Inspection on 26/10/06 for Fieldway

This inspection was carried out on 26th October 2006.

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

Fieldway 04/06/07

Fieldway 16/02/06

Fieldway 22/09/05

Fieldway 02/11/04

Fieldway 12/05/04

Fieldway 10/12/03

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

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

CARE HOMES FOR OLDER PEOPLE Fieldway 40 Tramway Path Mitcham Surrey CR4 4SJ Lead Inspector Liz O`Reilly Unannounced Inspection 26th October 2006 11:00 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 Fieldway DS0000019090.V317378.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. Fieldway DS0000019090.V317378.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fieldway Address 40 Tramway Path Mitcham Surrey CR4 4SJ 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) 020 8648 3435 020 8648 3577 BUPA Care Homes (AKW) Ltd Mrs Isabella Mackenzie Care Home 68 Category(ies) of Dementia - over 65 years of age (31), Old age, registration, with number not falling within any other category (68), of places Physical disability over 65 years of age (37) Fieldway DS0000019090.V317378.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home can admit up to four service users under the age of 65 years. The home can accommodate up to 31 service users with dementia, who are all over 65 years of age and do not require nursing care. 16th February 2006 Date of last inspection Brief Description of the Service: Fieldway Nursing and Residential Centre is a registered care home for sixty eight older people including thirty seven service users who may also have physical disabilities. The home has recently been acquired by BUPA Care Homes. The home is purpose built, with accommodation over two floors. Nursing care is provided on the ground floor with residential care on the first floor. All residents have their own single bedroom with en suite toilet facilities. Each floor has a dining room, a small kitchen and two lounges. Assisted bathrooms, shower rooms and toilets are provided on each floor. Two passenger lifts allow access to the first floor. Parking is available to the front of the building with gardens to the rear and one side of the home. Fieldway DS0000019090.V317378.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by two regulation inspectors. The inspection consisted of a visit to the home, discussions with residents and staff. Questionnaires were supplied to residents, staff, visitors and other professionals. Judgements in this report are based on information gathered from all these sources as well as observations made by the inspectors during the visit to the home. What the service does well: What has improved since the last inspection? The care planning on the ground floor has improved with more detailed information and guidance for staff in working with individual residents. Staff on the ground floor are making sure that risk assessments are in place and are reviewed and that fluid balance charts are used appropriately. Information on moving and handling equipment and equipment to be used for the prevention of pressure sores is also now more detailed. Since the new organisation has taken over staff have reported improved opportunities for training which should result in better informed staff group. The variety and availability of food has improved. Additional training and monitoring has been introduced. Fieldway DS0000019090.V317378.R01.S.doc Version 5.2 Page 6 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. Fieldway DS0000019090.V317378.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 Fieldway DS0000019090.V317378.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3&5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Assessments are carried out before people are admitted to the home. However staff were not using the information gained from these assessments to set up initial care plans. Residents and their families or representatives can visit before they make a decision about moving in. EVIDENCE: Before anyone is admitted assessments of their needs are carried out. These assessments are completed by staff from social services and or staff from the home. This information should be used by staff to ensure that the service can meet the individual needs of the person and to set up an initial care plan. Staff need to make sure that assessments include the social, emotional, cultural and religious needs and wishes of each person as well as their physical and medical needs. Fieldway DS0000019090.V317378.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The standard of care planning must improve to make sure that the health, personal and social care needs of each individual are known and can be met. The health care needs of each person must be monitored, recorded and acted upon. Staff must be directed to read and up date care plans on a regular basis. Further work needs to be done to ensure up to date and accurate records are maintained on medication and that medication is stored safely. Generally residents felt that staff treated them with respect and also respected their privacy. EVIDENCE: We found a difference in the quality and availability of care plans between the ground and first floors. Care plans were in place on the ground floor and contained good information on the physical and medical needs of individuals. Staff were provided with appropriate information on moving and handling and pressure relieving actions and equipment for residents. Referrals were seen to be made to other professionals if needed and staff were being provided with good information on communicating with individual residents. Fieldway DS0000019090.V317378.R01.S.doc Version 5.2 Page 10 Further work needs to be done to include more information on the social, cultural, emotional and religious needs of each person and how these are going to be met. Staff are clearly having some difficulty in completing care planning information on expressing sexuality. It is recommended that staff are provided with training on relationships and sexuality. The inspectors found instances where parts of the care planning documentation had not been fully completed. Staff need to provide more information in certain circumstances. In one instance staff had documented that one person suffered from confusion and could become aggressive. However no information was supplied as to what type of aggressive behaviour, if there were any known triggers or how this might be managed. Maps of Life which provide information on a persons previous interests, occupation and social links had been completed in some instances but this information was not used to inform the care planning. In one instance on the first floor a resident who had been admitted to the home eight days earlier had no care plan. A pre admission care management assessment was available. However this information had not been used by staff or added to provide a plan of care. Pre admission information stated that this persons low weight was a matter for concern and that they needed dietary supplements but these had been discontinued. Staff were unable to provide a clear reason for this. Staff informed the inspectors that they would be monitoring this persons weight over the next few days however staff had not recorded the residents weight since admission and so would have no base line to assess whether this continues to be a problem. Staff were not aware of the religion of this resident nor did they have any clear information on supporting this person to mobilise. The manual handling assessment carried out by staff did not take into account the pre admission assessment. The inspectors were informed that this resident did have a keyworker. However discussions with this member of staff revealed that they had been informed that they were the keyworker just before speaking to one of the inspectors. It is of serious concern that there was no evidence of any planning for the admission of this resident by staff on the unit. This lack of planning places residents at risk and indicates staff give little thought to the admission process or individualised care. The inspectors are aware that the organisation is about to introduce a new care planning system. Staff reported that they would be receiving training on the new system. However in order to meet the needs of the present group of residents a care plan using the present system must be in place for all individuals in the home. Fieldway DS0000019090.V317378.R01.S.doc Version 5.2 Page 11 Generally the daily records focused on the physical care provided by staff for individuals. This information tended to be repetitive, lacking in detail and with no information on the day to day social activities. Overall staff were seen to keep good records of visits by other professionals and to carry out risk assessments. Staff have also take time to talk with residents and or their representatives to make sure that they are aware of the wishes of individuals around terminal care and actions they want taken following their death. Staff must make sure that they sign for medication at the time of administration. Medication records were not signed by staff in a number of instances although the medication appeared to have been given. In one instance staff had signed that medication had been given and it had not. Staff must also ensure that where a medication has a shelf life when opened the date of opening in recorded. One bottle of medication which was to be used within fourteen days of opening was not marked with the date. One bottle of eye drops, which should be used within 28 days, was marked as opened in August of this year but was still in the home in October. Staff keep a record of the temperature of the fridges used for storing certain medication. On seven days in October of this year the record of temperature showed nine degrees centigrade. This is above the “safe” temperature. However there was no record that the fridge should not be used or that action had been taken to have the temperature adjusted. Staff must ensure that all medication is stored at the correct temperature. Fieldway DS0000019090.V317378.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are no restrictions on visitors to the home. Residents can meet with visitors in the privacy of their own room. Residents are given the opportunity to take part in a variety of activities. The activities within the home and the opportunities to take part in activities outside the home need to be reviewed. The social, cultural and religious wishes of residents need to be included within the care planning. Improvements have been made to the food and the majority of residents were happy with the choices available to them. Staff need to take care to communicate with the catering staff regarding the religious or cultural needs and wishes of individuals. The presentation of meals needs to be improved. EVIDENCE: At the time of this visit one person was employed specifically to organise and provide activities for residents. The inspectors were informed that the home was advertising for an additional part time worker. This reduction in the activities staff has restricted the availability of activities. The inspectors spoke with a number of residents who felt dissatisfied with the frequency and type of activities available. Comments included; “there are activities but I don’t do them”, “we are just sitting around counting the Fieldway DS0000019090.V317378.R01.S.doc Version 5.2 Page 13 patterns on the four walls”, “I’m stuck here in the morning and that’s it” and “It’s boring you get up, get dressed and come down here (the lounge). Some of the residents spoken to said that they were happy with their own company and so did not tend to join in activities. Others said they enjoyed some of the things on offer such as art and crafts. Residents said that there were “no trips out” and that “you never see outside”, one person commented that the only time they have been outside the home was the opening ceremony for the sensory garden. In light of the comments received a review of the type of activities, access to the community and the frequency must be carried out. In order for a comprehensive range of activity to be developed all staff will need to recognise the importance of and be engaged in the social aspects of the care provided. In order to meet the religious and cultural needs of individual staff need to be aware of individual needs and wishes and liaise with catering staff. The chef was unaware of the cultural or religious needs of the new resident as care staff had not passed on any information about this person. Information on how the religious needs and wishes of residents will be met must be included in the care planning. Residents confirmed that they can have visitors at any time and that they can meet with them in the privacy of their own room or in the communal areas of the home. A number of residents spoken to have regular visits from family and friends. Comments from residents on the food provided were mostly positive. Residents said “the food is very good”, “I get what I want when I want it”, “I can choose what I like”, “it’s very good, I am putting on weight” and “if you don’t like what is for dinner they will get you something else”. Residents felt they were given “plenty” to eat. A four week menu is in place with alternatives available at each meal times. Residents can choose from a variety at breakfast including a cooked meal, a two course lunch and a three course supper. A snack of sandwiches and cheese and biscuits is provided later in the evening. Fresh fruit is available as an alternative to cake in the afternoon. The chef can cater for various diets. Staff must ensure that the chef is informed of any new resident who may require a special diet for cultural or religious reasons. Residents make their own choices about meals on a daily basis. The chef frequently meets with residents to ensure that they have the opportunity to tell him of any problems. At the time of this visit staff were looking at providing more pictorial information and the organisation was providing new menu boards for the home. It was noted that staff were providing meals on trays without condiments. Fieldway DS0000019090.V317378.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A complaints procedure is available. Staff are provided with training on the protection of vulnerable adults and are aware of what action they must take should there be any allegations of abuse. EVIDENCE: The complaints procedure is available and residents comments indicated that they had confidence in the staff group to deal with any concerns they may have. A record of any complaint made about the service is kept along with any action taken and the outcome. Staff were aware of the complaints process. A number of complimentary letters were seen to have been received thanking staff for the care provided to relatives. The inspectors are aware that the manager is dealing with one complaint about the service at the moment. Staff have been provided with training on the protection of vulnerable adults which ensures that they are aware of their role and responsibilities should they have any concerns about a resident. Fieldway DS0000019090.V317378.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A number of areas in the home are showing signs of wear and tear. The organisation is aware of these and the inspectors were informed that a plan for the redecoration of the home was in place. In order to make sure that residents live in a clean environment a review of the cleaning programme must be carried out. EVIDENCE: This is a purpose built home where each resident is provided with their own single bedroom accommodation with en suite toilet facilities. The home has a variety of assisted baths and showers on each floor. The inspectors were informed that a programme for redecoration had commenced. A number of areas are showing signs of wear and tear. One lounge has been redecorated to a high standard. Other lounges are in poor condition and give the appearance of being quite bare. Fieldway DS0000019090.V317378.R01.S.doc Version 5.2 Page 16 A number of bathrooms were also being used to store equipment. It is recommended that if there is a shortage of storage space one area is used thereby keeping other bathrooms free for residents use. The standard of hygiene needs to be improved. The inspectors found lounge chairs to be very dirty. Bathrooms needed cleaning. In one bathroom the inspectors found a soiled china cup and a latex glove which had become stuck to an old temperature record. The carpets in both first floor lounges needed cleaning. The standards of cleanliness in the small kitchen unit on the first floor needs to be improved. Residents felt happy with their individual rooms. A number of residents had individualised their rooms with personal belongings. One resident felt that more call bells were needed in the lounge area and it was noted that the call bell for one resident did not have a long enough lead. Fieldway DS0000019090.V317378.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents made positive comments on the approach of the staff team. The recruitment procedure assists in making sure that residents are protected. Staff are provided with good opportunities for training which ensures that residents are supported by a well informed staff group. Further work needs to be done so that staff can produce person cantered care planning. EVIDENCE: Residents said that staff are; “very good”, “nice girls”, “very good I ring my bell and they come” and that “nothing is too much trouble”, “staff are lovely”, “they are good to you here “and “always polite”. Comments from two residents indicated that they felt staff could communicate more and spend more time with them. They felt that staff focused on “what was to be done” and then moved on to the next task. Comments from one resident indicated that new staff in particular were not always well informed on their special needs and did not provide care in an appropriate manner for example leaving drinks out of reach or providing food which requires two hands to eat. This can be addressed by providing detailed care planning and making sure that staff read and understand the care plans. Sufficient staff were seen to be employed to meet the needs of the present resident group. Fieldway DS0000019090.V317378.R01.S.doc Version 5.2 Page 18 Staff said they are offered good opportunities for training. Recent training has included the protection of vulnerable adults, challenging behaviour, fire and first aid. Staff spoken to have completed NVQ level 2 and new staff have completed an induction programme. The record of staff training needs to show that all staff providing care have received a minimum of three paid days training a year and that they have received updates on training such as manual handling and first aid. The home has a keyworker system which staff said offered them the opportunity to spend more time with individual residents and give them “extra” attention. The keyworker role could be further developed and expanded to offer more personalised work and care planning. Staff records showed that the appropriate checks are carried out, including Criminal Records Bureau checks and that references are sought before anyone starts working in the home. This assists in making sure that residents are protected from unsuitable staff. Fieldway DS0000019090.V317378.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registered manager has the knowledge and skills to run a home of this type. Further work needs to be done to ensure that residents are involved and consulted on the way in which the home operates. Appropriate checks are carried out on the home and equipment to ensure the health and safety of residents, staff and visitors to the home. EVIDENCE: The registered manager has the appropriate experience and knowledge to run this type of service. Facilities are available for residents to deposit small amounts of money with the home for safekeeping. The organisation has well organised, safe systems for the storage and management of this money. Fieldway DS0000019090.V317378.R01.S.doc Version 5.2 Page 20 Further work needs to be done to complete an annual appraisal of the care provided. This appraisal needs to include consultation with residents and the results of such consultation needs to be made available to present and prospective service users. Evidence that residents are consulted on the way in which the service is run needs to be in place. Records showed regular checks being carried out on the environment and equipment to ensure the health and safety of residents. Staff have received training on health and safety issues. As noted previously improvements need to be made to the standards of cleanliness to protect the health and safety of residents and staff. A record of all accidents with actions taken is kept and all incidents are signed off by the registered manager. Fieldway DS0000019090.V317378.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X 3 X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Fieldway DS0000019090.V317378.R01.S.doc Version 5.2 Page 22 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 OP7 Regulation 15 Requirement The Registered Persons must ensure that a care plan is in place for each resident. Timescale of 01/06/06 not met Failure to comply with this requirement may result in enforcement action. Timescale for action 09/03/07 2. OP7 15 The Registered Persons must ensure that care planning for each individual includes information of the social, emotional and spiritual needs and wishes of residents with information on how these needs will be met. timescale of 15/12/05 and 01/06/06 not met Failure to comply with this requirement may result in enforcement action. 09/03/07 Fieldway DS0000019090.V317378.R01.S.doc Version 5.2 Page 23 3. OP7 13(4) The Registered Persons must ensure that where moving and handling equipment is required clear information on the type of equipment is made available to staff. 09/03/07 4. OP9 13(2) The Registered Persons must ensure that all medication is signed for at the time of administration. All medication must be stored safely, at the correct temperature and in line with manufacturers instructions. All medication with a limited shelf life must be marked with the date of opening and discarded at the appropriate time. 09/03/07 5. OP12 12(1)(2) (3)(4) The Registered Persons must carry out a review of the activities available to residents within and outside the home. The Registered Persons must ensure that information on how the religious and cultural needs and wishes of residents will be met is documented. 09/03/07 6. OP12 12(4) 09/03/07 7. OP26 23(2)(d) The Registered Persons must carry out a review of the cleaning programme in the home to make sure that all areas are kept clean. System for checking the cleanliness of the home must be put in place. 09/03/07 Fieldway DS0000019090.V317378.R01.S.doc Version 5.2 Page 24 8. OP33 24 The Registered Persons must supply the CSCI with a copy of the annual review of the service. 09/03/07 9 OP30 18 The Registered Persons must ensure that the record of staff training includes evidence of at least three paid days training for each member of staff and that staff have received regular refresher training. 09/03/07 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 OP7 Good Practice Recommendations It is recommended that all care staff are provided with training on person centred planning to enable care staff to compile care plans with the support of care coordinators. It is recommended that consideration should be given to the provision of an appropriate vehicle to enable resident to access community activities and facilities. Consideration should be given to developing the keyworker role to provide more person centred care and planning. 2. OP12 3. OP27 Fieldway DS0000019090.V317378.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 Fieldway DS0000019090.V317378.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. 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