Inspection on 20/06/08 for Gotton Manor Care Home

This inspection was carried out on 20th June 2008.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Gotton Manor Care Home 19/10/06

Gotton Manor Care Home 01/03/06

Gotton Manor Care Home 04/08/05

Gotton Manor Care Home 10/12/04

Gotton Manor Care Home 17/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Gotton Manor Care Home West Monkton Taunton Somerset TA2 8LL Lead Inspector Unannounced Inspection 10:00 20th June 2008 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 Gotton Manor Care Home DS0000003261.V362516.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. Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gotton Manor Care Home Address West Monkton Taunton Somerset TA2 8LL Telephone number Fax number Email address 01823 413118 01823 412943 gotton.manor@fshc.co.uk Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 4 Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 5 Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Grandcross Limited(wholly owned subsidiary of Four Seasons Health Care Ltd) Mrs Susan Yvonne Stephens Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (60) of places Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 6 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Gotton Manor - Up to 27 places for older persons of either sex , not less than 60 years of age, who require general nursing care. Gotton Manor - Up to 6 places for personal care, for persons not less than 65 years of age. The Coach House - Up to 27 places for persons over the age of 65 who require personal care. 19th October 2006 Date of last inspection Brief Description of the Service: Gotton Manor Care Home is registered for 60 service users. There are two Gotton Manor and the Coach House. Gotton Manor caters for 27 people requiring nursing care and 6 requiring personal care. The Coach House caters for 27 people requiring personal care only. The providers are Four Seasons Health Care Ltd; the Registered Manager is Ms Susan Stephens. There is a registered nurse on duty at all times in Gotton Manor. The home is situated in the countryside, near the village of West Monkton, about 4 miles from the centre of Taunton. There are beautiful grounds that are accessible to service users. A large number of rooms have an open aspect and good views. Both sites share a kitchen and laundry facility. A ramp is available for wheelchair users to enter the sites. Passenger lifts and a stair lift are available to access all areas. There is a call system throughout. Locks are provided to each bedroom door. There is ample communal space available including a choice of lounges in Gotton Manor. Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 7 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who use this service experience good quality outcomes. The focus of this inspection visit was to inspect relevant key standards under the Commission’s ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are: - excellent, good, adequate and poor. The inspector made two visits to the home focusing on the Coach house on the first visit and on the main house, Gotton Manor on the second visit. On each day the manager of the home Sue Stephens made herself available to assist in the inspection process and to provide all records. A tour of the premises was made. Service users and staff were seen and spoken with. Lunch was observed in the dining areas of the home. Visitors were also seen and spoken with. Records were sampled these included care plans, medication records, staff recruitment and maintenance records. Comment cards were sent to people who live in the home, their relatives and health professionals. 10 cards from people who live in the home were returned in September 2007 and a further 8 were returned at this inspection. Overall people are satisfied with the home and pleased with the care they receive. There were some concerns that at busy times there may be a delay in answering a bell and some people felt further redecoration of the home was required. Comments from families and friends indicated that they were kept informed of any changes or issues for their people. Comments included “The care to my dad is second to none.” “Generally excellent care for my friend.” “There is a growing range of activities. They have library access now.” “Food is of a good quality.” A comprehensive Annual Quality Assurance Assessment was received. This provided detailed information about the home including achievements and challenges of the past year and plans for the coming one. The home has gained Quality Rating with Social Services and 5 stars in the local environmental health inspections. What the service does well: People spoken to throughout the home were positive and pleased with the care provided. One person in the Coach House said” I am very happy here. We are well looked after. I have been here a while.” Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 8 A person in Gotton Manor said “They are all very nice. Staff are kind.” A visitor confirmed “She seems happy here.” People confirmed that staff are kind and that the food is plentiful and “tasty”. People knew who to talk to if they had any concerns. There is a key worker system in place and people in the Coach House all knew who their key worker was. People are encouraged to spend their days as they wish. One person said “I am very happy here” was able to describe how she spent her day reading the daily papers knitting and visiting a relative in the main wing added “ I am quite busy really.” Following lunch one person was seen quietly watching the lunch time news because she “likes to know what is going on.” Other people are “more than happy” in their rooms. Activities are organised “mostly in the mornings” and trips are available for those who are able to enjoy them. The home benefits from a stable workforce. Staff spoken to were able to describe the training they had had recently. There is a good team spirit at the home. People do try to cover shifts and some “multi-task” working in the kitchen or across the two sites to ensure shifts are covered. One carer said “I have been here 7 years. I love it.” Senior care staff manage the Coach House for people with personal care needs. Staff on duty were knowledgeable and had produced care plans of a very high standard. There was evidence that nurses in Gotton Manor gave skilled care to people at the end of their lives as well as improving the health of others. The home is well managed. Sue Stephens has been manager at the home for ten years. She was very knowledgeable about all aspects of the home and was able to give detailed information on people who lived in the home. This is a big home and to have a “finger on the pulse” of up to sixty people is commendable. These views were confirmed in the comment cards returned. Two health professionals provided very positive feedback. One said “An excellent nursing home all round.” “I would be happy to be a resident.” The staff were praised. “I am extremely impressed by the quality of care given. The nurses seem highly motivated, professional and kind.” Staff and people who lived in the home found the manager to be approachable and caring whilst insisting on high standards. Staff confirmed that the manager provided strong leadership and people are protected by her approach. What has improved since the last inspection? Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 9 The home has continued to make improvements to the environment. Carpets and curtains have been replaced as part of an on-going process. New beds have been purchased including adaptable profiling beds. There have been new window restrictors installed and an improved supply of reading lamps. Gotton Manor Main House dining room has been refurbished and there is a new catering standard kitchen in place. Menus have been displayed in a larger format with daily choice clearly stated. Two new shower rooms have been installed. Activities co-ordinators have been on external courses. The library service now visits. Staff have gained experience and expertise in using the Gold Standard and company end of life care manual. Activities organisers have been on a diverse selection of external training. 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. Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 10 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 Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 11 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 6 Quality in this outcome area is good. The home provides information for service users and their families/carers. A pre admission assessment is undertaken before people are accepted into the home to ensure that their care needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is an information booklet for people who are considering coming to the home. There is a clear admission procedure. Trial periods are offered to new residents and a day at the home is offered to enquirers. The fees at the home are £522:00- £682 for nursing care (including the RNCC) and £390- £ 590 for residential care. Records in care files showed that the manager visited people prior to admission and completed a comprehensive assessment. A good summary of peoples’ health needs and social situation enables appropriate admission decisions to be Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 12 made. Transfers are possible between the residential and nursing wings of the home when peoples’ needs change and following appropriate re-assessment. Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 13 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 Quality in this outcome area is good. There is evidence that care in the home is very good. There is attention to peoples health needs. Care planning is comprehensive. People say they receive kind respectful care at all times. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Six care plans from across the home were seen. Care plans observed in the Coach House were well organised and comprehensive. There is a clear index and plans were very well maintained. They gave clear instructions regarding care to be provided but also the underlying values of respect and maintaining independence were clear in the plans. A care plan for a person recently admitted to the home included assessment of risk of pressure damage (Waterlow score) and pressure damage prevention and management guidance. There were records in the Coach House and Gotton Manor that showed people had their position changed regularly. Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 14 There was guidance on maintaining peoples safety and promoting independence including a clear request from one person not to be disturbed at night as they would “ring the bell.” In other files there was evidence that people were checked very regularly according to need. There were plans to encourage people with memory loss. Records of any bruises or small injuries were comprehensive. There was attention to peoples’ nutritional needs and it was clear that interventions for one person who had stopped eating had been appropriate and effective. There was guidance on preventing falls including an emphasis on giving a person “time”. Guidance was also included for when people accessed the grounds. Plans had been reviewed and up-dated. The home has implemented the Gold Standards Framework which is a system of care planning that ensures peoples needs are met at the end of their life. One nurse is the named “link nurse” and gave a good account of how the plan worked. There were compliments from families who felt that their relatives had been very well cared for. In addition to plans for aspects of daily living there are records of professionals visiting the home. It is useful to keep these records up to date so that at a glance staff can see when the last visit was. In Gotton Manor people who were frail and poorly appeared comfortable and peaceful. It was clear from records that people were offered regular fluids and food. It was clear from the records how much of an offered meal or drink had been taken. There are records indicating regular visits from doctors and when needed from community nurses. People visit the dentist and are assisted to get to consultant clinics. The chiropodist visits the home. People looked well presented and confirmed that the hairdresser visits regularly. Medication system is safe and records are clear although attention must be given to the clarity of signatures on the MAR charts in the Coach house. Staff receive a thorough medication training which includes an in-house assessment. There are medication audits as part of the quality assurance frame-work. The records for two controlled dugs were seen and found to be accurate. In comment cards from two health professionals there was praise for the skill of the staff and the “outcomes for long term patients.” Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 15 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 good. People are supported and encouraged to spend their day as they chose. There is a range of activities offered at Gotton Manor and the Coach House. These activities are well publicised. Meals looked appetising and service users were complimentary about the food offered. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People are able to spend their day as they wish. One person has a notice on the door saying “Private. Do not enter.” Other people spoke of being able to go out with their families. Some people come to the sitting rooms others do not leave their rooms. People are encouraged to come down for lunch but peoples’ choices are respected. Records of social activities are good. One person had visited Vivary Park and had enjoyed a recent barbeque and cream tea at the home. Families are welcome to the home and those spoken to during the inspection were pleased with the care provided. Future events included a musical afternoon and a visit from a group of “birds of prey.” Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 16 At the time of the inspection one activities person had recently left and a carer was leading an impromptu activity. A group of six people played skittles and talked to each other. There is a gardening club and specialist interests groups. During the inspection some people who were tired or unwell were seen resting or asleep. They looked comfortable and well cared for. Lunch was observed in the Coach House on the first day of the inspection.. Most people come to the dining room although meals on trays are provided to those who chose to stay in their room. There was evidence that special diets are catered for and that all people were given a choice of vegetables. Lunch was leisurely and assistance was provided when needed in an appropriate manner. There was again a choice of lunch in Gotton Manor on the second day of the inspection. The gammon was carved at the point of service and there was a choice of potatoes and vegetables. People can chose to have a salad or an omelette. People were seen to receive assistance with meals. Staff are to be reminded that a soup spoon can be difficult to eat from when it contains pureed food. Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 17 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 17 18 Quality in this outcome area is good. The home has a clear complaints policy and procedure. There are policies and procedures in place to protect people. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People in the home and their relatives and advocates were confident that their concerns would be listened to and action would be taken. There are policies and procedures in place to protect people. The home keeps a record of all complaints. Two complaints referred to the home by CSCI were investigated promptly and thoroughly by the manager. There is a low incidence of written complaints and a firm emphasis on addressing concerns as they arise. There are links with other agencies and the manager has a good understanding of safe guarding issues. Staff confirmed that they had received training although from training records this was not clear. Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 18 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. People live in a safe, well maintained environment that is adapted to their needs. A programme of up-dating and improvement is on-going. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Overall the home is very clean and tidy. Many people have wonderful country side views and some rooms have patio doors that have risk assessments that enable people to benefit from fresh air when they want to. Whilst some communal areas are looking “tired” all are comfortable and light . Bedrooms have been personalised to reflect peoples’ tastes and staff respect peoples belongings. A member of domestic staff was polishing furniture in one room and the belongings were replaced carefully “in the right place.” Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 19 All beds in Gotton Manor are nursing beds. Some are “state of the art” adjustable beds. There appeared to be plenty of pressure relieving equipment available. Two new shower rooms have been recently installed. There are plans for further refurbishment in the coming year. Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 20 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. People who use the service have confidence in the staff that care for them. Rotas show that there are sufficient staff on duty and that staff work as a team to cover shifts. There is a good recruitment procedure that is followed completely. Training takes place regularly but the planning and recording of events could be clearer. Staff are supervised and supported however this process should be formalised to meet National Minimum Standards. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a Registered Nurse on duty at all times in the Care Home. Although registered as one care home, the residential care in the Coach House is led by a Care Manager who reports directly to the homes Registered Manager, Mrs Stephens. The Coach House is overseen by an experienced and NVQ qualified senior carer at all other times. Rotas confirmed that there are adequate staff on duty although some people in the home felt that at times they were “too busy.” Staff spoken to confirmed that they had had recent training and received guidance and support from senior staff. New staff confirmed they had had a thorough induction. Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 21 Staff records were seen for a sample of new and established staff. For two new staff there were records of a comprehensive corporate recruitment procedure that includes POVA and CRB checks. Files seen contained references and documents of identification. There are interview records and health checks. The staff induction programme follows the Skills for Care format and can take three months. There was evidence that new staff are allocated a mentor. There is training going on at Gotton Manor and the Coach House but at the time of the inspection some records were erratic. Not all staff have an annual appraisal. There should be recorded supervisions to meet the NMS. The manager may wish to consider allocating some responsibility for the recording of training and supervision of staff to a senior person in the home. Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 22 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. The home has an experienced Registered Manager and the home is well run in the interests of people who live in the home. There are robust financial procedures and records are accurate. There is planned and regular maintenance of the home that protects people who live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is experienced, well qualified and continues to be committed to improvements in the home. The manager is person centred in approach and is aware of current developments in care and provision of the service. Quality assurance is important in the home. There are a number of components to the quality assurance system in the home. There is an internal Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 23 Team Audit process that is detailed and comprehensive. It contains 18 sections including all aspects of care and provision. The manager completes the check lists and as a result of the outcome a “Remedial Action Plan” is completed. This forms the basis of the home development plan for the coming year. There are customer surveys completed by people who live in the home. These cover key areas such as Personal Care, the Environment and Activities. Questionnaires are very detailed. The last summary of responses indicated that of the people who returned a questionnaire 55 found personal care to be “good” while 28 found it to be “very good.” The manager holds meetings for people who live in the home and their relatives and friends. There are notices in bedrooms “Are these bedrails safe?” and regular checks are recorded. There are comprehensive risk assessments in care plans. There is a robust system of recording peoples’ finances. Accounts are audited monthly. Maintenance is planned and organised. There is a company manual that gives guidance to the full-time maintenance man. There are contracts for the servicing of hoists which are due this month. All slings and hoists have a monthly recorded check. PAT testing had taken place on 2/06/08. There is regular testing of fire alarms. There were records of fire drills and fire training for staff. Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 24 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 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 3 3 Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP36 Regulation 18 (2) Requirement The manager must ensure that records are kept of supervision and training of staff. This will include ensuring all staff have an annual appraisal. Timescale for action 31/08/08 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 OP15 Good Practice Recommendations Staff consider the size of cutlery and peoples preferences when assisting service users to eat at meal times. Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Gotton Manor Care Home DS0000003261.V362516.R01.S.doc Version 5.2 Page 27 - 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. 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