Inspection on 16/08/06 for James Page House

This inspection was carried out on 16th 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 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

James Page House 31/10/07

James Page House 18/01/06

James Page House 28/09/05

James Page House 19/10/04

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

CARE HOMES FOR OLDER PEOPLE James Page House Deyes Lane Maghull Liverpool Merseyside L31 6DJ Lead Inspector Ms Lorraine Farrar Unannounced Inspection 16th August 2006 12:15 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 James Page House DS0000017244.V295420.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. James Page House DS0000017244.V295420.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service James Page House Address Deyes Lane Maghull Liverpool Merseyside L31 6DJ 0151 531 8702 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) Parkhaven Trust Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places James Page House DS0000017244.V295420.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 31 OP (N). The service has two named service users under pensionable age. Date of last inspection 18th January 2006 Brief Description of the Service: James Page House is owned and run by Parkhaven Trust, an organisation who have several care homes in the Maghull area of Liverpool. The home is on a large site on Deyes Lane in Maghull and is shared with another registered home belonging to the organisation. The grounds are large and there is plenty of room for Residents to sit out or go for a walk. Although in its own grounds the home is in the middle of a residential area and there is a public transport service nearby, car parking is provided and local shops and facilities are not far away. The building is single story and has been adapted to a high standard, there are 30 single bedrooms each of which has an en-suite with toilet and sink. The home has three wings and a main dining / sitting area. Each wing has bedrooms, sitting and dining areas and bathrooms. In addition there is a main laundry, kitchen, offices and a reception area. The home is registered to provide care with nursing for 31 people over retirement age. Registered Nurses and Carers are available at all times, in addition there are domestic and kitchen staff during the day. James Page House DS0000017244.V295420.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Information for this inspection was gathered in a number of different ways. This included an unannounced site visit where time was spent reading records and looking at the building. ‘Case tracking’ was used as part of the visit. This involves looking at the support a person gets from the home including their care plans, medication, money and bedroom, time is also spent meeting with the Residents and with Staff about how they meet the persons needs. Case tracking was used to look at life in the home for three of the people living there. Discussion also took place with the Relative of a Resident, other Residents, four members of Staff and the Manager. Fees for the home are set at £463.50 per week. What the service does well: Before a new Resident moves into the home, qualified Staff meet with them and assess their needs, they also contain copies of the persons Social Worker assessment if available and provide the person and their Relatives with information about the home. This helps both the prospective Resident and the Staff to make sure that the home are able to meet the person’s needs and their choices. Medication is adequately managed in the home and staff work with Residents and their Relatives to plan and deliver the care the Resident needs and chooses. Each Resident has a named Keyworker, and Residents spoken with knew who this was and the things they provided help with. Staff are available to support Residents with their health and personal care needs and Residents have a positive view of the Staff team, describing them as “very good” and explaining, “they couldn’t do more”. Resident views are obtained at meetings and a Resident explained that “it takes time but they do listen and get things right”. Staff are respectful towards Residents and ensure that they respect their privacy. There are some arranged activities available in the home and space for people to sit quietly or in private if they choose. James Page house provides a pleasant, well maintained and homely environment for Residents to live in. Visitors are welcomed and residents able to personalise their bedrooms in accordance with their choices. There is a clear system in place for the home to monitor and improve on the service they offer, this includes obtaining the views of Residents and Staff. James Page House DS0000017244.V295420.R01.S.doc Version 5.2 Page 6 There is a clear management structure in place and an experienced, Staff team who receive suitable training. Health and safety checks are carried out at suitable intervals to ensure the safety of Residents, Staff and Visitors. 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. James Page House DS0000017244.V295420.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 James Page House DS0000017244.V295420.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): 1,3 & 6 The quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Sufficient information is obtained about and given to, potential Residents to help everyone decide whether the home can meet the persons needs and choices. EVIDENCE: Documents are available in the hallway of the home, which provide information to Residents and their Relatives about the service the home offers. This information is written in an easy to understand manner and includes how to make a complaint, fees and terms and conditions. Care plans were looked at for two Residents who had moved to the home within the past year. Both contained copies of the person’s Social Worker assessment and care plan and both had assessments and care plans completed by Registered Nurses working in the home, these identified the person’s needs and provided guidelines for staff on how to meet these. The James Page does not provide an intermediate care service; therefore standard 6 was not looked at during the site visit. James Page House DS0000017244.V295420.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The home meets Residents identified health and personal care needs however further development of care plans is needed to ensure any potential health needs are quickly identified and acted upon. EVIDENCE: The home has individual care plans for each Resident, three of which were looked at during the site visit. These contained copies of assessments, which identified the person’s health and care needs and written guidelines for staff to follow to meet these needs. Care plans looked at had all been signed by the Resident or their representative and had been reviewed within the past month. Information is recorded about the person’s health care needs, including any nursing and personal care needs and there is some information recorded about their likes and dislikes. Files contain entries written by the Nurse on duty and separate entries written by the person’s Keyworker. Not all entries had been cross-referenced or followed up. For example one person’s Keyworker notes recorded that they James Page House DS0000017244.V295420.R01.S.doc Version 5.2 Page 10 were complaining of feeling sore, no entry was made the following day and on the third day the Keyworker record stated “fine today”. This could lead to Residents not getting all of the care they need in a timely manner. The Manager must look at putting a system into place that ensures all care plan entries or unusual occurrences are followed up on. Records evidenced that the home works with other healthcare professionals including the GP, Dietician and Optician to provide healthcare support to Residents. Clear records are maintained of healthcare treatment including that to pressure areas and sores. The home has a separate room for storing medication and provides locked trolleys on each wing. The medication room was clean, tidy and well organised. Three Residents medication and samples of the storage and recording of controlled drugs were looked at. All were stored correctly and records well maintained. A Nurse was observed giving out medication after the evening meal, this was carried out in accordance with the homes procedures and care was taken to ensure that it did not interfere with Residents enjoyment of their mealtime. Oxygen cylinders are stored in the medication room, these were not secured to prevent them falling over, which could cause a fire hazard. Staff were observed to talk quietly and respectfully to Residents and to give them time and space to meet in private with their Visitors. They were also observed to knock on bedrooms doors and obtain the Residents permission before entering. None of the bedrooms in the home are shared and each room has an en-suite facility, which provides further privacy for Residents. James Page House DS0000017244.V295420.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home supports Residents to make their own decisions about their daily lives and provides opportunities for them to spend their time engaged in activities of their choice. EVIDENCE: The home’s Service User Guide states “Visitors are always welcome. We actively encourage their participation and support”. During the site visit Visitors were observe to come and go throughout the day and a Resident explained “ you can come and go as you please and have Visitors when you want”. No communal or arranged activities were taking place during the site visit, however Residents were seen occupying themselves by socialising, entertaining Visitors, watching TV or reading. Some Residents chose to spend their time in the communal areas and in their bedrooms. James Page House DS0000017244.V295420.R01.S.doc Version 5.2 Page 12 The Manager explained that the home had an activity co-ordinator twice a week and has access to the organisations mini-bus, which is adapted for use by people in wheelchairs, and is used for local outings. Residents spoken with said that they enjoy the entertainers arranged by the home, although one Resident commented she would like more arranged exercises. Regular Residents meetings are held with subjects including meals and activities. The minutes of the July meeting record Residents being asked if they found the meetings of use and one Resident commenting, “everyone has there say”. A Resident spoken with explained, “we have meetings every month, it takes time but they do listen and get things right”. Although these meetings are recorded it may be of use for them to include an action plan, the Manager can then review this to make sure issues raised have been addressed. A relative spoken, said that she would like the home to arrange relatives meetings so that they can provide support for each other and work with the home to provide activities for Residents. Residents confirmed that they make their own decisions about everyday matters, with one explaining they likes to get up at 7 am and another that they like to go to bed late and get up at 11 am. In the week prior to the site visit there had been two alterations to the way in which the home manages meals and mealtimes. Previously the meals were contracted out, although cooked on site the Manager did not have control of the budget, responsibility for staff or full control of menus. The organisation has now taken over this role and the Manager advised new menus have been introduced, which will be discussed at the next Residents meeting. The home have also worked with the local Primary Care Trust (PCT) to introduce a system called ‘protected mealtimes’. This system ensures Residents are given time, support and quiet to enjoy their meals, Visitors are asked to respect this although the Manager explained they are welcome to stay for a meal. Staff are assigned to a group of Residents and support them throughout the meal and medication is not given out whilst people are eating. Residents spoken with were happy with these changes, with comments on the meals including, “there is a variety of food”, “ we get something different” and “ Its definitely better since Monday”. Part of the evening meal was observed, this appeared to be a pleasant experience with staff providing support discreetly and quickly, the meal looked appetising and the dining rooms were welcoming with nicely laid tables. Residents were also positive about the ‘protected mealtimes’ commenting, “we get help quickly, the staff are more of a team, they don’t allow us to wait for help” and “they couldn’t do anymore”. There were limited stores of fruit and vegetables available, however the Chef advised that a delivery was due the following day. Menus reflect a choice of meals; the Chef confirmed that he makes alternatives on request and was able James Page House DS0000017244.V295420.R01.S.doc Version 5.2 Page 13 to provide examples of this. No record of the amount of fruit and vegetables or the alternative provided is kept. The home should keep an accurate record of all meals served, including fruit and vegetables, this will help them to ensure they are offering a nutritious diet for Residents. James Page House DS0000017244.V295420.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 & 18 The quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The home follows clear policies for dealing with complaints and adult protection issues and Residents are made aware of how to use these. EVIDENCE: Records in the home show that staff receive training in identifying and dealing with possible abuse allegations and the home has up to date policies and procedures available for dealing with complaints and adult protection. The complaints procedure is clear and gives advice on how long a complaint will take to deal with and the action that will be taken. This information is made available to Residents via the Service user Guide. The Manager and organisation have previously evidenced that they are aware of procedures for reporting allegations of possible abuse and have followed these. The home has a complaints record, which has clear information about the nature of the complaint and action taken. Good practice was noted in that separate pages are used to record each complaint to maintain confidentiality and that a Resident had felt comfortable enough to record their complaint in the book. Appropriate polices and practices are in place for supporting service users to manage their money safely. James Page House DS0000017244.V295420.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): 19,20,23, 24 & 26 The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home is clean, tidy and well maintained with sufficient space for Residents, Staff and Visitors. EVIDENCE: There is enough space within the home and the grounds for Residents, Staff and Visitors to feel comfortable and spend time alone or socialising as they chose. The building is single-storey and divided into three wings with sufficient office and storage space. There is a lounge / dining area on each wing, and a larger central lounge/ dining area. Outside there are large gardens and a small patio and seating area, which Residents can use. All communal areas were viewed and all were nicely decorated with good quality furnishings and had a homely and welcoming atmosphere. Several James Page House DS0000017244.V295420.R01.S.doc Version 5.2 Page 16 bedrooms were looked at, each appeared, warm and comfortable and was personalised for the Resident. Bedrooms are furnished and fitted with wardrobe, drawers and a chair, all had a lockable door and drawer, sufficient electrical sockets and a TV point and Residents can choose to have a phone line fitted in their bedroom. All bedrooms are en-suite providing a shower, basin and toilet. In addition there are toilets throughout the home and three bathrooms with adapted baths, these were viewed and were well maintained and clean. The kitchen was generally clean, although the cooker filters were clogged up and in need of a deep clean. Care staff were observed entering the kitchen to make drinks. No protective clothing was available for them to wear whilst in the kitchen. As they also provide personal care for Residents this could lead to cross infection and must be risk assessed. The home has a laundry room with a permanent member of staff who looks after the laundry and Residents clothes. This room was clean and well organised with industrial machines and disposable equipment including aprons, gloves and soluble bags to help prevent the spread of infection. James Page House DS0000017244.V295420.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 The quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The home provides sufficient, suitable and experienced Staff to meet Residents needs. EVIDENCE: The rota records that there are usually 2 registered Nurses and six Carers working in a morning with 1 registered Nurse and 5 Carers in an evening, this was also confirmed in discussion with Residents. During the site visit staff were seen to respond quickly to Residents requests and answer call buzzers in a timely manner. Some Residents spoken with explained that at certain times of the day staff are busier and it can “take as long as 10 minutes” for them to respond, others felt that there were enough staff to meet their needs. The home also employs Cleaners, Kitchen and Laundry Staff and has access to the organisations maintenance department. Staff records evidenced that 10 of the Care Staff hold a care qualification (NVQ) and another 4 are working towards obtaining this. The organisation has a good policy in place for recruiting new Staff and files evidenced that they carry out appropriate checks before employing new staff, this includes obtaining references, medical declarations, Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks. Staff files also contained copies of their contract of employment and terms and conditions. James Page House DS0000017244.V295420.R01.S.doc Version 5.2 Page 18 A new member of staff was spoken with, confirmed that these checks had been carried out prior to her being appointed. She also explained that she was working as an additional member of staff for the first few days and had a named, experienced member of staff to help her and that the staff team had been welcoming. Prior to starting work she was provided with a copy of the organisations staff information pack, “ all I needed to know was in that”. Residents were positive about the staff team with comments including, “I’ve got a keyworker I can go to, I can talk to any of them they are all so good” and “ the carers are good”. All Residents spoken with knew who their identified keyworker was. The organisation provides a planned induction programme for staff and discussions with one member of staff confirmed that they were following this. There is a training department within the organisation, who provide and arrange training for staff. The Manager explained that training from outside agencies is also used. Training records evidenced that training had recently taken place in moving and handling, equal opportunities, infection control and fire, amongst other things. James Page House DS0000017244.V295420.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): 31,33,35 & 38 The quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The home benefits from a clear management structure and is run in the best interests of Residents. EVIDENCE: The Registered Manager of the home is Mrs Maggie O’Reilly, she is supported in this role by a Clinical Nurse Deputy Manager. Mrs O’Reilly has significant experienced as a Manager within a care setting and holds a management in care qualification. She does not hold a current care qualification but confirmed during the site visit that she is willing to undertake this and has undertaken several relevant training courses recently including the Protection of Vulnerable Adults and wound care. Staff spoken with said that they find the Manager approachable with one commenting, “I’m not frightened to go and see her”. James Page House DS0000017244.V295420.R01.S.doc Version 5.2 Page 20 The home had an external audit of their service carried out in May 06 and were awarded a 5 star rating for the environment and care service. The audit report states this is in the ‘exceptional range’. Part of the audit included obtaining views of Residents and Staff. In addition to this the home holds regular Residents meetings and the organisation carried out and published, the results of a staff survey in November 2005. Each month a member of the Board of Trustees visits the home, speaks with Residents and Staff, examines records and the building and prepares a report on their findings. Records and amounts of money held for the Residents case tracked were examined, these were in order. Records evidenced that where possible Residents or their Relatives manage their money, if this is not possible the organisation act as appointee but ensure they do not hold money belonging to Residents within an organisational account. Certificates and records for health and safety checks were examined, this included gas, electrics and fire, all were up to date and satisfactory. James Page House DS0000017244.V295420.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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 3 3 X X 3 3 X 2 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 James Page House DS0000017244.V295420.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15(2)(b) Requirement The Manager must implement a system for ensuring unusual occurrences recorded in daily records are followed up on. The Manager should ensure filters in the kitchen areas are deep cleaned The Manager must carry out a risk assessment for the practice of care staff entering the kitchen without protective clothing. Timescale for action 12/10/06 01/10/06 01/10/06 2 3 OP27 OP27 23(2)(d) 13(3) 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 OP14 OP14 Good Practice Recommendations The Manager should provide Relatives with the opportunity to attend meetings. The Manager should introduce a system for recording and reviewing actions to be taken following Residents meetings. DS0000017244.V295420.R01.S.doc Version 5.2 Page 23 James Page House 3 4 OP15 OP31 The Manager should ensure a full record is maintained of meals actually served The Manager should contain a care qualification (NVQ or equivalent) James Page House DS0000017244.V295420.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 James Page House DS0000017244.V295420.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!