Inspection on 31/12/07 for High Street, 56

This inspection was carried out on 31st December 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

High Street, 56 02/12/09

High Street, 56 31/08/06

High Street, 56 06/09/05

High Street, 56 15/04/05

High Street, 56 29/11/04

High Street, 56 13/04/04

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

CARE HOMES FOR OLDER PEOPLE High Street, 56 Chislehurst Kent BR7 5AQ Lead Inspector Miss Rosemary Blenkinsopp Unannounced Inspection 09:10 31 December 2007 st 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 DS0000006905.V346309.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. DS0000006905.V346309.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service High Street, 56 Address Chislehurst Kent BR7 5AQ 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) 020 8468 7016 020 8468 7016 Community Options Limited Mr Cliff Mark Barry Care Home 10 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (10) of places DS0000006905.V346309.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 10 Elderly persons of either sex suffering with mental illness Date of last inspection 31st August 2006 Brief Description of the Service: This facility is part of the Community Options group of homes. This service is registered for ten residents in the category of mental disorder, excluding learning disability. At the time of the visit there were nine residents in the home, one was attending a hospital appointment. The home is a large detached house in the centre of Chislehurst High Street. There are three floors and bedrooms are located over two floors. There are two sitting areas and a separate dining facility. There is a dedicated smoking room. There is parking to the front of the building. The service is for those residents who have long-term mental health problems. The majority of the residents are now in their later years Staffing is provided throughout the 24-hour period including waking night staff. The fees for this home are made up of £ 361.61 Local Authority contribution and £98.60 from the resident. DS0000006905.V346309.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 unannounced by one inspector. The site visit was relatively short, as staff had little time to spend with the inspector as all were fully occupied .The Manager too had little time although did provide the inspector with all items as requested. Residents in this home have limited ability to concentrate and several did not wish to talk with the inspector at all. Prior to the inspection the AQAA had been completed and good information was contained within it. Several comment cards were sent out prior to the inspection although only one was received from a Care Manager prior to the inspection. During the site visit one resident’s comment card was received. A tour of the premise was undertaken including individual bedrooms and communal areas. A selection of documentation was inspected including individual care plans and supporting records. Health and safety service records as well as quality assurance information was inspected. What the service does well: The service is part of the Community Options group of homes who operate within home specialise in providing services for those suffering from mental health conditions. Community Options have a number of facilities, which are registered as well as unregistered establishments. Community Options have a wealth of experience in the field of mental health and within the organisation are a number of qualified mental health nurses. The company have established good links with members of the multi disciplinary team and local services. The company place great value on staff and ensure they are provided with regular and on going training to ensure that they are competent to do the work they do. Senior support is always available. Staff turn over in this home is minimal. It was evident that comprehensive assessments are conducted prior to any new admission and included within those records was evidence that the resident had opportunities to sample the service. DS0000006905.V346309.R01.S.doc Version 5.2 Page 6 Within this home it was evident that a great effort is being made to ensure that the premises remain pleasant, tidy and odour free. 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. The summary of this inspection report can be made available in other formats on request. DS0000006905.V346309.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 DS0000006905.V346309.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are fully assessed and supporting information obtained prior to any trail period in the home. This assessment process provides residents with an opportunity to sample the service and staff to have information about the potential admission. EVIDENCE: The inspector selected tow newly admitted residents to case track. As part of the case tracking the admission assessment information and care plans were inspected. The residents met briefly with the inspector during the site visit. The inspector saw evidence of the licence agreement and individual service agreement for both residents. These were signed and dated by the resident. Residents are subject to a three month probationary period and this is confirmed by way of a letter. Written confirmation of the home’s ability to meet resident’s needs was on file. DS0000006905.V346309.R01.S.doc Version 5.2 Page 9 In the first file there was good information obtained by the Manager following an assessment visit. This was well documented. One resident had been subject to four separate assessments prior to moving in Evidence of the individual assessments were on file and provided a good overview of her needs. Information relating to the medication that the resident required was also available. A letter is sent to the next of kin advising of the move into High Street. Other information included old CPA documentation and information on benefits and finances. In one file there was form headed “ Application for residential projects “ which contained good information. The home provides residents with a Statement of Purpose and Service User Guide which details the service and facilities provided. In light of re current dependency in the home the Manager must ensure that the needs of the residents, who are already in the home, are carefully considered before any future resident is accepted. DS0000006905.V346309.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual care plan formats are in place and are reflective of assessed needs. The combined information in the two documents provides staff with a framework to address needs. Medications were safely stored, with supporting records maintained to a good standard, thus ensuring residents are provided with safe medication systems. EVIDENCE: Within this home there are ten resident of mixed gender. Eight residents are on Enhanced Care Programme Approach, whilst two are subject to no aftercare arrangements. The home is for residents with mental health issues. It was very noticeable at this inspection the level of physical dependency amongst residents, including two wheelchair users, incontinence as well as presenting mental health issues. DS0000006905.V346309.R01.S.doc Version 5.2 Page 11 The Manager advised the inspector that he had referred three residents to the older adults team and one to a brain injury unit. In light of the current incontinent problems he had sought the advise of the continence advisor as well as ensuring that all protective clothing was made available to staff. Training on incontinence was planned for January 2008, and a revision of the infection control policy was underway. The two staff interviewed had a good knowledge of infection control principals and food safety. The care plans of the two residents included as part of the case tracking were inspected. Both care plans had a brief overview of risk and thereafter, individual more comprehensive risk assessments. The two files had two formats for recording care plan issues. The first was the original Community Options format, which was brief and provided limited details of interventions and objectives, and did not fully reflect the identified needs of the resident. The second format was a document headed “ care plan”. This contained good information although was without a stated objective or a review date. In addition the issues were generic and not specific to the individual. The two documents together outlined the residents needs although if they had of been combined would have given a comprehensive care plan format. There was supporting information obtained through the CPA including a care plan in one file dated August 07 This provided good information. Included in the multidisciplinary information was a wheelchair referral for one resident. Other correspondence from multidisciplinary team members included an occupational health referral and a subsequent report, a diabetic screening appointment and hospital appointment letters. Other information regarding health appointments was located in the diary and in the “Recordmaster”, which provided more details of the actual appointments and treatment. There were a number of additional charts in use for the monitoring of issues such as incontinence and untoward behaviour. Weight charts were in use for one of the two residents included in the case tracking. One gentleman had weighed 10 stone 11 pounds July06; by October 07 he had lost two stones. The last entry for this resident, indicated a further weight loss of 12 pounds, this was dated 4/11/07. In the event that residents are loosing weight, close monitoring of the situation must be in place. The Manager was aware of the weight loss and there was involvement of the multi disciplinary team. Physical health investigations were underway. There was limited reference to food intake included in his care plan. DS0000006905.V346309.R01.S.doc Version 5.2 Page 12 Currently there are no resident who self medicate. On the medication charts clear photographs were attached and the allergies recorded. Those medications returned to pharmacy were recorded and a list of staff signatures of those administering medications was in the front of the file. The medication cupboard was tidy and there was no overstocking evident. No controlled drugs were in use. Information relating to medications in use, was available and provided staff with information on side effects etc. Other supporting charts such as blood sugar testing were also on file. Hand transcribed medications had two staff signatures as confirmation of the record. One” as required” medication needed full instructions to be included. DS0000006905.V346309.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Rehabilitation activities are limited because of a number of factors including the resident’s ability and staff availability. Staff were occupied with addressing physical health needs hence there was little time to support residents with other aspects of rehabilitation that they required. EVIDENCE: At the time of the site visit several resident were in the home either in the communal areas or their bedrooms. During the course of the morning limited engagement with resident was observed, only once was a resident accompanied out of the home by a staff member. Other activities were in the main the TV, radio and newspapers. Little in the way of active rehabilitation was observed. Staff seemed to be fully occupied with tasks such as dealing with incontinence and cleaning areas. Within the records inspected there was written documentation relating to activities in house and locally in the community. DS0000006905.V346309.R01.S.doc Version 5.2 Page 14 Residents are provided with opportunities to make choices and be involved in decisions regarding the running of the home. Community Options actively see the views of residents in their care and encourage resident representation at senior level including the Annual General Meeting. Residents with whom the inspector met were positive about the service staff and the accommodation provided. One resident who met with the inspector said, “ This was the best home I’ve ever been in”. In addition, over the Christmas period she said, “ the food was bloody marvellous- and I ate all the time “. One resident attends the day centre. Visiting is open to encourage family contact. Home visits, to family and friends, can be arranged and overnight leave facilitated if requested. Residents are able to come and go in the main unaccompanied. They are provided with freedom passes that enables them to travel free on public transport. Please see requirement 1. DS0000006905.V346309.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are taken seriously and investigated thoroughly which ensures that residents can be confident when raising concerns. Staff had a sound knowledge of adult protection and the reporting of such matters. They are provided with regular training to ensure their knowledge is updated. EVIDENCE: The home has available and on display the complaint’s policy, which included external bodies for the referral of such matters. Community Options have comprehensive complaints procedures, which details time frames for action and response times. In previous dealings with Community Options the inspector has found them to be open and receptive to complaints. The home has a complaints monitoring form for recording of complaints and this includes details of whether the complainant is satisfied with the outcome of the investigation. Within the information included in the AQAA it was stated that 1 complaint had bee received in the last twelve months. This complaint had been investigated through staff at the Head Office. In the complaint file there was some information in relation to this although other information was retained at Head Office for confidentiality purposes. DS0000006905.V346309.R01.S.doc Version 5.2 Page 16 The inspector met with the two support staff one a permanent staff the other a bank member. The contact with both staff was brief although both knew what action to take in the event that adult protection issues were identified. Both staff were aware of the term whistle blowing and when this could be applied. Both staff confirmed that they had received training on adult protection at induction and updates thereafter. DS0000006905.V346309.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is maintained in a domestic manner with some aids provided for physically disabled residents. EVIDENCE: The communal areas were reasonably well maintained. The lounge was decorated with Christmas decorations. The home had extended the wood style floor throughout the majority of corridors. The lounge was maintained in a domestic fashion. The carpets were in need of a deep clean, this had been actioned and quotes to undertake the work obtained. New blinds for the kitchen window were waiting to be erected. A selection of bedrooms were inspected and these were to a variable standard. Some clean tidy and personalised. One bedroom was particularly malodorous DS0000006905.V346309.R01.S.doc Version 5.2 Page 18 where the resident was incontinent. It was evident in some bedrooms that residents were smoking, ash on the floor and burns to furniture indicated this. Individual risk assessments were in place to cover this issue. The home has a five-person lift, which was in working order. One resident has significant mobility problems and her room is located on an upper floor this needs to be reviewed. The inspector was aware that staff and the Manager were working hard on both the daily maintenance of the environment as well as longer term issues such as upgrading. In homes such as this the environment can be a problem and whilst the home was not in perfect order, significant efforts were being made to maintaining it in the best condition. It is essential that sufficient cleaning hours are allocated to maintain the home. This is further referred to under the section headed staffing. The Manger advised the inspector that three bedrooms are to be redecorated in January 08 and replacement of furniture will also be include in the refurbishment of those areas. Please see recommendation 1. DS0000006905.V346309.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There were insufficient staff to address the needs of residents with in the main physical needs restricting staff from other areas of support. Staff are subject to robust recruitment procedures and provided with sufficient training to undertake their work. EVIDENCE: On the day of visit the home was short of a cleaner and a cook This was in spite of the Manager trying through agency services to get a cook, The Manager was himself in charge of the home, facilitating the inspection and preparing the lunch, he is a trained chef. No domestic was on duty and staff were having to adders the general cleaning as part of their care duties. This was unsatisfactory and as previously mentioned it did impact on resident’s daily lives. The inspector discussed the situation with the Manager who explained that the domestic cover was provided through recruitment agencies, as they had had no success appointing to a permanent position. The domestic cover is for four hours a day, five days a week. DS0000006905.V346309.R01.S.doc Version 5.2 Page 20 The cook works Monday to Friday – term time only, at other times care staff undertook the role. In a home where there is such a high level of incontinence and physical health issues there must be sufficient support staff to enable care staff to undertake their role. The home must ensure that there are sufficient staff to meet resident needs. It was evident that on this site visit that there were insufficient staff to address resident’s needs including promoting rehabilitation. It was evident from this site visit that low staff moral prevailed, this is in sharp contrast to previous visits where staff have expressed great satisfaction with their work and employment. A selection of staff personnel files were inspected at Community Options head office December 2007. In general the staff personnel files were organised with information easy to access. Sections indicated where items could be located. The standard of information included was good. Evidence that recruitment checks are made prior to employment were on file including application forms, interview information, two references, CRB clearance, offer letter and contract. Information relating to the CRB was evidenced either by the CRB document itself, or those which had been destroyed, on the advise if the CRB helpline, evidence was on the file including the reference number, date of issue and an indication of whether it was satisfactory .The CSCI state that CRB’s should be retained for inspection, however the current system was seen to be working satisfactorily. There was discussion with Chris Mansie regarding staff recruitment and the need to record the discussion and exploration of any convictions, which appear on CRB checks. The record should include evidence of the discussion and the outcomes arising from this, on whether to employ the candidate or not. Community Options needs to obtain verification in writing, of any person who has worked in a care employment, either working with adults or children. This record needs to specifically identify the reason for leaving the employment. Community options are undertaking the recommendation that CRB’s be repeated every three years. Any gaps in application forms or conflicting information included within it, must be explored and written notes retained with the reason provided. The training files of two staff evidenced that training was provided regularly on both the mandatory topics and those related to resident’s conditions. All staff have archived, or are in the process of obtaining NVQ level 2 or 3 qualification. DS0000006905.V346309.R01.S.doc Version 5.2 Page 21 Staff supervision is conducted regularly and an annual appraisal system in place. Please see requirement 2 DS0000006905.V346309.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed by an experienced and competent individual. Health and safety issues are taken seriously providing resident with safe accommodation. EVIDENCE: The Manger is experienced and trained. He has completed the NVQ level 4. In addition he has completed an advanced health and safety qualification and is level 2 trained as a risk assessor. He is due to re sit the Heath and Safety certificate 2008 as part of periodic updates. The Manager completed the National Certificate in Supported Housing in 2004. He had been within the Community Options group for approximately 18 months. DS0000006905.V346309.R01.S.doc Version 5.2 Page 23 In the documents inspected, High Street had an individual risk assessment in place, which had been conducted April 2007. The home is audited quarterly for health and safety issues. A selection of health and safety certificates and records were inspected. Certificates were in place for the annual electrical inspection gas safety certificate and the lift inspection. Confirmation of the five year electrical inspection as received after the site visit. The records relating to fire procedures include weekly fire alarm testing and checking of door closures. Emergency lighting systems were subject to regular checks. Fire drills had been conducted April and September 2007, although there were no signatures of attendees. Other fire drills had been conducted January 07 and November 06, all of which had the staff and residents initials as confirmation of attendance. Other health and safety records indicated regular checks on fridge freezer temperature; hot water temperatures and emergency pull cord. There was gap for three months in the hot water testing records the months omitted were July September and December. The employer’s liability insurance certificate was on display and current. The Manager is trained in health and safety precautions and is the representative in the home for such matters. Recent Regulation 26 visits had been conducted, and a report on the findings made for July, August October and November 2007. Community Options conduct an annual staff survey the results of which are published and action taken where possible. Staff confirmed that staff meetings were held, recently attended by Tracy Simpson from Head Office. Venues and opportunities for residents to voce their views are provide by way of 1:1 key worker sessions, meetings and other forums. Community Options have a five year plan which includes specific areas for each of the homes. It was noted in the Regulation 37 report file that there were eight incidents pertaining to staff. The Manager sated that all staff incidents would be referred to head office and be discussed the health and safety committee meetings. Residents monies were checked and found to be correct with receipts in place The home has an individual wallet for each resident and a balance sheet for the recording of all transactions. Two staff signatures confirmed all transactions. Residents had their own bank account and one resident has a financial appointee. It was noted that a significant amount of money was held for one resident this should be reviewed and less money retained on site. DS0000006905.V346309.R01.S.doc Version 5.2 Page 24 DS0000006905.V346309.R01.S.doc Version 5.2 Page 25 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 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 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 X 3 DS0000006905.V346309.R01.S.doc Version 5.2 Page 26 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. OP14 Standard Regulation 12 Requirement The Registered Manager must ensure that residents are supported to engage in appropriate rehabilitation activities. The Registered Manager must ensure that there are sufficient staff employed including support workers and ancillary staff to meet residents needs. Timescale for action 30/03/08 2. OP27 18 30/03/08 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 OP23 Refer to Standard Good Practice Recommendations The Registered Manager should undertake a review of bedroom accommodation with special attention paid to those with impaired mobility. DS0000006905.V346309.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection SE London Area Office River House 1 Maidstone Road Sidcup Kent DA14 5RH 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 DS0000006905.V346309.R01.S.doc Version 5.2 Page 28 - 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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