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Inspection on 05/06/07 for Highcliffe House Nursing Home

Also see our care home review for Highcliffe House Nursing Home for more information

This inspection was carried out on 5th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

What has improved since the last inspection?

The main lounge in the front of the house has been redecorated and had new carpet laid. It looks fresh and light. There is a rolling programme of redecoration for the bedrooms and at least two have been done since the last inspection.

What the care home could do better:

Not all residents have care plans written to help staff meet their needs in the way they would choose. Care staff and nursing staff complete separate parts of the daily records and these do not always match up so the resident`s day is not clearly recorded. The medication administration policy needs expanding to give full and clear guidance to staff on all aspects of the management of medicines. Medication administration, recording and storage need to be improved to meet recognised standards. Some fire doors were seen wedged open and a fire exit route that had signs leading to the back of the building was blocked by building equipment. An immediate requirement was left in respect of these two issues. Some policies and documents need updating or expanding. The Statement of Purpose does not have the correct manager`s details and the policy on abuse does not offer guidance on reporting any suspected abuse. A number of staff have not had updated training on protection of vulnerable adults (POVA). A cleaner`s trolley that held some products that fall under the control of substances hazardous to health (COSHH) regulations was observed outside a resident`s bedroom unattended.

CARE HOMES FOR OLDER PEOPLE Highcliffe House Nursing Home 10 Cobbold Road Felixstowe Suffolk IP11 7HQ Lead Inspector Jane Offord Unannounced Inspection 5th June 2007 09:45 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 Highcliffe House Nursing Home DS0000024414.V342452.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. Highcliffe House Nursing Home DS0000024414.V342452.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highcliffe House Nursing Home Address 10 Cobbold Road Felixstowe Suffolk IP11 7HQ 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) 01394 671114 01394 671298 alison@highcliffehouse.com www.highcliffehouse.com Highcliffe House Limited Mrs Bridget Bone Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27), Terminally ill (1) of places Highcliffe House Nursing Home DS0000024414.V342452.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named resident who is terminally ill Date of last inspection 31st May 2006 Brief Description of the Service: Highcliffe House is registered as a care home with nursing, providing care for a maximum of 27 older people. The home is registered to provide general nursing care to one individual service user falling within the registration category of terminal illness. The home is privately owned by Highcliffe House Limited and is managed by Mrs Bridget Bone. Highcliffe House is a large Edwardian building situated in a residential area of Felixstowe within walking distance of the sea front and local amenities. It is a detached building with gardens to the front of the property and parking at the rear. Accommodation is over three floors with communal rooms located on the ground floor. Access to the upper floors is by stairs or passenger lift. Fees range from £625.00 to £700.00 per week depending on level of dependency. The fees do not include the cost of toiletries, hairdressing, chiropody or newspapers. Highcliffe House Nursing Home DS0000024414.V342452.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection looking at the core standards for care of older people took place between 9.45 and 17.00 on a weekday. The registered manager was on annual leave but one of the directors was present during the day and helped with the inspection process. This report is compiled using information available and evidence found on the day. During the day a tour of the home was undertaken with the director but all areas were later revisited. A number of staff, residents and relatives were spoken with and part of a medication administration round was observed. A selection of files was inspected including three staff files, the policy folder, some maintenance records, the duty rotas and activities programme. On the day the home was clean and tidy with no unpleasant odours. The home is in the process of having an extension built at the back of the property that will increase the number of residents’ bedrooms and enlarge the communal space. The work does not yet encroach on the day-to-day running of the home except that car parking is limited. Residents looked well cared for and comfortable. Interactions between staff and residents were friendly and visitors said they were always made welcome. The lunchtime meal looked appetising and was clearly enjoyed by residents. What the service does well: What has improved since the last inspection? The main lounge in the front of the house has been redecorated and had new carpet laid. It looks fresh and light. There is a rolling programme of redecoration for the bedrooms and at least two have been done since the last inspection. Highcliffe House Nursing Home DS0000024414.V342452.R01.S.doc Version 5.2 Page 6 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. Highcliffe House Nursing Home DS0000024414.V342452.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 Highcliffe House Nursing Home DS0000024414.V342452.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): 1, 3, 6. Quality in this outcome area is good. People who use this service will have their needs assessed prior to admission. The service does not offer intermediate care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The files for three newly admitted residents were seen and each contained a pre-admission assessment. The assessment covered areas of need such as eating and drinking, elimination, personal hygiene, communication, mobility and night needs. There was also information about past medical history and the medication the person was taking. The statement of purpose and service users guide were both seen and contain all the required information to allow a prospective resident to make an informed decision about living in the home. Details of the new manager need to be included. Highcliffe House Nursing Home DS0000024414.V342452.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is poor. People who use this service can expect to have their health needs met but cannot be assured that they will have a relevant care plan in place or be protected by the present medication management practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three new residents’ files were inspected and contained information about their health needs and contact details for their GP. One resident and relative spoken with said their GP had visited that day as the resident had been ‘off colour’ for a couple of days and the nurse had called the doctor in. There were records in the files of any visits to or by health professionals and any treatment prescribed. A physiotherapist visits the home on a weekly basis and helps to keep residents mobile and as independent as possible. The physiotherapist was in the home on the day of inspection and observed encouraging a resident using a Zimmer frame to walk a short distance. Highcliffe House Nursing Home DS0000024414.V342452.R01.S.doc Version 5.2 Page 10 None of the three residents tracked had a care plan to help meet their care needs. One was very recently admitted to the home but the two others had been in the home a number of months. None of the files contained a moving and handling, skin integrity or nutrition assessment for the resident. The daily records gave limited information about the residents and were completed in two formats, one by the trained staff and a tick box form by the care staff. In one case the records said a resident had had only one bath since admission but the tick box record said they had had three. Some records were not signed or dated. A care plan seen for another resident was compiled based on the activities of daily living (ADLs) and included an intervention for managing the anxiety the resident felt about settling into a care home. The medication policy was seen and gave basic guidance on managing medicines. It needs to be expanded to give procedures for correct disposal of medication, covert administration and giving medicines in a format not licensed by the manufacturers. The last inspection left a requirement that a procedure be put in place for staff to follow if medication is wrongly administered and this has not been done but should be included in the policy. Part of a medication administration round was observed and the medication administration records (MAR sheets) inspected. On two occasions the nurse left the trolley unlocked while giving medication out of sight of the trolley and on one occasion the keys were left on the trolley while they were out of the room. Medicines were not dispensed with a non-touch technique. There were some signature gaps noted on the MAR sheets so it was unclear if the resident had received their correct medicines. There were no carry forward numbers of tablets and when a prescription had a choice of dose, i.e. one tablet or two, the number given was not always recorded so an audit trail was not possible. The clinic room was visited to check the controlled drugs (CDs) and it was noted that the drugs refrigerator, which contained medication including insulin, was unlocked and the clinic room door open. The clinic room is situated within feet of the front door of the home. The contents of the CD cupboard did not tally with the records in the CD register. The home had recently commenced a new register and some of the CDs had not been transferred over but were recorded in the old book. However one prescription for buprenorphine patches that had been delivered since the new register was begun had not been logged at all. Care practice was observed during the day and staff were seen to knock on doors before entering rooms and asking residents where they would like to sit when they came to the lounge or dining room. Residents were called by their preferred name and staff helped them sensitively encouraging as much independence as possible. Residents spoken with said all the staff were kind and willing, ‘nothing is too much trouble’. Highcliffe House Nursing Home DS0000024414.V342452.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. People who use this service can expect to be offered meaningful pastimes and receive a wholesome diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In the residents’ files that were seen there was an activities assessment that had information about the resident’s past hobbies and life style. The home employs a part time activities co-ordinator who also does some shifts as a nurse. They produce a weekly plan of activities that range from bingo and skittles to board games and exercise. Staff said the musical mornings are popular with residents and live entertainers are sometimes booked. Several people said they had been out for a fish n’ chip lunch to the Red Cross hut on Felixstowe promenade the previous day. They had had a lovely time and enjoyed the meal. One resident said they prefer their own company and stay in their room a lot but the staff understand that and, ‘pop in frequently to make sure I am alright and have a chat’. Highcliffe House Nursing Home DS0000024414.V342452.R01.S.doc Version 5.2 Page 12 The home has an open visiting policy that allows visitors to come and go at any reasonable hour and on the day of inspection a number of people came and went. Staff were heard welcoming people and directing them to the person they were visiting. The files seen all had contact details of the resident’s next of kin and the relationship to the resident. One visitor spoken with said the staff kept them informed about their parent and that they always felt welcome in the home. The kitchen was visited and found to be clean with good stores of dry ingredients and a selection of fresh fruit and vegetables. Records showed that refrigerators and freezers were functioning within safe temperature limits for food storage and hot food was probed to check temperatures before being served. The kitchen had had a ‘deep clean’ in November 2006. The menus were seen and for one randomly selected day the meals offered were a choice of turkey and leek pie or a vegetable quorn tart for lunch, with fresh carrots and broccoli followed by rice pudding. There was carrot cake for tea and supper was soup, sandwiches or cheese soufflé with banana custard for dessert. The cook said that a cooked breakfast is available each day if residents wish and one resident has fried tomatoes for breakfast each day. For residents with a poor appetite they make up enriched smoothies to encourage them to eat. Highcliffe House Nursing Home DS0000024414.V342452.R01.S.doc Version 5.2 Page 13 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, 18. Quality in this outcome area is good. People who use this service can expect to have complaints taken seriously and be protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s complaints policy is robust and fulfils the criteria required. Comment cards returned by relatives prior to this inspection indicated that they knew how to complain if the need arose. Neither CSCI nor the home have had a complaint about the service since before the last inspection. Staff spoken with were clear about their duty of care and understood that abuse could be subtle. POVA training is covered in induction but a number of staff have not had updates since then. The home’s abuse policy needs expanding to include guidance on the correct procedure for making a referral if abuse is suspected. One visitor spoken with said they felt their relative was safe in the home and that gave them peace of mind when they left them. Highcliffe House Nursing Home DS0000024414.V342452.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26. Quality in this outcome area is good. People who use this service can expect to live in a homely, clean environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the home was undertaken with the director who explained the plans for the proposed extension that was being constructed. A further five residents’ rooms are planned together with new kitchen facilities, a large conservatory and an extension to the existing quiet lounge. The present laundry will be relocated from the building that is outside the house to an internal situation. Since the last inspection the main lounge has been redecorated and had new carpet laid. The soft furnishings co-ordinate and the room looks fresh and attractive. Two residents’ bedrooms have also been redecorated. Highcliffe House Nursing Home DS0000024414.V342452.R01.S.doc Version 5.2 Page 15 The day of inspection was lovely and sunny and the French doors in the lounge had been opened to the front garden so residents could benefit from the nice weather. A large sun awning had been lowered to protect the residents who chose to sit outside from sunburn. The front garden looked very pretty and was tended by the gardener during the day. The home had not entered the Felixstowe ‘flower in bloom’ competition this year because of the building work that they felt would detract from the appearance of the garden. Individual residents’ bedrooms seen were clean and tidy and personalised with items such as family photographs, pictures and ornaments. A number of the rooms at the front of the house have pleasant sea views. The laundry, which is situated to the side of the main building and can only be accessed by going outside, was visited. It houses all the washing and drying equipment required but is very cramped and gets hot. The laundry worker was able to explain the procedure for the management of soiled linen to prevent cross infection. Protective clothing and hand washing facilities were evident in the home. Highcliffe House Nursing Home DS0000024414.V342452.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is good. People who use this service can expect to be supported by correctly recruited and trained staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three new staff files were seen and contained documentary evidence that the person’s identity had been verified. Each file had two references and a criminal records bureau (CRB) check. Overseas staff had police checks from their country of origin as well as a CRB. Staff spoken with said they had had an induction programme when they commenced in post. The files contained completed induction questionnaires covering fire awareness, the principles of care, records, moving and handling, health and safety, infection control, first aid, food handling and care procedures. Care staff also said POVA issues were covered during the induction but some ancillary staff had not had training in POVA. The duty rotas were seen and showed there is a trained nurse on duty throughout the twenty-four hours assisted by five carers in the morning, four in the afternoon and three at night time. Ancillary staff in the kitchen and laundry and domestics for cleaning support the care team. Highcliffe House Nursing Home DS0000024414.V342452.R01.S.doc Version 5.2 Page 17 Discussions with staff and residents indicate that there are sufficient staff rostered to meet the assessed needs of the residents. Staff said they had had updates of training in moving and handling, fire awareness and control of substances hazardous to health (COSHH) regulations. Some staff had had updated food handling training and some instruction on hazard analysis. Highcliffe House Nursing Home DS0000024414.V342452.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38. Quality in this outcome area is adequate. People who use this service can expect it to be managed by a person suitably qualified for the post but cannot be assured that all health and safety issues are adequately addressed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The present manager, who has been registered with CSCI, has been in post nearly a year but has been known to the service for a number of years working as a staff nurse and previously as matron. They are a trained nurse and have many years experience in the care field. Staff spoken with say they are approachable. Highcliffe House Nursing Home DS0000024414.V342452.R01.S.doc Version 5.2 Page 19 The director confirmed that the service does not involve itself with residents’ personal monies except to provide a lockable drawer in their room. There have not recently been any quality assurance surveys undertaken but residents spoken with said they would be happy to raise any issues with staff if anything arose that they felt needed attention. A number of service certificates and maintenance records were inspected and showed that Hoists had been serviced and loler tested in January 2007, the gas installation was checked in August 2006 and valid for a year and portable electrical equipment had been tested in April 2007. The fire log showed that fire alarms, automatic door releases and fire exits are checked weekly and emergency lighting monthly. During the course of the day it was noted that some fire doors were wedged open and one fire exit at the rear of the building was blocked with building materials. The fire exit signs directed people to this exit. An immediate requirement notice was left in respect of these two issues. Also during the day a cleaner’s trolley, with products that fall under the COSHH regulations, was left unattended for a period of time outside a resident’s room. Highcliffe House Nursing Home DS0000024414.V342452.R01.S.doc Version 5.2 Page 20 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 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 1 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 1 Highcliffe House Nursing Home DS0000024414.V342452.R01.S.doc Version 5.2 Page 21 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 OP1 Regulation 4 (1) (c) Sch 1 Requirement The statement of purpose must be updated to contain all the information required by regulation to ensure that prospective residents can make an informed decision about moving in to the home. A care plan must be written for each resident as soon after admission as needs are identified to ensure residents receive the care and support they need. The arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines in the home must be reviewed to ensure staff and residents are safe and there is a clear audit trail of medication. Staff training on medication administration, recording and safekeeping must be updated to protect residents. The medication policy must be expanded to give staff full guidance on all aspects of dealing with medication in the care home to protect residents and staff. DS0000024414.V342452.R01.S.doc Timescale for action 30/06/07 2. OP7 15 (1) 05/06/07 3. OP9 13 (2) 05/06/07 4. OP9 13 (2) 30/06/07 5. OP9 13 (2) 31/07/07 Highcliffe House Nursing Home Version 5.2 Page 22 6. OP9 13 (2) 7. OP18 13 (6) 8. OP30 18 (1) (c) (i) 23 (4) (b) (c) 23 (4) (b) (c) 13 (4) (a) (c) 9. 10. 11. OP38 OP38 OP38 The procedure for managing controlled drugs must meet the requirements of the Misuse of Drugs Act 1971 to protect residents and staff. The home’s POVA policy must include guidance on making a referral to ensure correct procedures are followed if abuse is suspected. All staff must receive updated POVA training to ensure residents are in safe hands. This is a repeat requirement. Fire doors must not be wedged open to protect residents and staff from harm. Fire exit signs must direct people to clear fire route exits to protect residents and staff from harm. Staff must observe the requirements of the COSHH regulations to protect residents. 05/06/07 30/06/07 31/08/07 05/06/07 05/06/07 05/06/07 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 OP7 OP33 Good Practice Recommendations The recording of daily care and support should be comprehensive and accurate to ensure factual records are maintained. Consideration should be given to establishing a formal quality audit process so the residents can express their views about the service they receive. Highcliffe House Nursing Home DS0000024414.V342452.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Highcliffe House Nursing Home DS0000024414.V342452.R01.S.doc Version 5.2 Page 24 - 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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