Inspection on 24/04/07 for Herewards House

This inspection was carried out on 24th April 2007.

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

Herewards House 17/04/08

Herewards House 08/06/06

Herewards House 23/01/06

Herewards House 10/05/05

Herewards House 05/10/04

Similar services:

St Vincents

The Cotswold Home

Winton House

Newbeech House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Herewards House 15 Ray Park Avenue Maidenhead Berkshire SL6 8DP Lead Inspector Chris Sidwell Unannounced Inspection 24th April 2007 12:00 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 DS0000060965.V331557.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. DS0000060965.V331557.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Herewards House Address 15 Ray Park Avenue Maidenhead Berkshire SL6 8DP 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) 01628 629038 Mr Bedanan Guru Seegoolam Mrs Dhanwantee Seegoolam, Mrs Sangeeta Rukunny, Mr Bolah Rukunny Mr Bolah Rukunny Mr Bedanan Guru Seegoolam Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places DS0000060965.V331557.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th June 2006 Brief Description of the Service: Herewards House is situated in a quiet residential area of Maidenhead. There is a parade of shops in walking distance with the River Thames close by. The building has been converted and extended to provide residential accommodation for 27 elderly persons. The home has a conservatory with access to the garden, a dining room and separate lounge. Some bedrooms have en-suite facilities. Since July 2004 the home has been under new ownership, and is managed by the proprietors. The current scale of charges is £400-450 per week. Additional items include sweets, cigarettes, hairdresser, chiropody and newspapers. DS0000060965.V331557.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was conducted over the course of three days and included a one day unannounced visit to the home. The key standards for older people’s services were covered. Information received about the home since the last inspection was taken into account in the planning of the visit. Prior to the visit, a questionnaire was sent to the manager with comment cards for distribution to residents, relatives and visiting professionals. Nine residents returned the questionnaires. Residents and families were also spoken to on the day of the unannounced visit. Discussions took place with the manager and care staff. Care practice was observed. A tour of the premises and examination of some of the required records was also undertaken. The homes approach to equality and diversity was considered throughout. What the service does well: What has improved since the last inspection? Medication management has improved and resident receive their medication regularly and reliably. Activities are offered on a regular basis, although some residents said that they would like to go out more. New crockery and cutlery has been purchased to improve meal times. There has been an improvement in the management of complaints and residents said that any concerns were addressed promptly. The manager is DS0000060965.V331557.R01.S.doc Version 5.2 Page 6 more knowledgeable about the local authorities safeguarding procedures and some but not all staff have received training in this topic. Some areas of the home have been refurbished and many rooms have been repainted. A programme to improve the bathrooms has been commenced. Standards of cleanliness in the main areas of the home are good and there were no offensive odours. The manager has registered with ‘Skills to Care’ and all staff have had a personal development plan agreed with them. The management of the home has improved and one of the proprietors now manages the home on a full time basis. What they could do better: Information about the home should be provided in other formats suitable for those who cannot read it in the standard format. The manager should work with residents and families to ensure that residents have adequate clothing including socks and stockings and suitable footwear to reduce the risk of residents falling. The manager should work with residents and their families to ensure that residents have the opportunity to have their hair styled and permed if they wish, to help maintain their self-esteem. Whilst the standard of the food is good the manager should review the provision of meals in line with guidance entitled ‘Highlight of the day’ available on The Commission’s website www csci.org.uk . A senior member of staff should seek training in delivering therapeutic activities in care settings. All staff must have basic training in safeguarding vulnerable adults, with annual updates. A realistic development plan for the home to include the necessary refurbishment should be developed with annual priorities set. The unsafe floor in the second floor bathroom must be replaced and the bathroom refurbished. Control of Infection policies must be updated in line with guidance from the Department of Health. The recruitment procedures must be improved to ensure that the work history of all potential employees is known. The ‘POVA first’ check must be DS0000060965.V331557.R01.S.doc Version 5.2 Page 7 undertaken if staff are to commence work before the full Criminal Records Bureau disclosure is received. The quality assurance and monitoring systems in the home should be developed further to ensure that care is of a consistently high standard. 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. DS0000060965.V331557.R01.S.doc Version 5.2 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 DS0000060965.V331557.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There is information available to potential resident to help them decide whether the home can met their needs. EVIDENCE: There is information available to service users in the form of a Statement of Purpose, Residents’ guide and brochures. These documents have been updated recently. Six of the nine residents who returned the questionnaires said that they had received enough information about the home prior to moving. Two said that daughter and sons had chosen for them. One resident commented ‘I was shown around and all my questions were answered’. Another stated that ‘the internet report was helpful’. The information provided is not yet available in other formats to assist those who may not be able to read the information in the standard format. It is recommended that this be considered. DS0000060965.V331557.R01.S.doc Version 5.2 Page 10 The care of three residents was followed through in detail. Their files showed that the manager had visited them and assessed their needs prior to the move. The assessment document has been updated to include the information that is specified in the standards. The files also contained care managers assessments and discharge information from hospitals. The home does not offer intermediate care but can offer respite care. DS0000060965.V331557.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The personal, healthcare and medication need of people who live in the home are met and in a manner which protects their dignity. EVIDENCE: The care of three residents was followed through in detail. All had care plans, which had been reviewed on a monthly basis. The content of the care plans had improved since the last inspection and there was more information to help carers. Relevant risk assessments had been undertaken. There was evidence that residents care needs as identified by care managers had also been incorporated in the care plan. There was also some evidence that residents and families had been involved. All the residents who returned the comment cards said that staff listened and acted upon what they said and those spoken to on the day said that they had been able to say what care they would like. The files showed that the general practitioner visited residents regularly and that resident’s health needs were monitored by the home. All the residents who returned the comment cards said that they received the medical support that they needed. Residents are weighed regularly and the records showed that for most their weight was stable. There are moving and handling risk DS0000060965.V331557.R01.S.doc Version 5.2 Page 12 assessments in place. Everyone had a drink in the lounge. The residents spoken to said that the doctor or nurse from the local Primary Health Care Trust visited them if they asked. One resident had moved to the home with a history of falls. She had a falls risk assessment in place and a care plan. Her medication had been reviewed and the records showed that her mobility had improved. There are medication policies and procedures in place. The staff who administer medication have received training to do so. Records are kept of medication received and returned by the home. The medication administration records were completed in full with no gaps. The medication cupboard has been moved to the dining room from the conservatory and the temperature is recorded daily. Whilst it is cooler in the dining room this does have the effect of making the dining room appear institutionalised. This should be considered when placing essential equipment. The staff were observed to be respectful of residents. Some chose to stay in their rooms and not to join the others in the lounge. Residents were wearing their own clothes although not all residents had stockings or socks. Some had ill-fitting slippers. The manager should work with families to ensure that all residents have adequate clothing, socks, stockings and suitable footwear to maintain their dignity and to reduce the risk of residents falling. The personal care needs of residents had been met although several had very untidy hair. The staff said that the hairdresser visited every two weeks. The home should work with residents and families to ensure that residents have the opportunity to have their styled and permed, if they wish or if that was their usual style, before moving to the home. This will help residents to maintain their selfesteem. DS0000060965.V331557.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who live in the home are able to choose how they spend their day and a programme of in house activities is arranged to bring diversion and interest to the day. The meals in the home are good although the presentation and choice of food could be improved. EVIDENCE: The residents spoken to said that they had a choice as to how they spent their day. One said that she would like to go out more often but needed a companion. Mealtimes are at a fixed time although the staff said that a cold snack could be provided if a resident missed a meal. There is a daily activities plan which is displayed for residents. This comprises morning and afternoon activities, which are led by a named carer. These are recorded. Residents have a choice as to whether they join in or stay in their rooms or another lounge. One resident spoken to said that she enjoyed ‘a little diversion’. On the day of the inspection a carer was leading a singsong, which many of the residents clearly enjoyed. The residents who returned the questionnaires said that the home usually or sometimes provided activities. One resident said that she ‘would like to get out more especially in the spring and summer’. The residents spoken to said that their relatives and friends were welcome at the DS0000060965.V331557.R01.S.doc Version 5.2 Page 14 home at any time. The contact details of local advocacy groups were available for residents. There is a four-week menu plan. The resident spoken to said that they did not receive a choice of main meal although an alternative would be provided if they did not like the meal on offer. Although the weekly menu plan followed by the chef showed an alternative, a daily menu describing choices for residents should also be considered. The residents spoken to said that they enjoyed the food, as did those whose returned the questionnaires. One resident said that ‘the chef prepares nice meals for us’. The chef and the manager said that they would be able to provide meals to meet individual resident’s cultural needs, although none were required at the moment. Some new crockery, cutlery and glasses had been bought since the last inspection although the dishwasher had dulled the plastic glasses. Residents did not have the opportunity to serve themselves and tea was served from a trolley with the sugar put into the cups before they were handed to the residents. The manager should review the way in which meals are served to enable those residents who can to serve themselves to do so and to promote their independence. DS0000060965.V331557.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are policies and procedures in place to protect residents who feel that their concerns are addressed. People who live in the home would be further protected if all staff were to have training in safeguarding vulnerable adults. EVIDENCE: There are complaints policies and procedures in place. Seven of the nine residents who returned the questionnaires said that they knew how to make a complaint. A complaints log is kept. One person spoken to said that they had had occasion to complain and that their concern had been addressed immediately. The Commission for Social Care Inspection has not been notified of any complaints. There are safeguarding policies and procedures in place. The manager was aware of the local authority responsibility in this area and knew who to refer to if he had concerns. The staff spoken to were confident that they felt able to report any concern. Twelve of the twenty-one staff had had safeguarding training, although not all within the last year. The manager must ensure that all staff have training in safeguarding vulnerable adults with annual updates. DS0000060965.V331557.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 22 and 26 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Recent investment has improved the décor and safety of the home, although further investment is required if all areas are to be safe and comfortable for residents. Infection control standards are adequate although the policies and procedures should be updated to reflect latest guidance and general cleanliness in some areas should be improved. EVIDENCE: The home is situated in an Edwardian building in a pleasant residential area. The building is in need of refurbishment some of which has been undertaken in the last year. The external doors have alarms to protect residents and the perimeter of the garden has been made secure. Ceiling fans have been fitted to the conservatory. Some bathrooms have been refurbished although there remains a need to refurbish the bathroom on the second floor and to improve the flooring, which could be a trip hazard. There is a new call bell system. A new washing machine has been purchased although the laundry floor is DS0000060965.V331557.R01.S.doc Version 5.2 Page 17 carpeted and it is recommended that the laundry have an impermeable floor surface. The recommendations of the last environmental health officer’s report have been undertaken with the exception that additional cleaning in the kitchen has not yet been undertaken. The manager said that the kitchen would be deep cleaned as a priority. There are some infection control policies and procedures in place. They should be updated in line with guidance issued by the Department of Health in June 2006. The home was clean and tidy on the day of the unannounced visit with no offensive odours. DS0000060965.V331557.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The staffing levels are good and staff have access to training to give them the knowledge and skills that they need to care for residents. The recruitment procedures should be improved to ensure that unsuitable people are not employed to care for residents. EVIDENCE: A staff rota is maintained. There are six members of care staff on duty in the morning, three in the afternoon and evening and two at night. All the residents who returned the questionnaires said that the care staff were always available to help them when needed. The manager is reviewing the shift patterns of two members of staff who have worked a late shift followed by a night shift at their own request to ensure that their workload is such that they can are able to give good care at night. Since the last inspection the manager has made arrangements for more care staff to undertake the National Vocational Qualifications in Care at Level 2. Of the nineteen care staff, six hold the National Vocational Qualification in Care at Level 2 and a further four are undertaking it. Two members of staff hold the National Vocational Qualifications in care at Level 3. This almost meets the standard that 50 of care staff hold this qualification. DS0000060965.V331557.R01.S.doc Version 5.2 Page 19 Four recruitment folders were looked at in detail. All had evidence that their identity had been checked and two references had been sought. They had appropriate work permits. Criminal Records Bureau (CRB) checks had been undertaken for all, although a ‘POVA first’ had not been undertaken for one carer who commenced work before the full CRB disclosure had been received. This must be addressed in future and no staff should commence work until a POVA first has been obtained or the full Criminal Records Bureau disclosure received. The current application form in use did not include the applicants work history. This must be remedied and a full work history with accurate information regarding former employers must be sought from all employees. It is recommended that the manager review the recruitment processes in line with guidance available on the Commission’s website www.csci.org.uk. The manager has registered with ‘Skills to Care’ and has assessed all staff and developed a personal development plan identifying the training needs of all staff. A training plan has been commenced and records are kept. Staff have received training in medication administration and dementia care during the last year as well as some mandatory health and safety training. DS0000060965.V331557.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The management of the home has improved since the last inspection and the manager has an understanding of the areas in which the home needs to improve. The quality assurance and monitoring systems should be developed further to give confidence to residents and their families that the service is consistently well managed and in line with their wishes. EVIDENCE: One of the proprietors has taken the role of full time manager since May 2006. He has registered with Commission for Social Care Inspection and is currently undertaking the National Vocation Qualification in Care and Management at Level 4. The staff spoken to said that he was approachable and that the atmosphere in the home was happy. DS0000060965.V331557.R01.S.doc Version 5.2 Page 21 An annual development plan with associated costs was sent to the Commission following the last inspection and progress has been made to achieve this. There is a need to maintain this process and agree a realistic rolling programme of development and refurbishment of the home. Formal surveys of residents’ and their families’ views are sought and evidence was seen that their suggestions are put into action. The requirements made at the previous inspection have been addressed in a proactive manner and have been met or there is a plan in place to meet them. The proprietors do not manage any finances on behalf of residents and any expenditure incurred on their behalf is invoiced to them. The pre-inspection questionnaire shows that regular maintenance of services and equipment is undertaken. Basic training for staff in manual handling, food hygiene and health and safety has now commenced although the programme must be completed and all staff must have training in these topics. Sufficient staff must be trained in first aid to have one on duty at all times. This includes the night staff. An occupational therapist has reviewed the moving and handling equipment and the manager is awaiting his report. DS0000060965.V331557.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X 2 2 X X X 2 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 DS0000060965.V331557.R01.S.doc Version 5.2 Page 23 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 OP18 Regulation 13(6) Requirement All staff must have training in safeguarding vulnerable people to ensure that they have the knowledge to protect older people from harm. The bathroom floor on the second floor must be replaced and the bathroom refurbished. Control of Infection policies must be updated in line with guidance from the Department of Health. The recruitment procedures must be improved to ensure that the work history of all potential employees is known. The ‘POVA first’ check must be undertaken if staff are to commence work before the full Criminal Records Bureau disclosure is received. All staff who handle food must have food hygiene training Moving and handling training must be provided for all staff. There must be a carer qualified in first aid on duty at all times. Timescale for action 31/07/07 2 3 4 OP21 OP26 OP29 23(2)b 13(3) 19 and schedule 2 and schedule 4 30/09/07 31/07/07 30/06/07 5 6 7 OP38 OP38 OP38 13(3) 13(5) 13(4) 31/08/07 31/08/07 31/08/07 DS0000060965.V331557.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP1 OP10 Good Practice Recommendations Information for residents about the home should be provided in other formats suitable for those who cannot read it in the standard format. The manager should work with residents and families to ensure that residents have adequate clothing including socks and stockings and suitable footwear to reduce the risk of residents falling. The manager should work with residents and their families to ensure that residents have the opportunity to have their hair styled and permed if they wish to help maintain their self esteem. A senior member of staff should seek training in delivering therapeutic activities in care settings. Whilst the standard of the food is good the manager should review the provision of meals in line with guidance entitled ‘Highlight of the day’ available on The Commission’s website www csci.org.uk . The manager should review the recruitment policies and procedures in line with guidance entitled ‘Better safe than sorry’ on The Commissions website www.csci.org.uk A realistic development plan for the home to include the necessary refurbishment should be developed with annual priorities set. The quality assurance and monitoring systems in the home should be developed further to ensure that care is of a consistently high standard. 3 OP10 4 5 OP12 OP15 6 7 8 OP29 OP33 OP33 DS0000060965.V331557.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 DS0000060965.V331557.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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