Inspection on 26/06/07 for Fore Dore Nursing Home Ltd

This inspection was carried out on 26th June 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Fore Dore Nursing Home Ltd 07/10/08

Fore Dore Nursing Home Ltd 30/10/07

Fore Dore Nursing Home Ltd 09/01/07

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

CARE HOMES FOR OLDER PEOPLE Fore Dore Nursing Home Ltd Fore Dore Trebetherick Wadebridge Cornwall PL27 6SB Lead Inspector Alan Pitts Unannounced Inspection 26th June 2007 09:20 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 Fore Dore Nursing Home Ltd DS0000066667.V335422.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. Fore Dore Nursing Home Ltd DS0000066667.V335422.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fore Dore Nursing Home Ltd Address Fore Dore Trebetherick Wadebridge Cornwall PL27 6SB 01208 863471 01208 683963 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) Fore Dore Nursing Home Ltd Michael John Retter Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Fore Dore Nursing Home Ltd DS0000066667.V335422.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th January 2007 Brief Description of the Service: Fore Dore is a detached property situated within a rural village location, surrounded by countryside. The nearest main town is Wadebridge. Fore Dore provides accommodation and nursing care for up to 32 people in need of care due to old age, physical disability or terminal illness. The accommodation is on two floors, with the upper floor being accessed by a stair lift/narrow stairs. The upper floor accommodation is for more able, non-nursing residents. Fore Dore has several long corridors and wings, which give the feel of separate units. Most areas of the home are accessible by sloping corridors to facilitate differing levels of the floor. Service users have a choice of 4 sitting rooms and a dining area as communal space. There is an outdoor seating area to the front of the property. There is also a car park at the front of the home. A trained nurse is on duty over the 24-hour period. There is a registered provider in post. The range of fees charged was not ascertained at this inspection in the absence of the registered provider and registered manager. Fore Dore Nursing Home Ltd DS0000066667.V335422.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key unannounced inspection at Fore Dore took place over approximately 11 hours with two inspectors. Key standards assessed included an inspection of the safety and cleanliness of the home, medication, meals, staffing to include training and recruitment, policies and procedures, and the management arrangements for the home. The inspectors looked at records, toured the building, and spoke to staff and residents. Where possible evidence was crossreferenced to other sources (e.g. training records supported by staff comments). Observations of care delivery took place during the course of the inspection using a recognised observation tool, and residents were asked for their opinion of the home, the staff, and the care provided. Conclusions reached are that staff treat the residents in a kind and caring manner and that interactions between the staff and the residents are positive. There are a number of requirements and recommendations, but these should not detract from the overall impression of an improving service, and the hard work of the registered providers, registered manager, and staff is recognised. Overall, outcomes for residents are good, though the home is not always best able to demonstrate this as the managerial ‘systems’ are not all in place. The requirements and recommendations identified are predominantly of a managerial/administrative nature. The range of fees at the home per week is from £358 to £587. What the service does well: Fore Dore has progressed well under new ownership, and the registered provider, registered manager, and the staff are to be commended for the noticeable improvements achieved. Residents have easy access to safe and comfortable internal and external communal facilities, which are improving due to the registered provider’s investment in new furniture and fittings. Residents’ rooms are personalised. Residents were evidently at ease with staff. Staff were relaxed and pleasant in carrying out their duties. Residents have ready access to other professionals and services. Fore Dore Nursing Home Ltd DS0000066667.V335422.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Fore Dore Nursing Home Ltd DS0000066667.V335422.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 Fore Dore Nursing Home Ltd DS0000066667.V335422.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): 1, 3, 6 - Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home goes some way to providing residents with the information they need. The home ensures that the care needs of prospective residents are assessed prior to admission. The home does not provide intermediate care. EVIDENCE: The home goes some way to providing residents with the information they need. There is a Statement of Purpose and Service User Guide on display in the entrance. However, these documents are undated, are in need of review, and the nurse in charge was not aware if the residents (or their representatives) were provided with individual copies. The registered manager should do more to ensure that current and accurate information is properly distributed to those that need it. Fore Dore Nursing Home Ltd DS0000066667.V335422.R01.S.doc Version 5.2 Page 9 A sample of documentation relating to those residents recently admitted was inspected, and this showed that care needs were assessed prior to admission to ensure that the home could meet those needs. The nurse in charge showed a good understanding of the residents’ care needs and the capabilities of the home and the staff. The home does not provide intermediate care. Fore Dore Nursing Home Ltd DS0000066667.V335422.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 adequate. This judgement has been made using available evidence including a visit to this service. The resident’s health, personal and social care needs are being met as evidenced by direct observation, and discussion with the staff and residents. Medication arrangements were found to be satisfactory. The resident and staff interactions were noted to be very positive. EVIDENCE: Care plans are poor, being uninformative about the individual’s care needs and complicated by a plethora of unnecessary paperwork. The care plan entries tend to be of a generic/bland nature and do not tell the reader what the residents care needs are. The care plans do not direct care effectively. This was demonstrated by the information provided in discussion by the nurse in charge, which was in contrast to that provided by the care plans. Care plans were also seen to be inaccurate in some instances, despite having apparently been reviewed regularly by the nursing staff. There was no indication of resident involvement in the care planning process. The registered manager Fore Dore Nursing Home Ltd DS0000066667.V335422.R01.S.doc Version 5.2 Page 11 must ensure that there is an effective care plan in place for each resident that clearly states the care need and the manner in which the need is to be addressed. Where possible, the resident or their representative should be included in this process. There were two instances in the four care files inspected were a daily entry was not made for 5 and 10 days respectively. This is unacceptable. The registered manager must ensure that staff understand the importance of evidencing their work with entries in the care notes. Comments from residents and staff do nevertheless show that care needs are mostly being met (the deficit being in the area of social/recreational interaction), and the residents have ready access to other health care professionals as needed. All the residents are registered with a general practitioner. The residents receive annual health checks. Chiropody and dental services are available in the home as required. Dietary information is included in care planning and daily records include the intake of meals and drinks. Observations of residents in the communal areas occurred over a period of approximately 1 hour using the Commission for Social Care Inspection SOFI tool: • Approx 35 of the observations showed residents in a positive state of well-being, when they appeared generally happy, contented, comfortable, and relaxed. A further 46 of the observations showed residents in a passive state of well-being, when they were neither happy nor unhappy. Awake, alert but showing no signs of pleasure or sorrow. Approx 28 of observations included residents interacting with each other or with staff. Approx 25 of observations showed residents engaging with their environment in activities’, which had purpose to that individual. All interactions with staff were seen to be good: providing residents with the feeling of safety, are sensitive and assist the individual to be in control of their actions and lives. • • • The medication administration policy and procedure is satisfactory and medication administration records were also found to be satisfactory on the day of the inspection. Medicines are properly stored and administered. The home has a contract with an external company for the safe disposal of medicines. Staff were seen to knock before entering residents rooms. The observational tool supports the assertion that staff treat residents with respect. Residents were complimentary of the staff and their kindness and courtesy, confirming that they felt they were respected and their right to privacy upheld. Fore Dore Nursing Home Ltd DS0000066667.V335422.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 is an activity plan, but this is not reflected in the care notes. The home welcomes all family and friend visitors to Fore Dore and encourages them to stay in touch with their relative. Meals were well presented, and a rotational menu is in operation. A choice is available to residents. EVIDENCE: There is an activity plan for each month, and the June plan showed activities for almost every day. The July plan had not been decided at the time of the inspection. The care plans purport to include social/recreational preferences, but in fact say little about the individual resident. The daily records provide too little evidence of how these needs are being met, and whether the planned activities are actually happening. See comments made earlier about two instances when care entries were not made for a period of 5 and 10 days. On the day of the inspection there was an excellent flautist entertaining Fore Dore Nursing Home Ltd DS0000066667.V335422.R01.S.doc Version 5.2 Page 13 approximately 5 or six residents. Unfortunately this example was rather spoiled by: • One resident said she would have enjoyed this, but had not been advised of the entertainment • The residents, who were clearly enjoying the music, were moved into the dining room for lunch though the flautist hadn’t finished. Arrangements could and should have been made for a late lunch for these residents, or they should at least have been asked what they wanted to do. There is no doubt in the inspectors’ mind that there is an intent to provide social/recreational care, and that the activities shown on the activity plan do occur, but these are not being sufficiently evidenced. The registered manager should do more to ensure that staff understand the importance of the residents’ life at the home and record a picture of the residents’ day in the care notes. Residents confirmed that they are free to receive visitors and may choose who they wish to see. Visitors were seen to arrive on the day of the inspection. The visitors book in the entrance records visitors to the home. Please see comments above regarding lunch and the visiting flautist as an example of where the home can improve in offering residents choice and control over their lives. The cook is fully aware of the likes and dislikes of the residents and is able to provide a menu choice to meet the resident needs. Residents are asked daily for their choice of meal that day. There are two hot main lunch choices and up to four choices available at tea. A record of the choices made and food provided is kept. Specific diets can be catered for. The menu is planned a week in advance allowing the cook to use a fresh ingredients as possible. The cook has achieved the intermediate food hygiene certificate. The dining area was seen to be set nicely with fresh flowers and freshly laundered tablecloths. The inspectors only negative observation was that some residents are left in wheelchairs for their meals rather than being transferred to a dining chair. Fore Dore Nursing Home Ltd DS0000066667.V335422.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. Residents were confident that they would be listened to, though the nurse in charge was not familiar with the complaints policy. Residents are protected by an adult protection policy, but the nurse in charge was not familiar with the procedure to be followed in the event of an allegation. Residents are not sufficiently protected. EVIDENCE: The Commission for Social Care Inspection has not investigated any formal complaints since the previous inspection. Residents spoken with confirmed that the staff are considerate and kind, and that they would feel able to express any concerns they may have. The nurse in charge was aware that there was a complaints procedure, but was unsure where to find it. There is a complaints procedure displayed near the entrance to the home, but this needs updating. There is brief reference to a complaints procedure in the Service User Guide, but this is not enlarged upon. There is a different complaints procedure in the Statement of Purpose. The nurse in charge was unsure how residents would know about the complaints procedure. The registered manager must ensure that there is a current and accurate complaints procedure, and should also make reference to recommendation 1 at the end of this report. Fore Dore Nursing Home Ltd DS0000066667.V335422.R01.S.doc Version 5.2 Page 15 Staff have and continue to receive training in adult protection. The home has copies of the No Secrets DVD and guidelines. There are two copies of the ‘Reporting Allegations/Suspicions of Abuse’ procedure, one dated December 2006 and the other dated December 2007. There are two ‘Abuse’ folders available to staff in the office, one defining abuse and the other providing the contact details of the relevant agencies. However, the nurse in charge was unsure where the adult protection procedure was, and when asked to describe the procedure following an allegation of abuse did not include referral to Adult Social Care. The registered manager must do more to ensure that all staff understand and have a working knowledge of the steps to take in the event of an allegation of abuse. Please see recommendation 1. Fore Dore Nursing Home Ltd DS0000066667.V335422.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Fore Dore is suitable for its stated purpose. The property is generally well maintained and provides a safe, clean environment for residents. EVIDENCE: The home has had, and continues to be in the process of ongoing maintenance, upgrading, and redecoration since it’s recent purchase by the new owner. The registered provider’s commitment and investment in the fabric of the building is commendable. Access around the ground floor is generally level with ramped access where needed. The staircase is protected by a keypad system. There is sufficient, pleasantly decorated and comfortable communal space. There is generous car parking available. There are seating areas outside for residents, though more could be done with the gardens at a later date. Fore Dore Nursing Home Ltd DS0000066667.V335422.R01.S.doc Version 5.2 Page 17 Resident’s rooms were seen to be clean and tidy, and personalised to varying degrees. No odours or evident hazards were noticed in the home. The kitchen was seen to be clean and well organised. The laundry is modern, clean and well equipped. The laundry is away from the food preparation area and has industrial type machines. Service users’ washing is sorted into individual boxes to be taken to rooms. There is documentary evidence of regular and frequent maintenance of the premises and the equipment in use. Fore Dore Nursing Home Ltd DS0000066667.V335422.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of the staff meet the needs of the current residents. The welfare of residents is safeguarded. The home’s recruitment procedure protects residents. There is an evident commitment to ongoing training. EVIDENCE: On the day of the inspection the registered manager was on annual leave. The staffing compliment for 26 residents was as follows: • 2 Nurses • 5 care staff • 1 cleaner • 1 cook 1 kitchen assistant The staffing compliment at other times is normally: • pm; 1 nurse 4 carers • night; 1 nurse 2 carers The shift patterns in use are: • 7am – 2pm • 2pm – 9pm • 9pm – 7am • The shifts include a 15 minute handover period at the end of the shift. Fore Dore Nursing Home Ltd DS0000066667.V335422.R01.S.doc Version 5.2 Page 19 There is sufficient staff to meet the needs of the residents, and comments about the care from the residents was very positive. Occupancy at the home is steadily increasing and the registered manager should ensure that there is evidence of ongoing review of care needs and the ratio of staff to residents in order to maintain this positive outcome. A sample of staff personnel files were inspected which showed that the home is adhering to a robust employment procedure, though as discussed, care should be taken to ensure that references provided correlate with the given employment history. The personnel files and comments from the staff confirm that there is a range of training available and booked, including: adult protection, food hygiene, manual handling. The registered manager should note that there is a need for more 1st Aid qualified staff. There are 17 care staff, of whom 10 have achieved NVQ Level 2 or above (approximately 59 ). Whilst the home has some photocopied National Training Organisation paperwork there was no evidence of new staff undertaking the National Training Organisation induction programme (www.skillsforcare.org). The registered manager must ensure that an National Training Organisation compliant induction programme is in use at the home. The staff have worked hard, through some difficult times over the past year or so. There is evidence that the home, and therefore the outcome for residents, is continuing to improve and the staff should be thanked and commended for their continued commitment. Fore Dore Nursing Home Ltd DS0000066667.V335422.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager is experienced and able to meet the home’s stated purpose, aims and objectives. The home could do more to ensure that the interests of the residents are best served. Residents financial interests are safeguarded. Residents are kept safe. EVIDENCE: The registered provider is evidently making significant financial commitments into the fabric of the building. There are new carpets, chairs, mattresses, and furniture, with more improvements planned. This has vastly improved the environment for the residents and the staff. Fore Dore Nursing Home Ltd DS0000066667.V335422.R01.S.doc Version 5.2 Page 21 In keeping with the physical improvements the residents and staff would now benefit from more efficient managerial systems, a couple of examples being: • Ensure there is only one version of a document in use • Ensure that there are effective communications (both verbal and where there is a need to ensure people have specific information such as a new procedure). The inspectors did feel that there was tension between the care staff and the nurses. Working relationships ultimately affect the outcome for residents so this needs to be addressed. With strong leadership the home can only continue to improve. The registered manager did send out some quality assurance questionnaires earlier this year, though not all expected have been returned yet. The registered manager intends to re-issue the staff quality assurance questionnaires. The registered manager should continue with the quality assurance questionnaires, publishing a summary of the findings and any action taken as a result of the responses. Small amounts of residents’ money are held securely at the home, and are supported by records and receipts. Resident finances were not inspected in great detail, as this is the remit of the registered manager who was not available at this time. A sample of records relating to the safety of the residents, staff, and building were inspected and seen to be in order, including: • Fire records • Accident book • Maintenance records • Insurance certificates Fore Dore Nursing Home Ltd DS0000066667.V335422.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 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 2 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Fore Dore Nursing Home Ltd DS0000066667.V335422.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement The registered manager must ensure that there is an effective care plan in place for each resident that clearly states the care need and the manner in which the need is to be addressed. Where possible, the resident or their representative should be included in this process. Timescale for action 01/08/07 2. OP16 22 3. OP18 13 4. OP30 18 The registered manager must ensure that staff understand the importance of evidencing their work with entries in the care notes. The registered manager must 01/08/07 ensure that there is a current and accurate complaints procedure, and should also make reference to recommendation 1 at the end of this report. The registered manager must do 01/08/07 more to ensure that all staff understand and have a working knowledge of the steps to take in the event of an allegation of abuse. The registered manager must 01/08/07 DS0000066667.V335422.R01.S.doc Version 5.2 Page 24 Fore Dore Nursing Home Ltd ensure that an National Training Organisation compliant induction programme is in use at the home. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP1 OP12 Good Practice Recommendations The registered manager should do more to ensure that current and accurate information is properly distributed to those that need it. The registered manager should do more to ensure that staff understand the importance of the residents’ life at the home and record a picture of the residents’ day in the care notes. See also recommendation 1. The registered provider should ensure that the staff, residents, and their representatives have the necessary information and understand how to make a complaint and how to manage a complaint. The registered manager should continue with the quality assurance questionnaires, publishing a summary of the findings and any action taken as a result of the responses. 3. OP16 4. OP33 Fore Dore Nursing Home Ltd DS0000066667.V335422.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Devon Office Unit D1 Linhay Business Park Ashburton Devon TQ13 7UP 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 Fore Dore Nursing Home Ltd DS0000066667.V335422.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!