Inspection on 22/11/05 for Fourfields

This inspection was carried out on 22nd November 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Fourfields 06/09/06

Fourfields 30/06/05

Fourfields 01/03/05

Fourfields 18/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Fourfields Rosedale Way Flamstead End Cheshunt Hertfordshire EN7 6HR Lead Inspector Tom Cooper Unannounced Inspection 22nd November 2005 10:30 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 Fourfields DS0000019350.V266053.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Fourfields DS0000019350.V266053.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Fourfields Address Rosedale Way Flamstead End Cheshunt Hertfordshire EN7 6HR 01992 624 343 01992 789 807 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) Quantum Care Limited Ms Carol Withers Care Home 52 Category(ies) of Dementia - over 65 years of age (52), Old age, registration, with number not falling within any other category (52), of places Physical disability over 65 years of age (52) Fourfields DS0000019350.V266053.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th June 2005 Brief Description of the Service: Fourfields is a purpose built home comprising six linked bungalow-style units surrounding a central garden, an administration block containing offices, a central kitchen, laundry and recreational facilities. The home, which is run by Quantum Care Ltd, provides personal care and accommodation for up to 52 older people. All bedrooms are for single occupancy, with the exception of one that is large enough to be a double room but it is only used as such when service users have made a positive choice to share. Fourfields blends in well with the other buildings on the Rosedale estate in Cheshunt. Local amenities are nearby and a local bus service passes the door. The home offers a safe and caring environment for its service users, some of whom suffer from dementia. Fourfields DS0000019350.V266053.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Fourfields is a residential care home operated by Quantum Care Limited, a provider with 26 homes in Hertfordshire. This was the second inspection for the year 2005/6 under the National Minimum Standards for Care Homes for Older People and the Care Homes Regulations 2001. The last inspection was carried out on 30th June 2005. This unannounced inspection took place over one late morning and early afternoon on a weekday. In addition to checking whether the statutory requirements made in the last inspection report had been complied with, discussions were held with service users, and members of staff on duty including the manager, laundry staff and care staff on duty in five units. Documentation examined included samples of service users’ care plans, the staff rota, the complaints procedure, the statement of purpose, medication records and some equipment service records. Staff were observed working with service users and a tour of the premises was made, including visiting a dozen residents’ bedrooms and the laundry. The inspection indicated that the new manager had made a considerable impact on the home since taking up post in June 2005. Service users were generally contented and praised the caring staff, who act well together as a team. What the service does well: Comments made by service users were very positive, with many praising the attitudes and performance of staff and the scope and availability of activities. Several said they were never bored in the home. All service users looked well cared for and seemed to enjoy positive relationships with staff, who obviously knew the residents well and understood their differing needs. Care plans seen, made out in the Quantum Care format, gave comprehensive overviews of the individuals concerned and the actions planned to meet them. The manager stated that all service users would be signing their care plans in the future. Service users expressed mixed views on the quality of the food provided, some saying it was always good and others rating it bland and unimaginative. The meals served at lunch on the day of the inspection were well presented and looked appetising and the corporate menus seen were varied and well balanced. The premises were very clean, with no unpleasant smells anywhere and no clutter visible on the day of the inspection. Fourfields DS0000019350.V266053.R01.S.doc Version 5.0 Page 6 No health and safety hazards were noted. The design of the building in six linked zones creates smallish living units that are homely and comfortable and are particularly suitable for those service users with dementia. The homely impression is reinforced by the provision of kitchenettes in each unit. Residents’ bedrooms were tidy and contained personal items. Adequate bathroom and toilet facilities are provided. Special equipment is provided and serviced as necessary. The home employs two activities organisers who produce a wide range of stimulating activities much appreciated by service users. Staffing levels by day and night are considered satisfactory. Staff training in relevant disciplines is ongoing. What has improved since the last inspection? The statement of purpose and service user’s guide have been updated to reflect changes in the management team. The medication policy has been updated to stipulate the retention of medicines for seven days following a service user’s death. Following requirements made in the last inspection report, risk assessments have been produced for service users prescribed anticoagulant medicine. Also, an external audit of the medication system was undertaken and extensive training for staff in safe medication practice has taken place. This has produced an improvement in performance, although some minor lapses in recording were noted in one unit. Other training since the last inspection has included subjects such as the protection of vulnerable adults, communications, continence promotion, assessment and mandatory health and safety topics such as fire safety and moving and handling. The premises were smart looking throughout after considerable repainting of skirting boards, doors and doorframes and some bedrooms. No clutter was present on the day of the inspection and all fire exits were unobstructed. The manager stated that fridge and freezer temperatures were now being checked daily. Staffing levels were reviewed after the last inspection and increased in the light of the increased dependency of service users, in particular the growing number with dementia. This has improved the ability of staff to meet residents’ needs, with staff sensibly deployed to provide more cover at busy times. Monthly activities timetables were on display in each unit, although many service users asked had evidently not noticed them. Fourfields DS0000019350.V266053.R01.S.doc Version 5.0 Page 7 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. Fourfields DS0000019350.V266053.R01.S.doc Version 5.0 Page 8 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 Fourfields DS0000019350.V266053.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 Prospective service users and their relatives/advocates can access sufficient relevant information to enable them to make an informed decision about the suitability of the home prior to admission. The home will not admit a service user without a detailed assessment of needs. Service users have contracts of occupancy. Admissions are subject to a suitable trial period. The home welcomes visitors and there are adequate facilities for service users to entertain them outside their bedrooms. EVIDENCE: The home has an up to date statement of purpose and a service user’s guide. Each resident has a statement of the terms and conditions of occupancy and a contract detailing the room to be provided, the care they will receive and other services. Admissions are only made following a thorough assessment of needs, made by a senior member of staff. This assessment forms the basis of the initial care plan. Service users spoken with confirmed that they and their relatives had the opportunity to visit the home to assess the atmosphere and care approach before making a decision to move in. Upon admission, a trial period follows during which the suitability of the home to meet the person’s needs may be determined. Fourfields DS0000019350.V266053.R01.S.doc Version 5.0 Page 10 The home has a stable and experienced staff team who clearly know the individual needs of service users. Relevant training has been provided to bolster staff skills, for example in understanding dementia. Fourfields DS0000019350.V266053.R01.S.doc Version 5.0 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 Care plans are in place for service users that contain comprehensive details of their needs and how they are to be met. Staff monitor and record the progress of service users and take action as necessary to meet their health care needs. The home has a sound medication policy and procedures that ensure the safety of service users. However care should be taken to ensure that medication recording is always accurate. Service users feel that staff treat them with respect and promote their dignity, privacy and right to make decisions for themselves. The particular wishes of service users regarding the arrangements to be made at the time of their deaths are noted to ensure that any specific requirements are satisfied. Fourfields DS0000019350.V266053.R01.S.doc Version 5.0 Page 12 EVIDENCE: Four care plans seen written in the standard Quantum Care format provided comprehensive details of individual needs and the actions determined to meet them. Good personal details were included to give a rounded picture of the person such as personal preferences, behaviour strategies considered effective, as well as personal care and medical needs. Individual progress was tracked on the daily record, all written in objective language. Staff were able to demonstrate good understanding of individual needs and good care practices and interactions between staff and residents were observed. Care plans viewed had not been signed by the service users however these were relatively longestablished plans and the manager explained that for all new care plans the service users were being asked to sign to confirm their agreement. Individual weights were being checked monthly. Risk assessments were in place for all relevant areas, including the risks associated with the anti-coagulant drug Warfarin. Specific requirements were noted for staff to follow at the time of the service user’s death. Each care plan had been regularly updated. Each resident is registered with a GP. Community nurses visit the home to provide nursing treatments and specialist advice and equipment to staff. Service users asked said that staff monitored their daily condition and felt confident that outside help would be summoned as necessary. This was supported by information on referrals to outside health professionals found in notes on the care plans. Service users also felt that staff treated them with respect and promoted their privacy. For example they said that staff always knocked and waited for permission to enter before going in their rooms. Service users looked well cared for, were well presented physically with tidy hair and fingernails etc. and were sensibly dressed in their own clothes. The home has a written medication policy that conforms to the guidelines of the Royal Pharmaceutical Society. Many staff had been given refresher training in safe medication practice. Before qualifying to administer medication to service users a member of staff must be observed three times and assessed by the supervisor against a checklist of items to establish competence. New medication trolleys had been purchased for each unit. The Monitored Dosage System is used. Storage and records were checked in two units and found to be sound apart from two unexplained signature gaps noted on the medication administration record (MAR) sheets and a confusing discrepancy between the administration of one item of medicine to a service user and the number of pills left in the blister pack, which had also been popped out of sequence. Also, the dates of opening had not been recorded on all packs and bottles of medication held outside the blister packs. Accurate records of all movements of medication must be kept. Despite the recording failures found medication performance was much improved since the last inspection. Staff on duty were confident in the operation of the system and understood the various procedures. See requirements. Fourfields DS0000019350.V266053.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 &15 Service users are able to follow a rewarding lifestyle by taking part in the numerous activities available that are publicised in advance. Service users can maintain contact with family and friends outside the home and involvement with the local community is encouraged. The care planning process ensures that service users’ personal preferences are identified and met. Service users can also exercise choice and maintain autonomy with the support of staff as necessary. The food provided is nutritious, varied and well balanced. However some residents feel that it is bland and rather dull. The catering manager should review the corporate menu. EVIDENCE: The home employs two activities coordinators who between them work 35 hours per week. They have organised a wide range of stimulating activities, including games and quizzes, performances by outside entertainers, film shows, arts and crafts, aromatherapy, knitting, outings in the minibus, gardening and so on. A monthly timetable of planned activities is displayed in each unit in a highly visible place. Even so several residents asked were unaware of the timetable. Fourfields DS0000019350.V266053.R01.S.doc Version 5.0 Page 14 Several service users said that they were very happy with the number and scope of the activities available and suggested that there was “no need to be bored at Fourfields”. Activities occurring had been recorded on special forms. Community links are maintained with the involvement of local groups who raise funds and assist with development projects and the minibus is an invaluable resource to facilitate outings. Volunteers are also recruited to assist in enriching service users’ lives. Visitors are welcome in the home at any time and one visitor commented that she was always treated well. Service users asked said they were able to make decisions for themselves regarding food and activities, where to spend time, rising and retiring times and so on and references to individual wishes were noted in care plans. Other evidence of residents’ autonomy was in the personalisation achieved in bedrooms with small items of furniture, pictures and ornaments on display. Most of the service users have family or friends to assist them with financial matters. The home has links with the advocacy service provided by Age Concern and will put individuals in touch as necessary. The home uses the Quantum Care corporate menu, which rotates over a four week period and describes a well balanced and nutritious diet. Special dietary requirements e.g. for soft foods or diabetics are catered for appropriately. The lunch served on the day of the inspection was well presented and appetising and drew favourable comments from the residents. Alternative meals were served to those not suited by the main choice. Many residents said they liked the food provided and praised the general standard, however several said that they considered it bland and rather dull. It is acknowledged that it is very hard to satisfy everybody in mass catering situations but in the light of these comments a recommendation has been made in this report for the catering manager to review the corporate menu. Fourfields DS0000019350.V266053.R01.S.doc Version 5.0 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Service users are confident that their complaints will be heard sympathetically and responded to. Service users’ interests and welfare are safeguarded by means of the home’s anti-abuse policy and the provision of adult protection training for staff. EVIDENCE: A robust complaints procedure is in place that contains the required elements to meet the standard. Most service users asked said they knew how to go about making a complaint and expressed confidence that the senior staff and manager would listen and react promptly to resolve the matter if possible. Two complaints were ongoing about matters of care practice and the manager was dealing with them in accordance with the procedure. However details were unavailable for inspection on the day therefore a recommendation has been made that these be filed in the complaints file immediately upon receipt so that a running record can be examined. Following a requirement made in the last inspection report, most care staff had attended adult protection training, with a further session booked for January 2006 to take in the remainder. Staff spoken with had a good understanding of the principles of adult protection and were aware of their responsibilities in relation to any alleged incidents or suspicions of abuse. This represents good progress since the last inspection. Fourfields DS0000019350.V266053.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 The premises offer a pleasant, safe, well maintained and comfortable environment well designed for the needs of older people who may have restricted mobility and confusion. Communal areas are homely and compact. The gardens are accessible, level and tidy. Bathroom and toilet facilities are ample for the service users’ needs. Specialist equipment is provided as necessary to maintain service users’ independence and safety. Bedrooms are safely arranged and personalised to reflect the tastes of the occupants. Heating, ventilation and lighting are effective and safe. Hot water temperatures are regulated within safe limits. The premises are kept clean and tidy and free from clutter. However there is an obvious shortage of storage space that should be addressed with the provision of extra capacity. Laundry facilities are adequate and hygienic with sufficient capacity to cope with the workload generated. Fourfields DS0000019350.V266053.R01.S.doc Version 5.0 Page 17 EVIDENCE: The home meets all the space standards. The unitised single floor design creates homely living areas that suit elderly people with restricted mobility and possibly dementia. On the day of the inspection the units were very clean and tidy, with no clutter visible and all fire exits clear. Adequate toilet and bathroom facilities are provided, although some toilets are too small to allow a service user to be assisted with the door shut. Despite the absence of clutter the manager said that the lack of storage space remained an ongoing concern given the high number of residents with mobility equipment now accommodated and she had requested the provision of a metal shed to provide extra capacity in the grounds to alleviate the pressure. This would be a positive move. Service users said they liked the units and felt comfortable in their surroundings. All furniture seen was of domestic type and suitable for the use of older people. Grabrails and other aids are provided in corridors, bathrooms, toilets, communal rooms and bedrooms. These promote independent movement by service users. The units all looked smart, following repainting of numerous areas and bedrooms. The manager has drawn up a programme of planned maintenance to be carried out over the coming year. The laundry is well equipped and able to cope with the likely workload from fifty residents. Good infection control procedures are in place. Fourfields DS0000019350.V266053.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 30 Staffing levels by day and night are sufficient to meet service users’ needs. Staff have appropriate skills and experience to identify and respond to individual needs in a consistent way. EVIDENCE: Following concerns raised at the last inspection staffing levels were reviewed by the manager and cover increased, especially at night. The staff rota indicated that there were now five care staff on duty at night and ten staff on duty during the day shifts. Care assistants spoken with confirmed that daytime levels had improved and more help was available at busy times such as early mornings. The permanent team had also been strengthened by recent recruits and this had improved morale. All staff have a training needs profile that is reviewed annually. Staff felt that they had excellent access to relevant training opportunities. New staff undergo a thorough induction programme that familiarises them with the policies, procedures and routines of the home. Fourfields DS0000019350.V266053.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 37 & 38 The manager is very experienced in the care of the elderly and has relevant qualifications and management experience, therefore is a very suitable person to manage the home. The manager communicates a clear sense of direction and has identified a number of areas for improvement in the home that should benefit service users. Most of the records required by regulation are kept correctly, although further work needs to be done to ensure accurate medication recording. The home is a safe place for service users to live in, with proper health and safety and working practices followed. However more storage space should be provided given the increasing amount of mobility equipment on the premises. Fourfields DS0000019350.V266053.R01.S.doc Version 5.0 Page 20 EVIDENCE: The manager has been in post since June 2005. She has over twenty five years experience in the care of the elderly and holds NVQ4 and the Registered Manager’s Award. She is therefore ideally qualified for the post. She has a strong commitment to raise and sustain standards and the numerous improvements noted in the operation of the home since the last inspection provide evidence of her effectiveness. Staff spoken with said that she was approachable although firm in providing guidance, especially in matters of care practice. Documentation examined such as care plans, risk assessments and the statement of purpose was correctly ordered. However as noted earlier in this report, medication recording needs tightening. It was encouraging to find evidence of regular monitoring and auditing of care plans and medication records as that form of quality assurance will undoubtedly promote higher standards. No health and safety hazards were noted and it was very positive to find the premises so much improved since the last inspection. Staff spoken with indicated that they had received mandatory training in disciplines such as fire safety, moving and handling, food hygiene etc. Fourfields DS0000019350.V266053.R01.S.doc Version 5.0 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 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X X 2 3 Fourfields DS0000019350.V266053.R01.S.doc Version 5.0 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 OP9 Regulation 13 (2) Requirement Medicines must be administered as prescribed and the reasons for any omissions must be recorded. Medicines dispensed in ordinary containers must be dated when first opened for ease of reconciliation and auditing. Suitable provision must be made for storage in the home to ensure the premises remain safe and free from clutter. Timescale for action 22/11/05 2. OP9 13 (2) 22/11/05 3 OP22 23(2)(l) 22/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP7 OP16 OP15 Good Practice Recommendations Care plans should be signed by the service user and/or their relatives or representatives. Details of formal complaints received should be immediately filed in the complaints file. The catering manager should review the corporate menu. Fourfields DS0000019350.V266053.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Fourfields DS0000019350.V266053.R01.S.doc Version 5.0 Page 24 - 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!