Inspection on 05/06/06 for Laurel Court

This inspection was carried out on 5th June 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

Laurel Court 10/11/09

Laurel Court 19/12/07

Laurel Court 13/01/06

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Laurel Court Brockway Nailsea North Somerset BS48 1BZ Lead Inspector Patricia Hellier Key Unannounced Inspection 5th June 2006 09:15 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 Laurel Court DS0000064861.V295872.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. Laurel Court DS0000064861.V295872.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Laurel Court Address Brockway Nailsea North Somerset BS48 1BZ 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) 01275 859556 01275 859557 Southern Cross Healthcare (Kent) Ltd Mrs Marie Ann Watts Care Home 62 Category(ies) of Old age, not falling within any other category registration, with number (62) of places Laurel Court DS0000064861.V295872.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. May accommodate up to 31 persons aged 65 years and over requiring nursing care on the ground floor. Staffing Notice dated 08/05/2000 applies Manager must be a RN on part 1 of the NMC register May accommodate up to 31 persons aged 65 years and over requiring personal care on the first floor. May accommodate 2 people aged 60 years and over with physical disabilities 13th January 2006 Date of last inspection Brief Description of the Service: Laurel Court provides nursing care for up to 31 residents, and personal care for a further 31 residents. The home was purpose built and is owned by the Southern Cross Healthcare group. It is situated in a suburban position, close to shops and leisure facilities. The home is fully wheelchair accessible. All accommodation is in single rooms with en suite facilities. The accommodation is arranged over two floors. Residents who require nursing care are accommodated on the ground floor; those requiring personal care are accommodated on the first floor. Communal space on the ground floor is provided in a large dining room, with adjoining seating area, and two separate lounges. On the first floor there is a similar dining room, separate sitting room, and smokers’ lounge. In addition there is a small private dining room. A passenger lift provides easy access to all areas of the home. There is a pleasant enclosed garden to the rear of the building. An activities co-ordinator arranges a weekly programme of social events. The current fees charged are Residential Care £550per week; Nursing Care £650 per week. Laurel Court DS0000064861.V295872.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place over eight and a half hours with two inspectors and the manager was present throughout. Before the inspection the information about the home was received from the pre inspection questionnaire and comment cards received from relatives and residents. The last inspection report was reviewed and all correspondence since the last inspection. The accumulated evidence for this report comes from the above and also fieldwork that included the following: discussions with 18 residents, 3 relatives and 8 staff, observation of practices, tour of the premises, review of documents relating to care, recruitment and health and safety; review of policies; inspection of medication records and storage. As part of the inspection a recent complaint regarding the fees charged and the use of the Registered Nursing Care Contribution (RNCC) was investigated. The complaint was not upheld. Of the 20 resident surveys returned a majority felt they always received the care and support they needed, that the home was always clean and fresh and that they would know who to speak to if they were unhappy. A small number felt they had not received enough information about the home and had not received a contract. See attached summary of the survey results. Comments from residents were “this is a happy environment”, it’s a fantastic home”, “the staff are very thoughtful”, its just like having an extended family”. From the relatives surveys five were returned. All five felt welcomed at the home and that they were consulted regarding their relatives care and needs. All five stated they were satisfied with the overall care of their relatives. Comments included “the staff are very friendly and welcoming”, my relative is very happy here”. All residents and staff spoken with told the inspector that the home was very good and the staff very kind. Comments received were “it is very homely and comfortable”; “I would recommend it to anyone”, “my relatives care needs are well met”. What the service does well: The staff ensure the well-being and comfort of the residents’ and treat them with great respect and kindness. For example all of the residents spoken with said, “the home is lovely, the staff are kind and caring, and the food is good.” Surveys returned spoke of “a very happy staff that will always help”. Laurel Court DS0000064861.V295872.R01.S.doc Version 5.2 Page 6 Residents live in a very comfortable, safe and homely environment. It is decorated and furnished to a high standard and there are many homely touches. Meals are varied, well balanced and nicely presented offering choice and variety. An activities co-ordinator works hard to provide a lively programme of activities to meet the varied needs and wishes of the residents. There is strong team spirit and work ethic at the home. Meeting residents’ needs is given priority. There are good communications systems and there is strong leadership. Staff training is encouraged Residents feel that if they had something to complain about they would speak to a member of staff. All residents spoken with said they had nothing to complain about. Three residents said ‘the home is excellent’. What has improved since the last inspection? What they could do better: Contracts of residency need to be reviewed so that they clearly state the fees to be paid; showing a breakdown of what is to be paid to make up the weekly rate and by whom. Attention to detail in care plans is needed to ensure that all necessary clear information is conveyed to all staff to ensure that care needs are well met. Laurel Court DS0000064861.V295872.R01.S.doc Version 5.2 Page 7 The risk assessment for residents who are self-medicating needs to reflect how the capability of the resident has been assessed to ensure they are safe to do this. The provision of plate guards, to assist residents who experience difficulty getting the food from their plate onto their fork or spoon. The maintenance records and garden need attention to ensure good facilities are provided to residents. The inspectors were told that this is being addressed with the employment of a handyman and a gardener. Foot operated bins should be working at all times to maintain good practices in infection control. To ensure that the weekly testing of the fire alarm is done and records kept to maintain the safety of residents. 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. Laurel Court DS0000064861.V295872.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Laurel Court DS0000064861.V295872.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 The quality outcome in this area is good. The Statement of Purpose and Residents’ guide is comprehensive and provides prospective residents with information to make an informed choice. The home’s assessment process is thorough and ensures that it is able to meet residents’ needs. Prospective residents and relatives are encouraged to visit the home to assess suitability. EVIDENCE: Residents are provided with a comprehensive Residents’ booklet containing the Statement of Purpose and all the information required to ensure they or their relatives have access to the relevant information at all times. The contract relating to the complaint, and four other contracts were inspected. All clearly stated that the RNCC was additional to the weekly fees. Contracts did not show clearly how the fees were to be made up, and who was to pay what. Two contract documents had space for this but it had not been completed. All contracts had been signed by the resident or their relatives. The surveys returned showed that three residents had not received contracts that they were aware of. Laurel Court DS0000064861.V295872.R01.S.doc Version 5.2 Page 10 Care needs are well met through a full assessment process and the completion of a care plan from this information. The assessment includes all the elements listed in the standard. One resident who had been admitted for respite care said that the care was “excellent.” “The staff were very attentive, kind and caring and fully met her needs”. Social services care plans had been obtained where relevant. Care practices observed showed that staff were fully aware of the residents needs as stated in their assessments. Laurel Court DS0000064861.V295872.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 The quality outcome in this area is good. Residents benefit from care plans that are well formulated and give clear information to enable staff to meet residents’ health and social care needs, and to provide sensitive care at the end of life. Personal and environmental risks are well managed. The systems in place for the management of medicines are good. Respect and dignity are well maintained by kind and caring staff. EVIDENCE: Individual records are kept for each of the residents, which include a social history. Six care plans were inspected and all reflected clearly current identified health and social care needs. Clear actions to met identified needs were recorded and regular evaluation noted. All care plans showed resident or relative involvement. Two of the five relatives who returned surveys said they did not feel well communicated with. Relative’s communication records in care plans had not been completed. All care plans contained well-formulated risk assessments for Manual Handling, Falls, Nutrition and Pressure areas. These risks had been translated into the care plans to meet the need identified, and reduce the risk. Daily records were up to date and written in a respectful manner. Laurel Court DS0000064861.V295872.R01.S.doc Version 5.2 Page 12 One care plan inspected had not been updated since the resident’s recent falls and changes to her needs, however staff were clearly able to describe the current needs. Consent for use of bed rails and recliner chairs had been obtained from residents or their relatives. One episode of poor practice was observed where a commode was in use to prevent a resident from falling out of bed. This was mentioned to the member of staff in charge of the area, who took action to address the issues during the inspection. All residents spoken with said “the staff are excellent”, “I am well looked after”, “I can do what I want when I want”, they are always there when I need them”. The medication administration system is good and reflects knowledge and understanding. There were no unexplained gaps on the Medication Administration Record charts and variable doses were well recorded. Residents who are self medicating had a completed risk assessment in their care plans. It did not clearly show how the residents’ capability and risk had been assessed to ensure their safety. Hand transcribed prescriptions were seen on the Medication Administration Records and these had not been signed by two members of staff when written thus not providing the recommended safeguard for residents. All residents spoken with felt that kind and caring staff respected their dignity and privacy. Three residents stating, “they always knock on the door”. Resident’s wishes following death were not well recorded, however staff interviewed showed knowledge of residents’ wishes. One resident who had recently died had very clear documented evidence of her involvement in the care planning and how the staff had respected her wishes. There is a clear policy in place to protect resident’s wishes while maintaining professional duties. Laurel Court DS0000064861.V295872.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 The quality outcome in this area is good. Social activities and meals are both well managed, creative and provide daily variation and interest for people living in the home. Residents right to choice and control over their lives is well respected, and encouraged. Autonomy and personal choice is promoted. Friendly staff always welcomes relatives and visitors. EVIDENCE: An excellent range of activities is provided with posters displaying information of forthcoming events throughout the home. Residents spoken with said, “we have plenty of choice and variety”. One resident said, “the activities are marvellous”. The activities co-ordinator works hard to provide a varied programme with activities that will appeal to all. She also plans time for one to one sessions with residents who find it more difficult to join in a group activity. Resident survey responses showed that most people feel that there are usually or always activities arranges that they can take part in. Spiritual needs are catered for and local clergy visit as requested. Several visitors were seen coming and going during the inspection. Relatives spoken with said they could come any time and felt that their relatives were well looked after by friendly staff. One relative said “the staff are so patient and residents never look untidy or uncomfortable”. Laurel Court DS0000064861.V295872.R01.S.doc Version 5.2 Page 14 A number of people living in the home were spoken to about the food and a mixed response was received. Most said they “usually like the meals”, others spoke of “the meat being tough”, and the food “not being cooked as they like”. Several said they would like more homemade cakes. The cook told the inspectors that the menus are being reviewed and that she will always provide an alternative for residents who would like it. Menus and mealtime arrangements are flexible enough to accommodate individual preferences and needs. A few resident were observed having difficulty getting the food onto their fork or spoon. The inspector recommended that plate guards are used to assist in this process. Good practice was observed in staff assisting residents with their food. Laurel Court DS0000064861.V295872.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The quality outcome in this area is good. Residents are confident that they are listened to and their requests acted upon. Residents are protected from abuse by knowledgeable and competent staff EVIDENCE: The home has a comprehensive complaints procedure that is well displayed and all residents have a copy of. There have been 5 complaints since the last inspection and all have been resolved satisfactorily by the home. There has been one other complaint that has involved the Commission and this was not upheld. Residents stated that if they were not happy about anything they would speak to the manager. Staff and residents spoken to, say the manager is very approachable and understanding. One resident said ‘I’ve nothing to complain about, it’s the best home I’ve been in”. A clear record of complaints received with actions taken and outcomes is kept. The home has a copy of the North Somerset ‘No Secrets’ guide and a local abbreviated policy/procedure for the home specifically for responding to allegations of abuse. Staff said they had never seen any signs of abuse in the home and demonstrated a good understanding of what abuse is. Staff have received training in the recognition and handling of abusive situations for the safeguarding of residents. Care plans inspected showed that consent for the use of bedrails and recliner chairs had been obtained from residents or relatives thus safeguarding choice. All residents spoken with said ‘the staff are very kind and take time, I can’t fault them’. Laurel Court DS0000064861.V295872.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21,26 The quality outcome in this area is good. Residents are provided with safe, comfortable surroundings. Robust Infection control practices are followed EVIDENCE: The property is well maintained, with homely and comfortable communal spaces. Residents’ rooms are personalised and comfortable. Maintenance jobs are not being seen to within a suitable timeframe, as the home lacks a handyman. The gardens also looked very untidy and overgrown in areas, thus not providing a pleasant area for residents to sit out in. The manager told the inspector that she has recently appointed a handyman and a gardener so these issues should be resolved fairly soon. The home has three bathrooms on each floor. Two of these on the first floor are assisted bathrooms, and one on the ground floor is an assisted bathroom. All residents have en suite facilities The home was clean and free from offensive odours throughout. The laundry facilities were well organised. Staff interviewed and observed demonstrated Laurel Court DS0000064861.V295872.R01.S.doc Version 5.2 Page 17 good understanding of Infection control procedures and practices and maintained a clean and hygienic environment. The home has good facilities for ensuring that staff can maintain good hand washing practices between caring for residents. In two of the lavatories pedal bins were not working and thus posing a risk for the spreading of infection from loose paper towels or the handling of the bin lid. Laurel Court DS0000064861.V295872.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,30 The quality outcome in this area is good. The home’s staffing levels are sufficient to manage the current care needs of residents. Staff access specific training to meet needs of residents EVIDENCE: Copies of two weeks staffing rosters were supplied to the inspector. Staffing levels rostered were sufficient to meet residents’ needs. Half of the residents spoken with told the inspector “staff are always there when you need them”, “ you only have to ring the bell and they come”. The other half said that staff were “usually available” however there are times in the evenings and at weekends when you have to wait a bit for staff to answer the bell. The manager should keep the staffing levels under review against the changing needs of the residents. A sufficient team of ancillary workers supports care and nursing staff to ensure the smooth running of the service. The home has a Key Worker system in place for all residents. Residents and staff were aware of the role and said, “it worked well”. A number of staff from overseas are employed at the home and form part of the close-knit team. Staff and residents said their presence brought a breadth of experience and interest to the home. Overseas staff interviewed said they felt very welcomed in the home and enjoyed their jobs. Three residents told the inspector they “liked the mixture of races and cultures represented as they reflected the areas they had come from, and thus made them feel at home”. Laurel Court DS0000064861.V295872.R01.S.doc Version 5.2 Page 19 Newly appointed staff confirmed they had completed an induction programme and evidence of this was seen in personnel files. The home provides all induction and in house training. Evidence of specialist training was seen e.g. Parkinson’s disease, Palliative care, dementia care. Staff interviewed spoke of the encouragement to access training and demonstrated a keenness to learn. Laurel Court DS0000064861.V295872.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,36,38 The quality outcome in this area is good. The manager provides clear leadership and guidance to staff to ensure residents receive consistent care in a safe environment. Quality assurance processes in the home are formal demonstrating that the home consults with residents, families and visiting professionals. Health and safety issues are monitored in the home to ensure that issues are identified and addressed where they arise. EVIDENCE: The manager gives clear leadership, guidance and direction to staff. Residents feel she is approachable, available and seeks to ensure all their needs are met. Staff interviewed stated that they felt well supported by an approachable manager. There have again been a lot of changes at senior level in the company that owns Laurel Court, which has not provided consistent support and information to the manager and relatives. The manager is currently undertaking her Registered Managers Award qualification. Laurel Court DS0000064861.V295872.R01.S.doc Version 5.2 Page 21 A formal quality assurance tool was available for inspection in order to demonstrate that the home consults with residents and that comments from them are acted upon. Residents and relatives can take part in meetings that are held three monthly and in which quality features as a regular agenda item. Minutes are kept. Residents and relatives told the inspector that they were always encouraged to express their view and “to air the grumbles”. One resident said “they always do something about a grumble if you tell them”. Since the last inspection regular supervision for all staff has been implemented. Records inspected showed a variety of issues discussed and training needs recognised to enable staff to fully meet residents’ needs. Staff interviewed were aware they had received supervision and said that it had been helpful. Records inspected indicated safety and fire checks are carried out. There were gaps when they had not been done in recent weeks. The emergency lighting has not been checked for some time. The manager said that this was because the home did not have a maintenance man. One has now been employed. Staff spoken to confirmed that regular fire instruction and drills had taken place. As stated in the environment section some maintenance tasks have not been done within the acceptable timeframe for the same reasons as mention above. Records indicating regular maintenance to gas and water systems were seen together with servicing records for all equipment. Wheelchairs did not appear to have been checked on a monthly basis. A number of staff have received First Aid training. A record of accidents is kept in compliance with Data Protection to maintain staff and resident confidentiality. Accident records seen showed clear details, actions and outcomes following the accident. The manager analyses the accident records on a three monthly basis and seeks to find trends and thus ways of reducing potential accidents and incidents, for residents and staff. This is to be commended. Laurel Court DS0000064861.V295872.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 2 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 3 X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 X 2 Laurel Court DS0000064861.V295872.R01.S.doc Version 5.2 Page 23 NO Are there any outstanding requirements from the last inspection? 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. Standard Regulation Requirement Timescale for action 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. 3. 4 5. 6 Refer to Standard OP2 OP7 OP9 OP9 OP15 OP19 Good Practice Recommendations Contracts of residency need to clearly state the fees to be paid; showing a breakdown of what is to be paid to make up the weekly rate and by whom. Attention to detail in care plans is needed to ensure that all necessary clear information is conveyed to all staff to ensure that care needs are well met. The risk assessment for residents who are self-medicating needs to reflect how the capability of the resident has been assessed to ensure they are safe to do this. Staff must sign and date hand written entries on the medicine administration records The provision of plate guards, to assist residents who experience difficulty getting the food from their plate onto their fork or spoon. To ensure that maintenance jobs are completed within and acceptable timeframe. To ensure that the gardens are kept tidy for residents to enjoy. DS0000064861.V295872.R01.S.doc Version 5.2 Page 24 Laurel Court 7 8. OP26 OP38 Foot operated bins should be working at all times to maintain good practices in infection control. To ensure that the weekly testing of the fire alarm is done and records kept to maintain the safety of residents. Laurel Court DS0000064861.V295872.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Laurel Court DS0000064861.V295872.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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