Inspection on 28/06/06 for Le Brun House

This inspection was carried out on 28th June 2006.

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.

Other inspections for this house

Le Brun House 11/03/09

Le Brun House 28/03/08

Le Brun House 15/05/07

Le Brun House 13/02/06

Le Brun House 10/05/05

Le Brun House 29/10/04

Le Brun House 01/06/04

Le Brun House 07/07/03

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

CARE HOMES FOR OLDER PEOPLE Le Brun House 9 Prideaux Road Eastbourne East Sussex BN21 2NW Lead Inspector Angela Gunning Key Unannounced Inspection 28th June 2006 11:00 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 Le Brun House DS0000021154.V289705.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. Le Brun House DS0000021154.V289705.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Le Brun House Address 9 Prideaux Road Eastbourne East Sussex BN21 2NW 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) 01323 734447 Mrs Ilona Austen Vacant Care Home 20 Category(ies) of Dementia - over 65 years of age (20) registration, with number of places Le Brun House DS0000021154.V289705.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is twenty (20). Service users accommodated must be older people aged sixty-five (65) years or over on admission. Service users only with a dementia type illness to be accommodated. Date of last inspection 13th February 2006 Brief Description of the Service: Le Brun House has recently been successful in changing its registration category to be able to accommodate and care for twenty (20) older people with dementia. The process was lengthy and required the provider to ensure that both the premises and staff were suitable for purpose. The home is a detached house that has been extended and provides 20 single bedrooms, 17 with ensuite facilities and 6 with shower facilities. Accommodation is provided on three floors and there is a passenger lift to access the first and second floor accommodation. The communal facilities include a lounge with a conservatory at the front of the house and a large dining with a lounge area at the rear of the house. There are well maintained gardens to the front and rear of the house. The home is situated approximately one mile from Eastbourne town centre, with a main bus route within easy walking distance. Prospective residents are given a copy of the home’s brochure and they can find out information about the services and facilities at Le Brun House via the internet on Carefinders and can also email the home direct. The range of fees charged as from 1 April 2006 is from £360 to £525 and in-house activities are included in the fees. Additional charges are made for hairdressing, toiletries, chiropody, newspapers and dry cleaning. Intermediate care is not provided. Le Brun House DS0000021154.V289705.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which included a visit to the home for 8.5 hours, seeking information and the views of residents and relatives by survey and telephone contact. Information was gathered from the pre-inspection information provided by the acting manager, previous inspection reports and information gathered throughout the registration process. Surveys from relatives and residents carried out in February 2006 were used to assist with the inspection process. A Social Worker was also contacted as part of the inspection. Four relatives were contacted by telephone as part of case tracking resident’s admission and care. Several people were spoken to during the visit, including six residents, two members of care staff, the acting manager, the deputy manager and the provider. Most of the environment was inspected, including the bedrooms, the communal areas, the kitchen and office. Three care plans and one staff recruitment file was examined. What the service does well: What has improved since the last inspection? What they could do better: Although the new manager is in the process of reviewing care plans, it was noted that not all residents care plans contain sufficient information, and implementing a new care planning system to assist staff in identifying and monitoring care needs. Le Brun House DS0000021154.V289705.R01.S.doc Version 5.2 Page 6 Although there are clearer lines of management and accountability, the manager and deputy manager need to have clear and specific jobs descriptions to enable them to competently take responsibility for fulfilling their duties at Le Brun House. Staff spoken with said that “supervision has not yet been implemented” and it was noted that the manager and deputy will require training and support to carry out regular supervision with care staff. Le Brun House will be monitored and supported during this transition period to ensure that the home successfully provides a high standard of care to older people with a dementia type illness. 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. Le Brun House DS0000021154.V289705.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 Le Brun House DS0000021154.V289705.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, 2, 3, 6 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Preadmission procedures identify prospective residents’ needs and enables a decision to made as to whether or not the home can meet their assessed care needs. Prospective residents and their relatives are given the necessary information to make an informed choice about where to live and how their care needs will be met. EVIDENCE: At the time of the site visit there had been no new admissions to the home, however the new acting manager had assessed one prospective resident at a local authority short-term care centre. The acting manager has developed a new preadmission proforma to record all necessary information to ensure people’s health and welfare needs can be met by Le Brun House. The acting manager said she “had talked to this person’s daughter during the assessment to find out more about her mother and they had both come for lunch”. Following the site visit, this person moved in and her social worker was contacted by phone as part this inspection and confirmed that she was actively involved in the admission process and said that “the home facilitated the Le Brun House DS0000021154.V289705.R01.S.doc Version 5.2 Page 9 transfer very well and she was very impressed when talking to the acting manager”. The home operates a keyworker system and a specific member of staff had been identified to support this new resident’s move into the home go smoothly. Relatives of this person were also contacted as part of this inspection and they confirmed that “the home told us every thing we need to know”, and have offered a 6 week trial period to ensure that they can meet her needs. Although, they had not received a Service User Guide as this is currently being rewritten to reflect the change in management. They said that their mother “has settled in well” and she “now considers Le Brun as her home and likes it there”. One resident has been in been in hospital following a fall and has undergone a hip replacement. The acting manager has confirmed that she went to the hospital to reassess this resident before she was readmitted back in to the home and said “she is weight bearing and walking with a zimmer frame”. This action was required following the outcome of an adult protection investigation carried out last year, to ensure that the home could still care for this resident and meet all her health and welfare needs. Prospective residents are given a copy of the home’s brochure and they can find out information about the services and facilities at Le Brun House via the Internet on Carefinders and can also email the home direct. The home’s Statement of Purpose and Service User Guide needs to be updated to reflect the change in registration details and staffing arrangements. The home does not provide intermediate care. Le Brun House DS0000021154.V289705.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Although a new care planning system is being developed, not all residents care plans contain sufficient information to assist staff in identifying and monitoring care needs. Staff respect each residents’ privacy to ensure their dignity is maintained. There are satisfactory systems in place to manage medication safely within the home, so that residents’ medication needs are met. EVIDENCE: The new acting manager is in the process of changing and improving the care planning system within the home. She is currently arranging care planning meetings involving the residents, where appropriate, their relatives and identified keyworker within the home to develop a person centred care plan, so that health and welfare needs can be identified and monitored. Three care plans were examined, one of which had been developed using the new system, although the acting manager said “it would need reviewing as this resident had been in hospital due to a fall and had suffered a broken hip”. Le Brun House DS0000021154.V289705.R01.S.doc Version 5.2 Page 11 It was noted that care plans were not being reviewed adequately to reflect the changes in a residents needs and how staff would meet these needs. One resident is having problems with her teeth and in need of dental treatment. However, the care plan for eating and drinking did not reflect the fact she is having to eat soft foods and is also losing weight. Since the site visit the acting manager has arranged for a Community Psychiatric Nurse and a General Practitioner to reassess this resident and she will be attending a dentist appointment, all of which will assist the home in meeting her needs. This residents nutritional and dietary needs to be monitored and appropriate dietary intervention implemented so that weight is regained. Le Brun House uses a monitored dosage system for the administration of prescribed medicines and it was noted that there are satisfactory systems in place for the management of residents medication needs. Only staff who have received appropriate training administer medication. However, it was noted that the pharmacist has still not carried out a monitoring visit since August 2005 to ensure that the management of medication within the home is acceptable. Staff were noted to treat residents with a caring and respectful attitude and knocked on bedrooms doors before entering to respect their privacy. All staff have recently received a 3 day training course in caring for people with dementia. Staff spoken with demonstrated a good understanding and awareness of caring for people with a dementia type illness. Le Brun House DS0000021154.V289705.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. There is good provision made for residents to engage in leisure and social activities to promote mental and physical wellbeing. Meals are varied and nutritious and residents are encouraged to be as independent as possible and to have choice and control in their everyday living at the home. EVIDENCE: Pre-inspection information provided by the acting manager confirms that residents are provided with a range of in-house and external social and leisure activities, such as monthly musical entertainers, a church service, a motivation group, trips out to the seafront and town centre. The acting manger confirmed that “staff carry out various activities with the residents” and she is obtaining games and activities appropriate for older people with dementia. Staff spoken with said they “carry out activities such as fingernail painting, reading, ball games, bingo and skittles with the residents”. One member of staff said “it is very important that we get as much information about the person as possible; that we embrace their past and their hobbies and that the care is person centred”. One relative spoken with said that her mother “loves playing cards and she took a pack of cards into the home and a member of staff was going to play rummy with her”. Le Brun House DS0000021154.V289705.R01.S.doc Version 5.2 Page 13 It was noted that residents are supported to access the local community. One resident said he “really enjoys music and was escorted by a member of staff to a music show at a local theatre”. Another resident spoken with during the site visit said she “enjoys her weekly visit to her local church” and two other residents “enjoyed their trip to the seafront the previous week”. Residents can also see relatives and friends at the home and spend time in various communal areas. It was noted that residents are offered a choice of lunchtime and supper meals. A weekly menu is displayed in the dining room and a daily record is kept of each resident’s choice of lunch and super-time meal. The lunchtime meal during the site visit was a relaxed and social event. Residents can chose to eat their meals in the dining room or their bedrooms and it was pleasing to see staff supporting and encouraging residents to be as independent as possible in a social environment, yet also offering assistance with eating and drinking when necessary to ensure nutritional needs are met. Residents spoken with said they “liked the meal”. Le Brun House DS0000021154.V289705.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 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. There are satisfactory arrangements for listening to residents concerns and complaints and protecting them from risk of harm or abuse. EVIDENCE: The home has a complaints procedure in place, which is displayed in the hallway and is contained within the Service User Guide, although this needs to be given to newly admitted residents. Surveys from relatives and residents indicates that they ‘are aware of the complaints procedure’ and ‘know who to speak to if they are unhappy about their care’. Pre-inspection information provided by the acting manager confirms there have been no complaints made to the home or to CSCI in the last 12 months. All staff are given the homes’ policy on protection of vulnerable adults and prevention of abuse and they receive in-house training as part of their induction training. There are 40 of care staff working at Le Brun House who have achieved a National Vocational Qualification in Care Level 2 and they learn about adult abuse in this course. All staff have recently received training in caring for people with dementia and also moving and handling to ensure staff and residents are not at risk of harm. Le Brun House DS0000021154.V289705.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, 26 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents live in safe, spacious and comfortable surroundings that meets the needs with people with dementia. EVIDENCE: The home has been extended to provide a further 5 single bedrooms with ensuite facilities. These are large, well decorated and furnished rooms. Residents can bring in their own furniture and bedrooms were noted to be personalised. Where bedrooms are vacant these are being redecorated and refurbished. At present a cleaner is employed three mornings a week and the home was found to be clean and tidy. The communal space has been increased and now includes a large dining room with lounge area at the rear of the house, a lounge with a conservatory at the front of the house and a small seating area at the entrance of the home. The rear garden has been made smaller due to the extension but both the front and rear gardens are well maintained and accessible to residents. On the day Le Brun House DS0000021154.V289705.R01.S.doc Version 5.2 Page 16 of the site visit one resident was seen to be enjoying the sunshine in the rear garden and staff said that this resident “also likes to sit in the conservatory for the sun and warmth”. It was noted that the lounge is now a more open, bright and aesthetically pleasing room. It was noted that new fire doors with a glass panel are being fitted on each level of the home and some doors have been fitted with hold open devices. The new call bell system was in working order on the day of the site visit. Further thought and consideration has been given to the environment to ensure it is appropriate for people with dementia. The acting manager said “that all the corridors are due to be decorated soon”. There are signs and symbols on each level and on toilet and bathroom doors to help orientate residents with dementia. Where there were patterned furnishings, these have been replaced by plain ones so as not to confuse people with dementia. The provider has said that “bedroom doors will have appropriate signs/symbols depending on the wishes and needs of each resident when they move in”. Le Brun House DS0000021154.V289705.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Staff are competent and employed in sufficient numbers to meet the needs of residents currently being accommodated. EVIDENCE: At the time of the site visit the home were caring for only 6 residents as 2 were in hospital. The staff rota indicated that there were always a minimum of two carers on duty and either the acting manager or deputy manager on duty and clearly identified who was in charge of the shift. Staffing arrangements were submitted to the CSCI as part of the registration process to ensure there will always be sufficient numbers of staff on duty and a maximum of two residents per month are allowed to be admitted each month until the maximum of 20 is reached. The majority of the staff are new to Le Brun House and a new staff team is being created, with most having had experience in caring for people with a dementia type illness. Staff spoke positively about their work and were looking forward to more residents moving in. All staff, including the cook and cleaner attended the 3 day dementia training course held at the home last month. Staff spoken with said they “found the course very intensive, detailed and helpful”. Pre-inspection information provided by the acting manager indicates that 40 of the care staff have an National Vocational Qualification in Care and there are 5 with a current first aid certificate and apart from dementia training, staff have had training in manual Le Brun House DS0000021154.V289705.R01.S.doc Version 5.2 Page 18 handling and medicines and some new staff will be receiving first aid and food hygiene training. Pre-inspection information suggests that new staff undertake a six-week induction programme. A new member of staff spoken with during the site visit confirmed that she had an initial ‘off duty’ induction day to become familiar with residents needs and the management of the home and then was on shift the next week. A record is maintained of the contents of the initial induction and staff sign to confirm they have received it but there was no record of a six week induction programme that meets the skills for care specifications. Recruitment records for one member of staff who had started since the last inspection indicated that there is a satisfactory recruitment procedure in place and Protection Of Vulnerable Adults (POVA) First check are carried out prior to any carer working at the home whilst awaiting their Criminal Records Bureau (CRB) check. The acting manager confirmed that staff employed prior to the return of a satisfactory CRB check are supervised at all times. Le Brun House DS0000021154.V289705.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, 36, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. There is a clear management structure in place, although roles and responsibilities need to be defined to ensure that the health, safety and welfare of residents and staff is promoted and protected. EVIDENCE: There is a new management structure within the home with a new acting manager and a deputy manager. The new manager is experienced and qualified in managing a home for older people with dementia and will be applying to become the registered manager. There are clearer lines of accountability, with an identified shift leader and a senior member of staff on duty at all times during the day. However, the manager and deputy manager need to have clear and specific jobs descriptions to enable them to competently take responsibility for fulfilling their duties at le Brun House. As Le Brun House DS0000021154.V289705.R01.S.doc Version 5.2 Page 20 part of the registration process it was pointed out that the job descriptions submitted for manager and deputy manager were not satisfactory. Staff spoken with said that “supervision has not yet been implemented” and it was noted that the manager and deputy will require training and support to carry out regular supervision with care staff. As part of the home’ quality assurance procedures the home carries out surveys with residents and the last service user questionnaires were given out in February 2006. During the registration process the provider confirmed that ‘the new manager will have responsibility for the day to day management of the home and that she will maintain responsibility for some financial aspects of managing the home i.e. payroll and service users fees and will make the required statutory visits to the home’. The provider is required to send a copy of these visits to the CSCI. The provider deals with the financial aspect of residents’ care and residents’ relatives or representatives receive itemised bills for services such as hairdressing, chiropody, newspapers and toiletries. The provider maintains a written record of all extra amounts payable for these additional services and this is documented in service users’ terms and conditions of residency. The home provides lockable facilities and where money/cheque books are kept on behalf of a service user this is agreed and signed. The acting manager confirmed that at present no money is kept for any resident. Pre-inspection information provided by the acting manager indicates that all health and safety checks are made and recorded. The deputy manager confirmed that the provider is “very health and safety conscious and if anything happens she will rectify it straight away”. Le Brun House DS0000021154.V289705.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 2 X 3 X X x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x 3 2 x 3 Le Brun House DS0000021154.V289705.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 4 Requirement That prospective residents and relatives are given a copy of the updated Statement of Purpose and Service User Guide. That the information provided in each care plan gives staff adequate information and guidelines to enable them to care for each person’s ongoing health and welfare needs. (Time scale of 28/04/06 not met) That the manager and deputy manager have clear and specific jobs descriptions to enable them to competently take responsibility for fulfilling their duties at le Brun House That care staff receive regular one to one supervision sessions. That a copy of the monthly monitoring visit is forwarded to the CSCI. That one resident’s nutritional and dietary needs is monitored and appropriate dietary intervention implemented so that weight is regained. That the manager and deputy DS0000021154.V289705.R01.S.doc Timescale for action 31/07/06 2. OP7 15(2)(b) (c) 31/08/06 3. OP31 12 31/08/06 4. 5. 6. OP36 OP33 OP8 18(2) 26(4)(c) 14(1) 12(1) 30/09/06 31/07/06 28/06/06 6. OP36 18(1)(c) 30/09/06 Page 23 Le Brun House Version 5.2 receive training and support to carry out regular supervision with care staff. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations That a pharmacist carries out a monitoring visit to ensure that the correct procedures for the storage, recording and administration is being carried out. That a record is maintained of the six-week induction programme. That a laundry assistant is employed. 2. 3. OP30 OP26 Le Brun House DS0000021154.V289705.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Le Brun House DS0000021154.V289705.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. 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