CARE HOMES FOR OLDER PEOPLE
Garsewednack Residential Home 132 Albany Road Redruth Cornwall TR15 2HZ Lead Inspector
Lynda Kirtland Announced Inspection 15th November 2005 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 Garsewednack Residential Home DS0000054567.V258499.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. Garsewednack Residential Home DS0000054567.V258499.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Garsewednack Residential Home Address 132 Albany Road Redruth Cornwall TR15 2HZ 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) 01209 215798 01209 611924 Mr Neil Edward Brazier Mrs Nicola Carla Brazier, Mrs Anne Brazier Care Home 21 Category(ies) of Dementia - over 65 years of age (4), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (4), Old age, not falling within any other category (21) Garsewednack Residential Home DS0000054567.V258499.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. Service users to include up to 21 adults of old age (OP) Service users to include up to 4 adults over 65 years with Dementia (DE) [E] Service users to include up to 4 adults over 65 years with a mental disorder (MD) [E] Total number of service users not to exceed a maximum of 21 Date of last inspection 16th May 2005 Brief Description of the Service: Garsewednack is a private residential care home accommodating twenty-one older people requiring personal care and accommodation, of which four older people may have dementia or other forms of mental ill health. The registered providers are Mrs Anne Brazier and Mr Neil and Mrs Nicola Brazier who have been registered under the Care Standards Act 2000 since 5th February 2004. The providers purchased the home in August 2003 and two providers own another residential care home in Newquay.The home provides day care facilities for a maximum of two service users attending on the same day. Since purchasing the home the management team have been investing in the building and training the new staff team that they have recruited, reviewing the homes records, policies and operational systems, plus getting to know the service users, families and representatives. The accommodation is on two floors and due to a lift it allows access to all parts of the building for service users resident in the home. The premises are clean, decorated attractively and is comfortably furnished. There are 19 single bedrooms and 2 shared rooms. No rooms have en suite facilities but there are sufficient toilet and bathroom facilities within the home. There is a main lounge, quiet room, smoking room, dining room and garden area accessible for all service users. Management stated that it is their intention to provide a quality residential experience for those service users living at the home whilst respecting their dignity and rights. Garsewednack Residential Home DS0000054567.V258499.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Two inspectors visited Garsewednack Residential Home on the 15 November 2005 and spent 6 hours at the home. This was an announced visit. The purpose of the inspection was to gain an update on the progress of compliance to the requirements that were identified in the last inspection report dated 16 May 2005. In addition the inspector focused on the following key areas of care: choice of home, care planning, health care, leisure, complaints, staffing and some management areas. On the day of inspection 21 service users were resident in the home. The methods used to undertake the inspection are to meet with a number of residents, staff, senior carer and Mrs Anne Brazier, registered provider to gain their views on the services that Garsewednack offer. One of the registered providers also completed the pre inspection questionnaire, which is similar to a survey asking for information on what services/facilities the home provide. Completed comment cards from 3 residents in gaining their views on the home were received and assisted in the inspection process. Garsewednack records, policies and procedures were examined and inspectors toured the building. This report summarises the findings of this inspection. It is acknowledged that due to a family bereavement that this had an impact on being able to process the statutory requirements identified at the previous inspection. Therefore seven out of ten requirements have been re notified to the home. What the service does well:
Residents stated that Garsewednack provides ‘good’ care and accommodation. They made various comments about staff such as; they are ‘kind’ and ‘caring’. All residents commented that they felt that they were consulted about their care needs which staff met. Residents and staff all commented that they felt there were sufficient staff on duty. The registered providers are encouraging staff to attend training to update their knowledge in older persons care. Garsewednack have a satisfactory complaints policy. Residents commented that they felt able to raise concerns and that the registered providers would listen, investigate into their concerns and appropriate action to remedy concerns would be taken. Residents stated they had no concerns about the service that Garsewednack provides. Garsewednack Residential Home DS0000054567.V258499.R01.S.doc Version 5.0 Page 6 Residents commented that they have access to health care and felt that all their health needs were met to a ‘good’ standard. Residents felt their visitors were welcomed to the home. What has improved since the last inspection? What they could do better:
The previous inspection identified 10 requirements and 6 recommendations. Of these the registered providers have complied with 3 requirements and 3 recommendations. It is acknowledged that due to a family bereavement that this has impacted on the progress of achieving compliance. From this inspection some requirements have been re notified and some additional ones identified during this inspection. In total nine requirements and three recommendations have been identified. However the requirements that have been re notified to the home are not for the first time. CSCI have extended the timescales for achieving compliance and need to see some development in these areas. The majority of these requirements focus on: care planning, pre admission processes, reviewing and developing policies and that staff receive training in these areas plus to develop a quality assurance process. An immediate requirement was issued at the time of inspection due to a lack of evidence that staff have received POVA/ CRB clearance before commencing
Garsewednack Residential Home DS0000054567.V258499.R01.S.doc Version 5.0 Page 7 employment at he home. All staff must have a minimum of POVA first clearance before they can commence employment at the home and then must be supervised in all intimate care tasks until the CRB clearance has been gained. The registered provider must send to the CSCI a list of all staff and the status of their POVA/ CRB application. The registered providers continue to consider employing a registered manager at Garsewednack. As the registered providers own two homes with some geographical distance involved this would benefit the service to have a registered manager in day-to-day control of the home. The registered providers must review the equipment within the home to ensure that it meets current service users needs and the homes policy on moving and handling. This is re notified. The inspectors would like to thank residents, their relatives, staff and the registered provider for their kind assistance during this inspection process. 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. Garsewednack Residential Home DS0000054567.V258499.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 Garsewednack Residential Home DS0000054567.V258499.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): 3,4,5 Garsewednack have a pre admission procedure. Information from referring agencies must be gained prior to or on admission to the home. Garsewednack are encouraging staff to update their skills in the care for older people. EVIDENCE: From inspection of four residents files, this evidenced that Garsewednack have a pre admission process. However it was noted and confirmed by the registered provider and senior carer that for the latest admissions this was not always completed prior to admission, and thus some occurred on the day following admission. It was noted that in just one case a pre admission assessment was completed. The inspectors found minimal or no pre admission assessments on the other files inspected or much information where appropriate from referring agencies. The inspectors re-advised that the home consider how they can evidence that residents and their representative’s views and participation at the point of assessment where incorporated. Requirements to this effect have been re notified.
Garsewednack Residential Home DS0000054567.V258499.R01.S.doc Version 5.0 Page 10 From records inspected and in discussion with residents they commented that staff carried out the ‘moving in period’ sensitively. A requirement was identified at the previous inspection to ensure that all staff attends relevant training in older persons care especially in the areas of dementia and memory loss. It is noted that 50 of staff now have achieved NVQ level 2 in care. This is despite recent staff changes in the home. The registered provider said that some staff would be attending a dementia course, first aid and mediation training especially in the area of diabetes. The inspectors acknowledged that access to training has improved and therefore this requirement remains in progress. Throughout the inspection the inspector observed staff that displayed great skill in communicating and providing personal and emotional care to residents. Garsewednack Residential Home DS0000054567.V258499.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 Care plans must be expanded to ensure that they identify service users physical, emotional, social, educational and leisure pursuits and the interventions expected of staff to approach the care need in a consistent manner must be recorded. Health needs are met in a satisfactory manner. The registered provider must audit the number of falls in the home and ensure appropriate actions are taken to minimise further falls. Service users commented that staff at the home approaches them with dignity and privacy. EVIDENCE: The inspector noted that the development of residents care plans remains ongoing. Further work continues to be needed to ensure that all physical, emotional and social care needs are included in the care plan. The care plan must specify what staff interventions are needed to meet individual needs in a consistent manner. This was discussed with the senior carer and registered provider who agreed that these changes must be made so that the care plan accurately reflects the individuals current care needs and promotes their skills and abilities.
Garsewednack Residential Home DS0000054567.V258499.R01.S.doc Version 5.0 Page 12 It was evident that the registered provider and senior carer have gained residents and their representatives’ views in the monthly review process of their individual care plans. Documentation evidenced who participated in the review and what changes, if any were made to the care plan. From discussion with residents they all said their health needs are met and that they see health professionals in private. Residents evidenced that advice received from health colleagues are recorded as is the actions staffs have taken. Nutritional assessments are undertaken as part of the care planning process where a particular need has been identified. Some areas of health care need to be developed further; moving and handling policy must be reviewed; staff are due to attend moving and handling training; a review of moving and handling equipment in the home must occur and purchased where appropriate. It is of concern that Garsewednack does not have access to a hoist especially as some care needs have deteriorated. The registered provider agreed to review this urgently. The administration, storage and disposal of medication was inspected and met in the main in a competent manner. A recent audit from the pharmacist also confirmed this. One MAR sheet for a new resident recently admitted to the home was missing and the senior carer agreed to investigate this immediately, all others were completed correctly. The accident book was inspected and showed that accidents are recorded. The inspector advised at two previous inspections that the registered provider audits the number of accidents and if the home can take actions to minimise future accidents, this has not occurred. Residents commented that they felt that all their care needs were met. Residents did not have any issues in respect of personal care and made comment such as ‘staff are kind’ and ‘wonderful’. The inspector observed during the inspection staff that approached service users in a sensitive manner. Garsewednack Residential Home DS0000054567.V258499.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): 12,13,15 Garsewednack provides a programme of activities to promote and encourage the pursuit of service users social, educational and leisure needs. Resident’s visitors are encouraged to visit their relative. Garsewednack have reviewed with residents the provisions of meals in the home. EVIDENCE: In the main residents commented that ‘there was enough to do’ in the home if they wish to participate. Some commented they ‘would like more to do’ but when asked what activities they would like they could not name any. From discussion with residents, staff, inspection of the activities book and observations it was evident that there is a number of activities that residents can participate in if they wish e.g. monthly church services at the home, entertainers, fortnightly craft shops, knitting and reading. Residents and relatives confirmed that visitors felt welcomed to the home and that they can visit their relative in private or in communal areas. The home has an open and flexible policy to visitors and there are no visiting restrictions. Garsewednack Residential Home DS0000054567.V258499.R01.S.doc Version 5.0 Page 14 As at the previous inspection the majority of residents commented that the quality and presentation of food are to a ‘good’ standard. Residents confirmed they have a choice of food and felt that the kitchen staff in the main knew their likes and dislikes and would provide an alternative if necessary. Some residents felt that the portions of food could be insufficient at lunch and tea. In discussion with the registered provider and senior carer they agreed to review this but commented that they have especially at tea time tried to vary the menu (which was demonstrated) but that residents choose the same type of meals at this time. Since the previous inspection the fly screen in the kitchen has not yet been purchased. Therefore this recommendation remains in place. Two members of staff are due to attend food hygiene training course. It is the homes aim that one will then go to gain the intermediate food hygiene certificate. Garsewednack Residential Home DS0000054567.V258499.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 Garsewednack has an appropriate complaints and whistle blowing policy. The management team encourage residents, their representatives and staff to voice any concerns so that they can be addressed. The registered provider ensures that service users are protected from all forms of abuse. The policy must be expanded. EVIDENCE: The homes policies and procedures in respect of complaints and accessibility to advocacy service are satisfactory. There have been no expressions of concern relayed to the home or CSCI since the last inspection. Residents told the inspectors that they had ‘no grumbles’ about the care or facilities provided at Garsewednack. The home has an adult protection policy; it was required at previous inspections that this needs to be expanded to include the POVA process .It also needs to refer to the Local Authority Multi Disciplinary Adult protection procedure and DOH ‘No Secrets’ guidance. The registered provider stated that this had not occurred and has been re notified to the home Garsewednack Residential Home DS0000054567.V258499.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): 21 Garsewednack provide a good standard of décor and furnishings creating a comfortable and safe environment for those living there and visiting. The home is cleaned to a good standard but a toilet area needs to be reviewed to minimise infection control risks. EVIDENCE: This section was inspected in detail at the last visit and therefore not inspected on this occasion. However inspectors observed that the home was clean, comfortably furnished and that a planned programme of redecoration is continuing. Residents were satisfied with the accommodation and spoke highly of the cleanliness of the home. The inspector did note that one toilet had a carpet fitted, it is required that for infection control purpose that the flooring is altered to impervious flooring to minimise cross infection risks. Garsewednack Residential Home DS0000054567.V258499.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Garsewednack ensure that sufficient staffs are on duty at all times. In the main the recruitment practices are followed. However all staff must have POVA/CRB clearance before commencing employment to ensure the protection and safety of all who live and work at the home. EVIDENCE: On the day of inspection three carers, senior carer plus domestics, kitchen staffs and registered provider were on duty. Staffing ratio during waking hours is aimed to be around 1:7. At night there are two waking night staff plus a manager on call. The registered provider stated that there are currently no staffing vacancies in the home. The inspector would comment on the day of inspection there were sufficient staffs on duty and observed staff to be communicating with service users in a caring, friendly and relaxed manner. The inspector would comment that service users spoke positively about staff. One recommendation was identified to ensure that 50 of care staff has obtained NVQ level 2 status. This has been achieved. From inspection of four recently recruited staff files it was noted that all had completed application forms and two references had been gained. However there was no supporting evidence available during the inspection that POVA/CRB clearance had been gained. The inspectors saw completed CRB forms to be posted and the members of staff were currently working in the home. An immediate requirement was identified, as no staff should commence
Garsewednack Residential Home DS0000054567.V258499.R01.S.doc Version 5.0 Page 18 employment until at least POVA clearance had been gained. From then the staff member cannot undertake any personal care tasks until the CRB clearance has been approved. CSCI require that this is addressed urgently and that the registered provider send to CSCI a list detailing all staffs POVA and CRB references numbers so that we are certain that staff working in the home have appropriate checks. In addition the application form must be amended to cover a persons work history as defined in the amended national minimum standards regulations Schedule 2.6. The registered provider was in the process of updating staff and residents’ photographs during the inspection. In respect of staff training, as stated in the first section of this report the registered provider is currently accessing training for all staff. Garsewednack Residential Home DS0000054567.V258499.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): 31,32,33,35,38 The registered providers are promoting a management structure, which creates an open, positive and inclusive atmosphere. The home aims to develop quality assurance systems involving service users to monitor the quality of the home. The registered provider needs to implement a policy on the management of resident’s money to ensure robust and safe procedures are in place. Satisfactory arrangements are in place to provide a safe environment for all who live, visit or work at the home EVIDENCE: There are three registered providers who jointly own Garsewednack and are accountable for its operational aspects of the service. The inspector met with one of the registered provider during this inspection. As two registered providers also own another home they divide their time between the two homes. The registered providers have experience in the social care setting. The registered providers are considering employing a registered manager at both
Garsewednack Residential Home DS0000054567.V258499.R01.S.doc Version 5.0 Page 20 homes. Residents and staff stated that the management team are approachable and skilled to carry out the tasks of managing the home. The introduction of residents meeting has occurred and residents viewed these positively. Staff felt that their meetings were also a good venue for discussion but commented they had not occurred for sometime due to recent personal circumstances in the home. Residents, their relatives and staff were made aware of the forthcoming inspection and welcomed the inspectors to the home and participated in the inspection process. The previous requirements in respect of implementing a quality assurance survey and implementing a policy on the management of service users monies has not occurred. Therefore these have been re notified to the home. The registered providers have ensured that health and safety of service users and staff is met. Regular monitoring of the condition of the home and appropriate inspections from Fire authority and the Environmental Health department take place. Garsewednack Residential Home DS0000054567.V258499.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 X X 2 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X 2 X X X X X STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 2 X X 3 Garsewednack Residential Home DS0000054567.V258499.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 OP3 Regulation 14 Timescale for action Service users must have a pre 30/01/06 admission assessment to ensure that the home can meet their social, educational and leisure needs prior to admission to the home, as detailed in the homes statement of purpose In addition service users and their representatives views should be incorporated in the pre admission documentation/ processes. (2nd re notification.) the registerd provider must 30/03/06 ensure that all staff recieves training in older persons care especially in the area of dementia and memory loss. (3rd notification) The registerrd provider must 28/02/06 review the care plans to ensure that they record all identified care needs, aims and objectives and specify staff interventions to ensure that care is provided in a consistent manner. (fourth re notification)
DS0000054567.V258499.R01.S.doc Version 5.0 Page 23 Requirement 2 OP4OP30 18 3 OP7 15 Garsewednack Residential Home 4 OP8 12 A review must occur to ensure 28/02/06 that sufficient equipment to enable the safe moving and handling of service users must be undertaken and equipment purchased. (2nd re notification) the adult protection policy must 28/02/06 be expanded to indlude the process of POVA and appropriate training given. (2nd re notification) The toilet flooring must be 30/01/06 impervious to minimise infection control risks. Immediate requirement: all staff 15/11/05 must have relevant POVA/CRB clearance before they can commence employment. No personal care tasks can be undertaken unsupervised until these clearances are both approved. A quality assurance process 30/03/06 must be implemented. The findings of the quality assurance process must be forwarded to CSCI annually (2nd re notification) the registerd provider must write 28/02/06 a policy in the administration, management and auditing of service users monies. This policy must be implemented. (2nd re notification) 5 OP18 12 6 OP21 13 7 OP29 18 8 OP33 24 9 OP35 20,16,17, Sch 2,4 Garsewednack Residential Home DS0000054567.V258499.R01.S.doc Version 5.0 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 OP8 Good Practice Recommendations the registerd provider should undertake an audit of all falls within the home and take appropariate actions to minise future falls.(3rd re notification) Service users and/or their representatives views in respect of their health deteriorating or in the event of death should be gained and incorporated in care plan (4th notification) All staff should have an individual training profile to identify individual needs. 2 OP11 3 OP30 Garsewednack Residential Home DS0000054567.V258499.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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