission to manage this home. Some efforts have been made to improve aspects of quality assurance through the use of questionnaires to health care staff and social work staff but this has not yet been translated into developing a full quality report. While the current system of care staff interviewing service users about the quality of the service is better than no one interviewing them it is recommended that people who are considered more independent of the home carry out such interviews. Examination of case files show that service users are given written terms and conditions. The home encourages service users to manage their own financial Fessey House DS0000035422.V262545.R01.S.doc Version 5.0 Page 19 affairs or have an appointee or family member to do this for them. The home will look after small amounts monies for personal spending that belong to service users. The inspector spent time with the designated administrator and examined various randomly selected accounts of personal monies belonging to service users held by the home. In all cases the amount of money accurately reconciled with the balance. No unusual spending patterns or expenses were evident and receipts of expenditure were being retained for each person. Access to people’s state pensions seemed well managed. It can be seen that where service users had special requests about the way they wanted the home to manage their money these were facilitated. It is a policy of the Council that the manager cannot act as an appointee for any service user. The system for managing resident’s monies is periodically audited by the Council. The home also maintains an ‘Amenity Fund’, which is used to pay for extras such as entertainment and outings. This account is not audited by the Council and according to the manager has not been audited for several years, partly due to the small amounts of money kept in the account and the cost of paying an accountant to audit it. There is a place to keep monies safe. The arrangements for providing staff with ‘one to one’ supervision meetings has improved since the last inspection with most care staff meeting with their supervisor at least once since the last inspection. Supervising staff report that some recent changes to the way supervision is being recorded are helping. It was noted that one senior staff member was behind in her schedule of supervision partly due to leave considerations. Care needs to be taken to ensure that this person better plans their supervision schedule so as to avoid unnecessary slippage. Plans are well advanced to ensure all care staff will have an appraisal before the end of March 2005. Records show that the Council have not undertaken any unannounced monthly management reports as to the ‘conduct of the home’ since July 2005. It was noted from records that at the time of the inspection the home was accommodating one person under the age of 65 years contrary to the current conditions of registration. Service user’s report without exception feeling safe at the home. Fessey House DS0000035422.V262545.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 3 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 4 2 2 X Fessey House DS0000035422.V262545.R01.S.doc Version 5.0 Page 21 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 OP33 Regulation 35 24(1)(2) Requirement A report must be sent to the Commission detailing the main findings of the manager’s quality review. Note; this requirement is carried forwarded from the previous inspection as it was not fully complied with. A new time scale has been set of 01/03/06 All care plans or service user plans must detail each person’s preferences in respect of bathing, showering or washing. When a service user complains about another service user abusing them or causing them undue distress, consideration must be given to activating the local protocols for the protection of vulnerable adults. Electric lights must be kept working effectively. The floor covering in the bedroom identified during the inspection must be replaced. The Council must ensure that the home is visited unannounced at least once every month by a DS0000035422.V262545.R01.S.doc Timescale for action 01/03/06 2 OP7 15(1)(2) 01/03/06 3 OP18OP16 22(1)(2)( 3) 01/02/06 4 5 6 OP19 OP19 OP37 23(2)(c) 23(2) 26(2)(3)( 4) 01/01/06 02/02/05 30/12/05 Fessey House Version 5.0 Page 22 7 OP37 CSA 8 OP19 23(1)(a) competent person and that this person produces a written report as to the conduct of the home, copied to the manager and to the Commission. The home must cease 30/12/05 accommodating people under the age of 65 years until such times as it is registered by the Commission to do so. A suitable locking mechanism 01/02/06 which can be over-ridden in an emergency must be fitted to the bathroom which does not have a lock. 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 3 Refer to Standard OP7 OP7 OP16 Good Practice Recommendations It is recommended that all relevant staff are given more guidance on how best to record their care inventions. It is recommended that the home involves relevant health care professionals in drawing up care plans for those residents who come for short stay or respite care It is recommended that all complainants, including any users of the service, be sent a letter acknowledging their complaint and they are kept informed as to the outcome of any enquiries made. It is recommended that all toilets, bathrooms and similar facilities with obscure glazing are provided with suitable curtains or blinds. It is recommended that from time to time the manager keeps under review the number of care staff deployed on each living unit so as to ensure the number is adequate to meet the needs of the residents. It is recommended that the manager reviews what arrangements are in place that help visitors find or summon staff if they need to do so. It is recommended that the amenity fund be audited within the next 3 months DS0000035422.V262545.R01.S.doc Version 5.0 Page 23 4 5 OP19 OP27 6 7 OP27 OP37 Fessey House 8 OP16 It is recommended the home keeps it own register of complaints, compliments and comments made about the service. Fessey House DS0000035422.V262545.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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. 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