Inspection on 16/01/08 for Leafield Residential Care Home

This inspection was carried out on 16th January 2008.

CSCI found this care home to be providing an Poor service.

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

Leafield Residential Care Home 24/07/08

Leafield Residential Care Home 12/10/06

Leafield Residential Care Home 11/08/05

Leafield Residential Care Home 18/04/05

Leafield Residential Care Home 10/01/05

Leafield Residential Care Home 17/08/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Leafield Rest Home 32a Springfield Drive Abingdon Oxfordshire OX14 1JF Lead Inspector Robert Dawes Unannounced Inspection 16th and 21st January 2008 10:00 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 Leafield Rest Home DS0000013103.V347080.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. Leafield Rest Home DS0000013103.V347080.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Leafield Rest Home Address 32a Springfield Drive Abingdon Oxfordshire OX14 1JF 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) 01235 530423 leafieldcarehome@aol.com Mr Prashant Brahmbhatt Care Home 24 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (24) of places Leafield Rest Home DS0000013103.V347080.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of persons that may be accommodated at any one time must not exceed 24 12th October 2006 Date of last inspection Brief Description of the Service: Leafield Care Home is situated to the north of Abingdon town centre, within a residential housing estate. The accommodation is provided on two floors and there is an automatic passenger lift for access. There are 21 single rooms, 5 of which are en-suite, and 1 double room with en-suite facilities. Plans to provide a further 5 en-suite facilities are being progressed at the present time. The communal areas of the home are spacious and provide a choice of places to sit, or entertain visitors. The grounds are accessible to the residents and offer a pleasant area to wander in safety, or to sit and enjoy the fresh air. The home is registered to provide care for older people who are frail and may be mentally infirm. The current range of fees is £436 to £525.00 per week. Leafield Rest Home DS0000013103.V347080.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 site visit, which took place during the day on the 16th and 21st January 2008. The Annual Quality Assurance Assessment, two health professionals’ surveys, nine staff surveys and three relatives’ surveys were returned to the inspector before the site visit. These, together with the site visit, were the main sources of information for the key inspection. During the site visit the inspector interviewed the manager, cook and two carers; discussed the quality of care with a resident and a visitor; toured the premises; looked at records; case tracked; and observed the interaction between residents and staff. Five requirements were made. ‘The quality rating for this service is ‘0’ stars. This means the people who use this service experience poor quality outcomes.’ What the service does well: What has improved since the last inspection? What they could do better: The registered provider must ensure the following actions take place: a) recruitment procedures comply with the regulations to protect residents from unnecessary risk. b) there is a photograph of every resident in the home to ensure there is no mistake in identifying individuals. Leafield Rest Home DS0000013103.V347080.R01.S.doc Version 5.2 Page 6 c) appoint a registered manager. d) a formal system is in place to review the quality of care provided in the home. e) complete reports of his monthly visits to the home on the conduct of the care home. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Leafield Rest Home DS0000013103.V347080.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 Leafield Rest Home DS0000013103.V347080.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Numbers 3 and 4. People who use the service experience good quality outcomes in this area. No resident moves into the home without having had his/her needs assessed which ensures their needs can be met by the home. The home meets the general needs of the residents very well. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Records showed that the health and social care needs of prospective clients are assessed prior to their admission. Appropriate admission procedures are in place. Staff were observed to respond to residents kindly and in a caring and patient manner. A visitor said ‘Leafield is near to a ‘home’ as you are likely to get. Staff are patient and kind’. Leafield Rest Home DS0000013103.V347080.R01.S.doc Version 5.2 Page 9 Staff interviewed considered the home provided a good standard of care. In response to the questions in the health professional’s survey, ‘do the care staff have the right skills and experience to support individuals social and health care needs?’ and ‘does the care service respond to the different needs of individuals?’ the health professional replied ‘usually’. The health professional commented ‘they offer a pleasant, caring, cheerful environment for patients and communicate well with medical staff. Very personal care of a high quality’. In response to the questions in the relatives’ survey, ‘do you feel that the care home meets the needs of your relative?’, ‘does the care home give the support to your relative that you expect?’ and ‘do the care staff have the right skills and experience to look after people properly?’, the majority responded positively. One relative was very negative about the care her mother was receiving, saying staff were not responding properly to her dementia. The relative has not made a formal complaint to the management of the home. The other relatives commented, ‘I feel they have welcomed my relative and made him feel comfortable’ and ‘they treat him with compassion and kindness when he is depressed’. From the evidence provided by these surveys and observations and discussions held during the inspection the judgement that the home generally meets the residents needs has been made. Leafield Rest Home DS0000013103.V347080.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Numbers 7, 8, 9 and 10. People who use the service experience good quality outcomes in this area. People who use the service have comprehensive and detailed individual care plans, which reflect diversity and cultural needs; their physical and emotional health needs are well met; they are protected by the home’s medication procedures; and are treated with respect and dignity. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Five residents’ files seen contained comprehensive and detailed individual person centred care plans, including background information, likes and dislikes and how they wish to be cared for. All plans looked at evidence there were reviewed internally every month. Additional reviews take place if the resident has involvement from social services or the mental health services. The home operates a key worker system. A photograph of residents was not found in their care records. This is in contravention of Regulation 17 of the Care Homes Regulations 2001. Leafield Rest Home DS0000013103.V347080.R01.S.doc Version 5.2 Page 11 Records showed residents’ health is regularly monitored, appropriate health professionals are involved when required, the prevention and treatment of pressure sores is a high priority in the home, nutritional screening takes place, staff maintain the personal and oral hygiene of each resident, and residents’ psychological health is monitored and responded to appropriately. A resident said ‘the home has responded to my health problems well’. In response to the questions in the health professionals’ survey, ‘does the care service seek advice and act upon it to manage and improve individuals’ health care needs?’ and ‘are the individuals health care needs met by the care service?’, both health professionals replied positively. A relative commented ‘they have been quick to seek medical care’. None of the clients self-administer their medication. Controlled drugs are stored and administered correctly and the medication administration records were in order. There are sufficient trained staff to cover all shifts. Appropriate medication policies and procedures are in place. A pharmacist visits the home once a year to inspect the storage, administration, recording and disposal of the medication. In response to the question in the health professionals’ survey, ‘does the care service support individuals to administer their own medication or manage it correctly?’ both health professionals responded positively. It would be good practice for a photograph of the resident to be attached to their administration records to ensure accurate identification. Residents can have telephones in their rooms, medical examination and treatment are provided in private and staff use the term of address preferred by the residents (this is recorded in the individual’s file). Staff were observed to treat clients respectfully and with dignity, e.g. staff knocked on bedroom doors before entering. In response to the question in the health professionals’ survey, ‘does the care service respect individuals’ privacy and dignity?’ both replied positively. Leafield Rest Home DS0000013103.V347080.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. JUDGEMENT – we looked at outcomes for the following standard(s): Numbers 12,13, 14 and 15. People who use the service experience good quality outcomes in this area. The residents’ are offered a range of leisure and social activities that reflects their diverse needs. They maintain contact with family and friends, are helped to have as much control over their lives as possible and are offered a balanced diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents are offered a range of activities such as games, reminiscing sessions, talking books and cake making. A carer is employed one day a week to concentrate on providing activities for the residents. Girls from the local secondary school visit to chat with the residents. Staff spend time in the afternoons to engage with residents in activities they like. Outside musicians and choirs come in to entertain the residents. Occasionally residents are taken out on day trips. One member of staff said ‘activities are good but it would be nice to see more entertainers from outside as residents see the same old faces’. Another Leafield Rest Home DS0000013103.V347080.R01.S.doc Version 5.2 Page 13 member of staff said, ‘there is enough time for activities and chats with residents’. A member of staff commented in a staff survey, ‘more activities for residents, we need to do more things for them around the house if we can’t take them out’. A Church of England service is held in the home every month and a resident has space in her room to practice her Buddhist faith. One relative commented ‘my mother receives no stimulation and is losing capacity as a result of boredom and neglect, no body spends any time with her except to carry out personal care tasks’. The manager said this resident refuses to engage in most activities offered to her. It would be good practice if the activities coordinator received specific training in how to engage and provide activities which people who have dementia would engage in. Residents’ likes and dislikes are recorded in their care plans. Staff were observed to welcome visitors and offer them a drink. In response to the questions in the relatives’ survey, ‘does the care home help your relative to keep in touch with you?’ and ‘are you kept up to date with important issues affecting your relative?’ the majority of relatives were positive commenting ‘communication has been excellent’. One relative was negative commenting ‘the home has not provided assistance for my mother to keep in contact with me’. The manager is aware of this relative’s concerns and said everything is done to enable her to keep in contact with her mother. A resident said ‘I get up and go to bed when I like; if I am not feeling too well I stay in bed; and I stay in my room if I don’t want to go down stairs.’ Staff said residents are assisted to have as much choice and control over their lives as possible. Care plans contained agreements, after appropriate risk assessments were undertaken, which were either signed by the resident or a relative for any restriction to their freedom i.e. pressure mats to monitor if someone has got out of bed and bed rails to stop a person falling out of bed which would also prevent them from getting out of bed easily. In response to the questions in the relatives’ survey, do you or your relative get enough information about the care home to help you make decisions?’ and ‘does the care home support people to live the life they choose?’ the response was generally positive. The menu showed a varied and balanced diet is offered to residents. The cook said as much fresh produce as possible is used and that residents are offered alternative meals if they don’t like the main meal, dietary needs are catered for and pureed food is presented in an appealing manner. Residents who are able are involved in the planning of the menu. Staff observe the likes and dislikes of redidents who are not able to help plan the menu. Leafield Rest Home DS0000013103.V347080.R01.S.doc Version 5.2 Page 14 A resident said ‘she likes the food, is never hungry and can have a cup of tea at any time’. The Environmental Health Officer who inspected the kitchen in August 2007 concluded that the kitchen was well run, with good systems in place. Leafield Rest Home DS0000013103.V347080.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Numbers 16 and 18. People who use the service experience poor quality outcomes in this area. People who use the service feel their views are listened to and acted on but are not protected from abuse because staff due to poor recruitment practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a comprehensive complaints procedure in place as well as a complaints procedure contained in the service users’ guide. A copy of the complaints procedure is also on the notice board in the entrance hall. No complaints have been received by the Commission or the home since the last inspection. In response to the question in the health professionals’ survey, ‘has the care service responded appropriately if you or the person using the service have raised concerns about their care?’ both health professionals replied positively. In response to the question in the staff survey, ‘do you know what to do if a service user/relative/advocate/friend has a concern about the home?’ all replied ‘yes’. In response to the question in the relatives survey, ‘has the care home responded appropriately if you or the person using the service has raised Leafield Rest Home DS0000013103.V347080.R01.S.doc Version 5.2 Page 16 concerns about their care?’ two relatives replied positively and one relative negatively. Staff have received training in safeguarding older people. Staff were clear about how to respond to protection issues. No allegations of abuse have been made to the Commission since the last inspection. Safeguarding older peoples’ policies and procedures are in place. Files of eight members of staff who started work in the home since the last inspection in October 2006 were inspected and evidence was seen that these staff had started work in the home before the Criminal Record Bureau disclosure check and the Protection of Vulnerable Adults first check were returned. The time between a member of staff starting work and the POVA first check being returned ranged from 6 days to 2 months. The acting manager said no new member of staff was allowed to work on their own until the CRB was returned. This practice is in breach of Regulation 19 of the Care Homes Regulations 2001. A requirement for the registered person to comply with this regulation was made at the last inspection. Failure to comply with this regulation will result in enforcement procedures being taken by the Commission. Leafield Rest Home DS0000013103.V347080.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Numbers 19 and 26. People who use the service experience good quality outcomes in this area. The home is comfortable, safe, and generally well decorated and maintained. Residents have all the technical aids and equipment to lead as full and independent life as possible. The home is clean and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is warm, accessible, safe, comfortable and generally well decorated and maintained with some areas needing attention i.e. a couple of bedroom carpets are stained and need cleaning. Recommendations at the last inspection have been actioned to improve the standard of decoration and maintenance and a downstairs bathroom was in the process of being completely refurbished. Leafield Rest Home DS0000013103.V347080.R01.S.doc Version 5.2 Page 18 One relative commented ‘some of the rooms are stark and lacking places to sit, the bedrooms could do with being refurbished, carpets very worn. Several staff commented in the surveys that the furnishings, decoration and carpets could be better. The Environmental Health Officer said in his report that the kitchen surfaces are worn and will soon need replacing. A major problem in the home is the lack of storage space i.e. incontinence pads are stored in the en-suite facilities of the shared bedroom. The inspector found the home to be clean and hygienic. Leafield Rest Home DS0000013103.V347080.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Numbers 27, 28, 29 and 30. People who use the service experience adequate quality outcomes in this area. Residents’ needs are met by the numbers and skill mix of staff. Residents are supported fairly, without discrimination and in a caring manner. Residents are not protected by the home’s recruitment current practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Rotas showed sufficient staff are on duty day and night to respond to the assessed needs of the residents. Agency staff are not used. In response to the question in the staff survey, ‘are there enough staff to meet the individual needs of all the people who use the service?’ two staff replied ‘always’ and seven staff replied ‘usually’. Out of a permanent care staff of sixteen, three care staff have achieved an National Vocational Qualification (NVQ) 2 or above in care, two staff are currently studying for a NVQ 2 in care and four staff are studying for a NVQ 3 in care. The registered person does not operate safe recruitment procedures, (see standard 18 Protection). Leafield Rest Home DS0000013103.V347080.R01.S.doc Version 5.2 Page 20 All new staff undertake an induction training programme. All staff have received basic training and training in key areas of their work such as first aid and safeguarding vulnerable adults. Refresher training of basic areas of work takes place. Staff said they considered training equipped them to undertake their work All staff have individual training profiles. Dementia training has been arranged for all the staff in May 2008. Leafield Rest Home DS0000013103.V347080.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Numbers 31, 33, 35 and 38. People who use the service experience adequate quality outcomes in this area. The service does not have a Registered Manager. The residents’ financial interests are safeguarded and their health and welfare are promoted and protected. The views of residents and relatives are listened to but there is no formal quality assurance and quality monitoring system in place to measure success in meeting the aims and objectives of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Leafield Rest Home DS0000013103.V347080.R01.S.doc Version 5.2 Page 22 The home has been without a Registered Manager for a year. This is in contravention of Regulation 8 of the Care Homes Regulations 2001 and Section 11 (Requirement to Register) of the Care Standards Act 2000. The acting manager, who is responsible for the day to day running of the home, is described by the staff as being supportive, approachable and communicates clearly how the residents should be cared for. The home’s recruitment practices could put residents at risk from abuse (see Standard 18 Protection). The acting manager and staff have established good communication with relatives and listen to their views and concerns. The acting manager also ensures staff listen to the residents and encourages them to express their opinions but there is no formal system for reviewing the quality of care provided at the home. This is in contravention of Regulation 24 of the Care Homes regulations 2001. The registered provider visits the home regularly but does not complete a written report on the conduct of the care home which should be made available for inspection. This is in contravention of Regulation 26 of the Care Homes Regulations 2001. No annual development plan for the home has been produced. It would be good practice for a plan to be developed each year to establish targets to improve the overall quality of care in the home. The home is not responsible for any of the residents’ finances. It does look after personal money if requested, which is kept in individual purses in a secure facility. Receipts are kept and records of all transactions made. Advocates and relatives can audit the records at any time. Staff are not allowed to accept any gifts from residents. Records showed all health and safety checks and inspections are up to date and completed as required. Necessary health and safety policies and procedures are in place. There is a home’s fire risk assessment in place. All the clients’ files contained appropriate risk assessments and had been reviewed regularly. All the staff have received the necessary health and safety training including first aid. Leafield Rest Home DS0000013103.V347080.R01.S.doc Version 5.2 Page 23 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 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 1 X 3 X X 3 Leafield Rest Home DS0000013103.V347080.R01.S.doc Version 5.2 Page 24 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 OP7 Regulation 17(1)(a) Requirement A photograph of every resident must be kept in the care home, i.e. in his or her individual records. Satisfactory CRB and POVA checks for prospective new staff must be received prior to the employment of staff to work in the care home. (This requirement was first made at the 12th October 2006 inspection). Timescale for action 29/02/08 2 OP29 19 Schedule 2 21/01/08 3 4 OP31 8 26 OP33 5 OP33 24 The registered person must 31/05/08 appoint a registered manager to run the service. The registered person must carry 29/02/08 out at least monthly unannounced visits to the home to monitor the standard of care provided and complete a written report. The registered person must 31/03/08 establish and maintain a system for reviewing the quality of care provided in the home including the views of residents, relatives and outside professionals. Leafield Rest Home DS0000013103.V347080.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Leafield Rest Home DS0000013103.V347080.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Oxford Office 4630 Kingsgate Oxford Business Park South Cowley Oxford OX4 2SU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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