Inspection on 21/05/07 for Five Oaks

This inspection was carried out on 21st May 2007.

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 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

Five Oaks 27/06/06

Five Oaks 15/11/05

Five Oaks 30/06/05

Five Oaks 20/10/04

Five Oaks 03/06/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Five Oaks 377 Cockfosters Road Hadley Wood Hertfordshire EN4 0JT Lead Inspector Mr David Hastings Key Unannounced Inspection 21st May 2007 09:30 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 Five Oaks DS0000010660.V333462.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. Five Oaks DS0000010660.V333462.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Five Oaks Address 377 Cockfosters Road Hadley Wood Hertfordshire EN4 0JT 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 8449 7000 020 8449 7311 FiveOaks@ScimitarCare.co.uk Scimitar Care Hotels Plc Ms Lynnsey Mitchell Care Home 44 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (44) of places Five Oaks DS0000010660.V333462.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th June 2006 Brief Description of the Service: Five Oaks is a private residential home owned by Scimitar Care Hotels PLC. The home is registered to provide personal care for 44 elderly people. Following an application by the owner to amend the category of registration, it has been agreed that six of the people accommodated at the home may have dementia. The home is purpose built; facilities include 42 single rooms and two double rooms on three floors; service users are never asked to share a room so the double rooms are used as single rooms. There is a large lounge with interconnecting doors to a dining room, a smaller lounge, the garden room, and a sitting area in the lobby, furnished with comfortable armchairs. The three floors are accessible via two shaft lifts. There is a well-maintained garden with patio, accessible, through French windows. The home is located in a quiet residential area. At front of the building there is a parking space for staff and visitors’ cars. The home is also accessible by public transport. The Cockfosters underground station on the Piccadilly line, is a few minutes’ car drive from the home. Weekly fees are between £682.50 (Residential) and £721 (Respite) This report is available through the internet. Copies may also be obtained from the provider of this service. Five Oaks DS0000010660.V333462.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place on Monday 21st May 2007 and lasted seven hours. I was assisted throughout the inspection by the registered manager who was open and helpful. I spoke with seven staff and eleven residents of the home. I inspected the building and examined various care records as well as a number of policies and procedures. I also spoke with two visitors to the home. The majority of residents I spoke with said they were very happy with the care and support they received. One resident told me the staff were, “Very nice indeed”. What the service does well: What has improved since the last inspection? What they could do better: Twelve new requirements and two good practice recommendations have been issued as a result of this inspection. The manager must write to all potential residents assuring them that the home can meet all their assessed needs. Staff must only sign for the amount of medication actually received by the home. Residents with swallowing problems must not have their meals pureed Five Oaks DS0000010660.V333462.R01.S.doc Version 5.2 Page 6 all together. Doors must not be wedged open as this puts people at risk in the event of a fire. The garden must be assessable to all residents in the home. The clinical waste bin must be replaced so that clinical waste bags are not allowed to spill out. Systems for providing staff at short notice must be developed so residents have enough staff to support them at all times. Recruitment procedures must be more robust to ensure the safety of residents at the home. Residents’ views about how well the home is meeting their needs should be sought and results of any surveys must be made available to all interested parties. Residents must be informed of the cost of any item purchased at the home. The manager needs to have regular supervision. Residents are being put at unnecessary risk from the lack of fire drills for night staff. A record of activities undertaken by residents would provide evidence that people at the home are being kept suitably engaged and occupied. 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. Five Oaks DS0000010660.V333462.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 Five Oaks DS0000010660.V333462.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 (6 not applicable) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Potential residents to the home have their needs assessed before making a decision to move in. However, at present, written confirmation that their assessed needs can be met by the home is not provided. EVIDENCE: A requirement was issued at the last inspection that all potential residents must have their needs assessed before moving into the home. I examined four assessments of residents who had recently moved in to the home. These assessments included those from people wanting respite at the home. The manager told me that the home has two respite places for those people who want a short break. This does not include intermediate or rehabilitation services. The manager and operations director confirmed that the home does not provide a service for people coming out of hospital and requiring intensive Five Oaks DS0000010660.V333462.R01.S.doc Version 5.2 Page 9 rehabilitation. The home’s Statement of Purpose also makes clear that intermediate care is not provided. Although the assessments were satisfactory the manager will need to write to potential residents confirming that the home has assessed their needs and can meet these needs. A requirement relating to this has been issued in the relevant section of this report. Five Oaks DS0000010660.V333462.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans clearly set out residents’ health, personal and social care needs so that staff know how best to support everyone at the home. Residents have good access to health care professionals and they are treated with respect. Residents get the medication they require, at the right times and by appropriately trained staff. EVIDENCE: Six care plans were examined. These plans were satisfactory and set out the plan of care for each individual for staff to follow. The plans set out the health, personal and social needs of residents. Staff I interviewed had a good understanding of the use of care plans and the needs of the people in their care. There was little evidence to suggest that residents are involved in the review of their care plans. A recommendation has been issued that residents views about the care provided to them are sought and recorded when care plans are reviewed. This will ensure that people have a say in how their care is provided. Five Oaks DS0000010660.V333462.R01.S.doc Version 5.2 Page 11 From records and discussions with the manager it was evident that people have been supported to access health care. The manager confirmed that a general practitioner visits every week and that dentists and opticians come to the home as and when needed. Health records in peoples’ files showed that a district nurse, a hygienist and an incontinence nurse also visit the home. A diary of health care input has been kept in each person’s file. A relative told me that if her husband became ill the home would always phone the doctor and keep her informed about what was happening. Satisfactory risk assessments were seen but the home must undertake an assessment for all residents in relation to the risk of developing pressure sores. A requirement has been made in the relevant section of this report. One resident at the home has a pressure sore, which is being treated by the visiting district nurses. Throughout the inspection I saw examples of staff treating people with respect and upholding residents’ privacy. For example staff were seen to be knocking on people’s doors before going in. People I spoke with confirmed that they were treated with dignity and staff upheld their need for privacy. Staff I interviewed were able to give practice examples of when they have upheld peoples’ privacy. Records were examined in relation to the receipt, administration and disposal of medication at the home. The home receives weekly “Dosett” boxes for each resident with a weeks worth of medication already prepared by the chemist. The MAR charts are being signed by staff that they have received a month’s supply of medication. This is not accurate and a requirement has been issued that staff only sign for the amount of medication they receive. All other records in relation to medication were satisfactory. The register of controlled drugs was accurate and the medication room temperature was being monitored. The manager confirmed that only staff who have completed medication training are permitted to administer medication. Five Oaks DS0000010660.V333462.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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can choose from a range of activities at the home and are kept suitably occupied and engaged. Visitors to the home are made to feel welcome and can visit at any reasonable time. Residents are helped to exercise choice and control over their lives. The food provided is of good quality and mealtimes are relaxed and enjoyable. EVIDENCE: People that I spoke to said they were happy with the range of activities provided at the home. On the day of the inspection, after lunch, an entertainer came to the home to play music and residents were clearly enjoying singing along. Residents’ files contained records of their social interests. However no record was being maintained of how people were being occupied or engaged during the day. A recommendation has been issued relating to this issue, as records of activities undertaken would provide evidence that people are kept suitably occupied. Staff I spoke with were able to give practice examples of how they kept people occupied at the home. I was impressed that both the manager and staff felt the most important activity was sitting and chatting to people and time was set aside for this. Programmes of various activities Five Oaks DS0000010660.V333462.R01.S.doc Version 5.2 Page 13 organised by the home are displayed on the wall in the main lounge. The activities provided by the home include music entertainment, bingo, reminiscence sessions, group interactions, quizzes, and going out to coffee shops. Those people who would like to bring pets are allowed to and indeed a “Pat” dog comes to the home and is used as a therapy. Discussions with the manager confirmed that some people attend places of worship and others worship at the home. All residents have a telephone in their bedrooms. I spoke with a number of visitors to the home who confirmed that they were made to feel very welcome and could visit at any reasonable time. The record of visitors to the home confirmed this. I saw a number of visitors during the day of the inspection. Residents confirmed that they were able to have choice and control over their lives at the home. One person said, “I’ve had my say”. Staff I interviewed were able to give examples of how they ensure people are able to exercise choice and control within their daily routines. The kitchen was inspected. The cook on the day of the inspection was aware of individual’s likes and dislikes as well as any special diets people may require. The kitchen was clean and there was a good selection of fresh food. Fridge and freezer temperatures were being monitored and recorded. People I spoke with were generally positive about the food provided by the home. The menus have recently been reviewed and residents confirmed they had been involved in this review. Lunchtime was a relaxed and enjoyable experience. Staff were observed providing discreet assistance were needed. I noticed that were residents have swallowing problems their meals are pureed but different parts of the meals must be pureed separately and not all together so residents can taste the different components. A requirement relating to this has been made in the relevant section of this report. Five Oaks DS0000010660.V333462.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are taken seriously and responded to in a professional manner. Residents are protected from abuse by clear policies and procedures and by an appropriately trained staff team. EVIDENCE: The home has satisfactory policies and procedures in relation to complaints and the protection of residents from abuse. The manager records all concerns and complaints however minor and records examined indicated that all complaints were dealt with in an open and professional manner in line with the home’s procedures. Staff were able to describe to me how vulnerable people could be at risk of abuse in a residential care setting. All staff were clear of their responsibility to report any suspicions of abuse to the appropriate authorities. Residents that I spoke to said they felt safe and well supported at the home. Records indicated that staff have undertaken training in the protection of vulnerable people. Five Oaks DS0000010660.V333462.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 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is clean and maintained to a good standard. Residents are being put at unnecessary risk from inadequate health and safety procedures. EVIDENCE: The manager showed me round the home and I visited some residents in their rooms. The home is clean and decorated to a good standard and has a relaxed atmosphere. Residents that I spoke with said they were happy with their rooms. There is a fulltime handyperson who checks and ensures that the building and equipment are maintained and repaired. The home has also three domestic staff with a responsibility to clean bedrooms and communal areas. A laundry assistant ensures that peoples’ clothes are washed, ironed and folded. There is an infection control policy and the staff were observed using gloves when transporting clothes to the laundry room. A requirement, issued at the last inspection that window restrictors are working properly has now been Five Oaks DS0000010660.V333462.R01.S.doc Version 5.2 Page 16 complied with. I noticed a number of residents had their door wedged open. This is not safe practice and a requirement has been issued that fire door guards are fitted to bedroom doors that residents wish to keep them open. The door to the garden has a step and this is not accessible for people with disabilities. A requirement that a ramp be fitted to this door has been issued in this report. Residents and visitors I spoke with said the home was always clean and there were no offensive odours detected throughout the home. The clinical waste bin located outside the home is broken and clinical waste bags were seen spilling out. A requirement has been issued that the bin be replaced in order to minimise the risk of infection to both staff and residents. Five Oaks DS0000010660.V333462.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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. All the staff at the home work very hard to meet the needs of residents and are provided with good training opportunities to further enhance their knowledge and skills. Recruitment practices are not sufficiently detailed in order to fully protect residents at the home. EVIDENCE: On the day of the inspection there were five care staff on duty. There should have been seven staff and the manager explained that two staff had phoned in sick. The manager told me this was a rare occurrence however staff were more rushed and residents were sitting on their own most of the morning. There is currently no agency or bank usage at the home, which may help to avoid staffing shortages. A requirement has been made that the organisation review the systems for staff to cover sickness at short notice. Residents were very positive about the staff team and it was clear from discussion with staff that they understood the individual needs of the residents in their care. I was able to meet with the training, development and safety manager who was visiting the home on the day of the inspection. Records indicated that just under 50 of care workers have now completed NVQ level 2 or equivalent. I Five Oaks DS0000010660.V333462.R01.S.doc Version 5.2 Page 18 saw that training had been booked to ensure that the home meets the required target of over 50 . Staff were very positive about the training offered to them and the training manager was able to show me individual staff training profiles which indicated that staff at the home receive the training required to do their jobs effectively. I examined three staffing files from staff recently employed at the home. Some of the references obtained for staff did not have a company stamp or letter headed paper enclosed to prove the identity of the referee. A requirement has been issued relating to this matter in the relevant section of this report. All other information was satisfactory and a requirement issued at the last inspection relating to CRB disclosures has now been complied with. Five Oaks DS0000010660.V333462.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, 36 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager of the home knows the residents very well and understands their needs. Residents do have opportunities to have a say in how the home is run. Residents’ financial interests are not being properly safeguarded when they purchase items at the home. In general the health and safety of residents and staff are promoted and protected. Some fire procedures will need to be reviewed to ensure residents continued protection. EVIDENCE: The manager has been in post for about nine years and both residents and staff were very positive about her work at the home. Staff, residents and Five Oaks DS0000010660.V333462.R01.S.doc Version 5.2 Page 20 visitors said the manager was very approachable and professional. The manager has completed the NVQ registered managers award and confirmed that she attends other training events as required. Quality monitoring questionnaires have been sent out to residents and their representatives and visitors confirmed that they had received them. The results of these questionnaires have not however been collated, analysed and published. To fully meet this standard the results of any quality monitoring review must be made available to all residents, their representatives and other interested parties. A requirement relating to this has been issued in the relevant section of this report. The home does not usually hold money on behalf of residents. If residents need anything the manager told me that this is purchased by the home and a monthly bill is sent to the resident or their representative. Receipts do not record how much the resident had been charged for purchases within the home. This means that people do not know the cost of the items they are buying. The manager does have a price list but this is not available to residents buying items at the home. This could lead to mismanagement of residents’ finances. A requirement has been issued that all items in the home that are available for purchase by residents are priced and all receipts clearly record the amount and date of purchase. The manager told me that she does not receive formal supervision and a new requirement has been issued in this report to address this matter. A requirement was issued at the last inspection that recommendations from the Environmental health officer’s visit must be addressed. This requirement has now been complied with. Fridge and freezer temperatures are being monitored and raw food was not being kept near ready to eat meals. Satisfactory records were seen in relation to fire prevention. Staff undertake fire drills every week, which is very good practice. A requirement has been made that night staff undertake fire drills at night. It is particularly important for night staff to be fully aware of the evacuation procedures as there are fewer staff on duty during the night. As detailed earlier in this report, some bedroom doors were being wedged open. Records indicated that staff are undertaking the required health and safety training. Other records seen in relation to electrical installation, Legionnaires, PAT testing and maintenance of equipment at the home were all satisfactory. Five Oaks DS0000010660.V333462.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 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 2 X 2 Five Oaks DS0000010660.V333462.R01.S.doc Version 5.2 Page 22 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 OP3 Regulation 14(1) d Requirement The registered person must ensure that written confirmation is given to all potential residents stating that the home can meet all of the individual’s assessed needs. This written confirmation must be provided before the person moves in to the home. The registered person must ensure that meals prepared for those residents with swallowing problems are pureed in to separate components. Timescale for action 01/07/07 2. OP15 16(2) i 01/07/07 3 OP19 23(2) a 4. OP26 16(2) j 5. OP27 18(1) a The registered person must 01/07/07 ensure that the garden is accessible to those residents who use wheelchairs. The registered person must 01/07/07 ensure that the clinical waste bin situated outside the home is replaced. The registered person must 01/08/07 ensure that there is a system in place to provide staffing cover at short notice at times when staff phone in sick. Five Oaks DS0000010660.V333462.R01.S.doc Version 5.2 Page 23 6. OP29 19(1) c 7. OP33 24(2) 8. OP35 13(6) 9. OP36 18(2) 10. OP38 23(4) The registered person must ensure that all written references received contain either a company stamp or a printed letterhead enclosed to confirm the authenticity of the reference. The registered person must ensure that the results of any quality assurance surveys are published and made available to all interested parties. This includes residents and potential residents to the home. The registered person must ensure that any items purchased by residents at the home clearly identify the cost of each item. The registered person must ensure that the manager of the home receives regular supervision and that this supervision is recorded. The registered person must ensure that night staff undertake fire drills every three months. These fire drills must be recorded. The registered person must ensure that staff only sign for the actual amount of medication received from the chemist each week. The registered persons must ensure that an automatic door closure device is installed on any bedroom door where the resident wishes to leave their door open. 01/07/07 01/08/07 01/07/07 01/07/07 01/07/07 11. OP9 13(2) 01/07/07 12. OP38 23 01/07/07 Five Oaks DS0000010660.V333462.R01.S.doc Version 5.2 Page 24 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 OP33 Good Practice Recommendations The registered person should ensure that the views of residents are sought every time care plans are reviewed. 2. OP12 The registered person should ensure that daily records are maintained of how residents are kept suitably occupied and engaged. Five Oaks DS0000010660.V333462.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Five Oaks DS0000010660.V333462.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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!