Inspection on 18/08/06 for High Haven

This inspection was carried out on 18th August 2006.

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

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

Other inspections for this house

High Haven 18/01/08

High Haven 10/11/05

High Haven 15/06/05

High Haven 09/11/04

High Haven 25/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE High Haven Howdale Road Downham Market Norfolk PE38 9AG Lead Inspector Mrs Jacky Vugler Unannounced Inspection 18th August 2006 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 High Haven DS0000035183.V309756.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. High Haven DS0000035183.V309756.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service High Haven Address Howdale Road Downham Market Norfolk PE38 9AG 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) 01366 382205 01366 385586 Norfolk County Council Mrs Susan Kathleen Settle Care Home 38 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (30) of places High Haven DS0000035183.V309756.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. People who need wheelchairs to assist with independent mobility at point of admission should not be accommodated in rooms numbered 2, 3, 8, 101, 102, 107, 138, 139, 140, 148, 150 and 151 (as at 31 March 2003). 10th November 2005 Date of last inspection Brief Description of the Service: High Haven is a care home providing personal care and accommodation for up to 38 older people including eight people who have dementia. It is a local authority home owned by Norfolk County Council. The current fees are £368.72 a week. Extra charges include hairdressing £6, beauty therapist £10, chiropody £10 and newspapers and magazines. These charges are indicated in the pre-inspection questionnaire received from the Manager 26th July 2006. The home is located in the market town of Downham Market, close to the shops, pubs, the post office and other amenities. High Haven is an established two storey, purpose built home. The home’s bedrooms are all single except for one double room. There are five day rooms, a visitor’s room and an activities room. There is a passenger lift. There is a small garden at the front of the building and a large well laid out garden at the rear of the building. A large car park lies to the side. High Haven DS0000035183.V309756.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection, which involved an unannounced visit to the home and an examination of information submitted, comment cards and information held by the Commission. On the day of inspection seventeen residents were accommodated in the main unit, seven in Marham unit (dementia) and five in the Nordelph unit (reablement). The Manager, Mrs Sue Settle, was present throughout the inspection. Preparation for this inspection had taken place at the CSCI office. A tour of the premises was undertaken and several records were viewed. Eight residents and seven members of staff were spoken with. Comment cards were received from ten residents and two relatives. They all commented positively of the care provided at the home. The following judgements have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. What the service does well: Many areas of good practice have been highlighted throughout the report. High Haven offers a good standard of accommodation and generous communal space. It is well equipped to meet the needs of its residents and has a homely feel to it. Although the staff team is relatively new, they appear to be caring and staff comments included the staff are caring people, we are a good team now, I love it, its such a friendly atmosphere when you walk in the door. Residents comments included, Its a marvellous place……..Ive had help all the way through and I havent a complaint at all, the staff treat me very well, I get on well with all of them, supportive. This is commendable in such a short space of time. The care plans are very detailed, they contain a lot of information and are regularly reviewed. The Primary Care Trust have funded the refurbishment of the Nordelph unit, which is partly opened and running very well. The majority of staff have received training in re-ablement. Although it has only been open since 20th High Haven DS0000035183.V309756.R01.S.doc Version 5.2 Page 6 March 2006, it is very successful with lots of communication between the Care Coordinator and the other healthcare professionals. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. High Haven DS0000035183.V309756.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection High Haven DS0000035183.V309756.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1&6 Quality in this outcome area is good. No service user moves into the home without having his or her needs assessed and being assured that these can be met. Service users assessed and referred for intermediate care are helped to maximise their independence and return home. EVIDENCE: The last two inspections confirmed that a suitable process is in place to assess residents prior to admission and evidence suggests that this is still the case. A ten-bedded wing of the home has recently been refurbished and opened on 20th March 2006 as a re-ablement unit called the Nordelph Crescent unit. Five beds are currently in use and the others will be active from the end of the month. This unit is overseen by an experienced, competent Care Coordinator who has her NVQ level 3 and has received re-ablement training as have the staff. Prior to admission, the home receives a detailed referral from the discharge liaison nurse and the occupational therapist, and any queries are brought to High Haven DS0000035183.V309756.R01.S.doc Version 5.2 Page 9 the attention of Dr Tupper, from the hospital, who will visit the person on the ward. The care coordinator completes the care plan and the occupational therapist and the physiotherapist add their goals and aims. As this involves a joint team, the resident signs a consent for the sharing of information. Any equipment required is supplied by the community rehabilitation team. Weekly meetings take place between the healthcare professionals involved and it is reported that the home receives a great deal of support from the community rehabilitation team who visit several times a week. A kitchenette can be used by the residents to make drinks or light meals, although it is reported that some prefer not to. High Haven DS0000035183.V309756.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. The residents health and personal care needs are set out in an individual plan of care which is of a high standard. The residents are protected by the homes policies and procedures for dealing with medicines. Medication practices have improved and are well audited. Residents feel they are treated with respect and their right to privacy is upheld. EVIDENCE: The last two inspections confirmed that the care plans were well completed. However, they have considerably improved. The last inspection required more detail to be recorded regarding residents falls. A falls risk assessment is now carried out for every resident and individual falls diaries are kept. If a resident has three falls, these are referred to the falls service coordinator. The majority of staff have received training in this area and the others are booked to attend in the near future. The personal care plans and risk assessments are detailed and of a high standard. Several areas of good practice were noted, for example, an High Haven DS0000035183.V309756.R01.S.doc Version 5.2 Page 11 informative social history and a recent history leading to admission; comments are recorded at the care plan review even when there is change. Evidence was seen of the involvement of other healthcare professionals, especially with regard to the re-ablement unit. The storage, administration and recording of medications is satisfactory. Since the last inspection, risk assessments have been completed for all residents wishing to self-medicate and the medications are kept in a lockable facility in their room. With regard to the medication for one resident recently admitted part way through a medication run, it was unclear which week in the medication pack, the staff were administering from. It is therefore recommended that the Manager writes a procedure, and meets with the care coordinators, so that in these instances, they are clear. The medications for this resident were correct however. Controlled drugs were checked and found to be correct, and appropriately stored and recorded. Many medication audits are carried out including a random sample of residents medications and records, frequent refusal of medication, use by dates, medication administration records, self medication risk assessments and many more. The last one was completed on 27th July 2006. This quality of auditing is commended. From observation and discussion with residents it was evident that the staff were respectful and their privacy was upheld. They also said the staff come quickly when I need them. All residents spoken with were satisfied with the care provided and one said everybody waits on me hand and foot. The comment cards received echoed these comments. High Haven DS0000035183.V309756.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. A variety of activities are offered to the residents, although they are under review in order to improve their suitability for all residents. Visitors are encouraged and made welcome. Residents are able to exercise choice and control over their lives. Nutritious and varied meals are offered in pleasant surroundings. EVIDENCE: The standards in this group have been met for the last two inspections and evidence seen suggests that this is still the case. The home currently employs a member of staff for twenty hours a week to do the laundry, this therefore allows the carers more time to spend on activities and taking the residents out. One of the care coordinators is responsible for organising the activities. Recently the residents helped to decorate the homes float for the carnival and then they helped with serving teas for the public. The activities on offer are indicated on the board in the dining room. The manager spoke of a team plan to send a questionnaire to the residents to establish what they think of the activities, she said they can then be tailored to suit all tastes. This will be good practice as in the comment card, one resident said that the activities were too childish. High Haven DS0000035183.V309756.R01.S.doc Version 5.2 Page 13 The home has a policy for open-visiting and this is displayed in the reception area. Observation and discussion evidenced that the residents have many choices in their day to day lives. For example, activities, lifestyle, meal times and what time they go to bed and get up. The menus on offer are varied and nutritious and all residents spoken to enjoyed the food, comments included we get a good pudding, they try and please you. there is always a choice of two meals. High Haven DS0000035183.V309756.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 17 Quality in this outcome area is good. Arrangements for dealing with complaints and protecting residents are satisfactory. EVIDENCE: All of the residents spoken with felt able to speak with a member of staff or the manager if they had any concerns. They felt their concerns would be listened to and acted upon. One resident gave an example of a concern she had, and the action taken, which she was very satisfied with. The complaints records were seen and there were very few in-house complaints, all dealt with satisfactorily. Thank you cards were kept in a file and seen. Since the last inspection there have been three allegations of abuse. The adult protection unit have been involved and none were substantiated. All staff have received training on the protection of vulnerable adults during their induction and NVQ training, and 17 (out of 34 staff) have received outside training in this. The Manager said that adult protection and the whistle-blowing procedure are also discussed during staff meetings. High Haven DS0000035183.V309756.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 25 & 26 Quality in this outcome area is adequate. Residents live in a comfortable and safe environment, but some areas need redecorating and requirements and recommendations have been made to improve the general maintenance, and accessibility for residents to outside areas. EVIDENCE: Displayed in the reception area is information relating to the home including the inspection report, the statement of purpose, Tell us What You Think leaflets, the weekly activities programme and a News and Views leaflet, which is a monthly newsletter written by a Care Coordinator. The News and Views leaflet is very informative and interesting, it contains topical comments, forthcoming events, birthdays, facts for that month and much more. This leaflet is commended. The home actively encourages comments by having a suggestion box and comment cards in this area. There are many photographs of residents displayed in the hallways. High Haven DS0000035183.V309756.R01.S.doc Version 5.2 Page 16 Since the last inspection the shrubs have been cut back from the pathways. The home has some old metal window frames, many of which need repainting internally and externally. Some are very difficult to close therefore the residents are unable to independently open or close their windows and may also live in a draughty environment if the window does not close properly. The Manager said that the Senior Premises Officer is aware and the Borough Council want to improve one elevation at a time for aesthetic reasons. A requirement has been made. Some parts of the home are looking tired and there are wheelchair scuffs around doorways. The toilets and bathrooms need redecorating and making more homely. A requirement has been made. Consideration should be given to making the garden more accessible to residents as currently they have to walk down a long slope and across the grass to get to the patio area, and this would be very difficult for wheelchair users. Radiators have been guarded and water temperatures regulated providing a safe environment for the residents. The home in general is well decorated clean and bright and has a comfortable homely feel to it. There are many communal areas available and residents were seen to be using these freely. Since the last inspection all wheelchairs are audited and checked monthly, and any faulty wheelchairs are labelled. There is sufficient specialist equipment available within the home to meet the assessed needs of residents. The Nordelph Crescent unit is a ten-bedded re-ablement unit, which has been completely refurbished and is very pleasant. It has a kitchenette, an assisted bathroom and an unassisted bathroom. Any equipment needed is supplied by the community rehabilitation team. Some areas in Marham Lodge are in need of attention. For example, there are many wheelchair scuffs, ceiling cracks in the lounge and the railings in the garden outside the lounge need painting. One bathroom does not have a control valve fitted for the hot water and toiletries are stored on a shelf. During the inspection this bathroom was found to be locked and the staff said it was always kept locked. However, it is recommended that a control valve be fitted to this hand wash basin as the water was very hot, and that a lockable storage cupboard be fitted in which to store toiletries. Consideration should be given to the development of the communal area in this unit as the residents currently are limited to a lounge/dining room. Consideration should also be given to providing the residents with safe access to a secure part of the garden. It was also noticed that some of the cushions on the easy chairs did not fit, however, the Manager said that funding for five replacements had been agreed. High Haven DS0000035183.V309756.R01.S.doc Version 5.2 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 Quality in this outcome area is good. Residents needs are met by the numbers and skill mix of staff and they are in safe hands at all times. Residents are protected by the homes recruitment procedures. Staff are trained and competent to do their jobs. EVIDENCE: The Manager works full-time. Twenty-nine residents were accommodated on the day of inspection. The duty rota shows there to be a Care Coordinator working from 7am - 10pm and additionally, the Care Coordinator for the Nordelph wing works another eighteen hours a week. Their responsibilities involve management tasks as well as caring when needed. In addition, two carers work in Marham unit and one in Nordelph unit, which will be increased to two when the ten beds are opened. Three carers, including a senior, work in the main unit throughout the day. Three carers work during the night, one of whom is dedicated to the Marham unit. In addition there is a laundry assistant and a domestic on a daily basis. As highlighted in the last report, the arrangements for the staff morning hand over in the Marham unit are not satisfactory. However, the Manager said that it has been agreed for the staff hours to be changed, although this has not yet been implemented. The requirement is therefore repeated. The administrator works fifteen hours for the home and additionally coordinates the meals on wheels facility. High Haven DS0000035183.V309756.R01.S.doc Version 5.2 Page 18 All residents spoken with were happy with the level of staffing saying staff are supportive, staff are always there when needed, I ring the bell day and night and someone comes. All the Care Coordinators have achieved the NVQ level 3. However, only three carers out of the twenty-nine employed have achieved the NVQ level 2. This situation has arisen as this is a relatively new staff group, since the new Manager has taken over. A care coordinator said that nine staff were booked to commence the NVQ training with a company, but it was then cancelled. However, it is a requirement that this level of training is improved in order to meet the standard. Recruitment files were randomly viewed and they evidenced good recruitment practices, including two references and the relevant criminal buraeu checks. There was however a volunteer who did not have a criminal check in place and this was applied for by Norfolk County Council on the day of the inspection. Each member of staff has an Evidence of Learning file. This is a relatively new staff group and they spoke of their induction and foundation training. All mandatory training has been undertaken and other training such as rehabilitation, vulnerable adults, oppressive behaviour, dementia, falls awareness, personal care and continence management. During the day of inspection a first aid course was being conducted. A plan was seen for other training. A care coordinator is responsible for in-house training and evidence was seen of sessions booked. It is required that all staff working in the Marham unit receive training in dementia. High Haven DS0000035183.V309756.R01.S.doc Version 5.2 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 Quality in this outcome area is good. The home is well managed by an experienced, competent manager. She demonstrates leadership and instills confidence in both resdients and staff. The home is run in the best interest of service users. Service users financial interests are safeguarded. The health, safety and welfare of residents andstaff are promoted and protected. EVIDENCE: The Manager has been in post at this home for ten months and was registered in March 2006. She was previously a Care Coordinator at one of the proprietors other homes. Mrs Settle is a Registered Nurse, has completed the NEBs Management training and she has nearly completed the Registered Managers Award. Many other training courses have kept her knowledge updated. High Haven DS0000035183.V309756.R01.S.doc Version 5.2 Page 20 Staff and residents speak highly of the Manager and she is commended for her management of the recent situation when the home was struck by lightening. Residents spoken to said that the staff were excellent, we all knew what was happening. The home has a quality assurance system in place and many audits are undertaken by the manager or care coordinators. For example, medication, care plans, health and safety. A kitchen comment book is in use to ensure continuity as the home does not currently have a permanent cook. Satisfaction surveys were seen ready to be posted to residents and their relatives and when they have been completed the results should be made available to current and prospective residents and other interested parties. A copy of the homes team plan for July 2006 was seen. This is identifying the standards which they feel could be improved. It indicates who will be responsible for the action and a timescale. This is good practice. A random sample of eleven residents financial records were viewed. The monies were all correct and the records indicated the income and expenditure, and receipts were kept and numbered. A sample of service certificates were seen and these were in good order. The accident records were detailed and included any follow-up action. The fire records were in good order with regular tests, drills and training. Since the last inspection the manager has contacted the fire officer with regard to the designated fire assembly point, and a method for keeping the gate locked has been agreed. However, it would be more satisfactory if the residents in Marham unit (dementia) had a secure garden. High Haven DS0000035183.V309756.R01.S.doc Version 5.2 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 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 3 3 X X 3 3 STAFFING Standard No Score 27 3 28 1 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 X X 3 High Haven DS0000035183.V309756.R01.S.doc Version 5.2 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 OP19 Regulation 23 (2)(d) Requirement The Registered Person must submit a plan of improvement to the Commission of those areas of the home which are tired, including repairing wheelchair scuffs and the redecoration of the bathrooms and toilets to make them more homely. The Registered Person must submit a plan of improvement to the Commission which includes making the gardens accessible and safe for all residents, and a secure garden for those residents with dementia. The Registered Person must submit a plan of improvement to the Commission for redecorating and replacing the windows causing the most discomfort. The Registered Person must ensure that a thermostatic control valve is fitted to the hand wash basin in the bathroom in the dementia unit. The Registered Person must make suitable arrangements for the care of service users during staff hand over periods. Repeat DS0000035183.V309756.R01.S.doc Timescale for action 30/11/06 2 OP19 23 (2)(o) 30/11/06 3 OP24 23 (2)(b) 30/11/06 4 OP25 13 (4) 30/11/06 5 OP27 18(1)(a) 30/11/06 High Haven Version 5.2 Page 23 6 OP28 18 (1)(a) 7 OP29 18 (1) (c)(i) requirement (previous timescale of 30.11.05 not met). The Registered Person must ensure that the number of staff achieving the NVQ level 2 or above qualification is increased. The Registered Person must ensure that all staff working in the dementia unit receive the appropriate training. 31/10/06 30/09/06 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 OP9 Good Practice Recommendations It is recommended that the manager issues guidance to staff regarding the starting point for residents medications when they are admitted part way through the month. High Haven DS0000035183.V309756.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI High Haven DS0000035183.V309756.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!