Inspection on 07/12/06 for Linden House

This inspection was carried out on 7th December 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

Linden House 11/12/08

Linden House 14/10/05

Linden House 04/01/05

Linden House 28/07/04

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 Linden House 44 - 46 Station Road Sholing Southampton Hampshire SO19 8HH Lead Inspector Chris Johnson Unannounced Inspection 7th December 2006 10:30 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 Linden House DS0000011902.V319441.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. Linden House DS0000011902.V319441.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Linden House Address 44 - 46 Station Road Sholing Southampton Hampshire SO19 8HH 023 8044 1472 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) Mrs Rita Baker Mr Mark Baker Mr Mark Baker Care Home 21 Category(ies) of Dementia (4), Dementia - over 65 years of age registration, with number (21), Mental disorder, excluding learning of places disability or dementia (4), Mental Disorder, excluding learning disability or dementia - over 65 years of age (21), Old age, not falling within any other category (21) Linden House DS0000011902.V319441.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Persons in the category MD or DE referred to above are not to be accommodated under the age of 55 years No more than 4 service users to be resident at any one time between the ages of 55-65 years 14th October 2005 Date of last inspection Brief Description of the Service: Mrs Baker and her son Mr Baker own Linden House and are the registered providers and Mr Baker is the registered manager. Linden House provides care and support to 21 elderly residents over the age of 65 and is registered to accommodate residents with dementia. Mrs Baker and her son, Mr Baker, over the years have extended and made extensive improvements to the home. The home has three floors with a stair lift to the first floor. The home has 17 bedrooms, four of which are doubles, a large lounge, and conservatory; separate dinning room and an additional quiet area. The home has an interesting scenic enclosed garden, with plenty of seating for residents to enjoy the garden in the warmer months. Linden House is located within a three-mile radius of the City of Southampton, which has a range of social, recreational and historical interests available. The home is situated within a residential area, which has good transport links to the city centre, local health facilities and local shopping. The cost of living at the home ranges from £329- £465 a week. Additional charges are made for newspapers if someone wishes for an alternative to those supplied by the home. A hairdresser visits the home and charges for this service range from £7.50- £20. A visiting chiropodist attends the home regularly and charges for this service are £10. Linden House DS0000011902.V319441.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of this inspection was to assess how well the home is doing in the meeting of all key National Minimum Standards and compliance with regulations. The findings of this report are based on a number of different sources of evidence. These included: An unannounced visit to the home, which was carried out on 7th December 2006. During this visit a tour of the premises was completed that included looking at service user’s bedrooms and all communal areas of the home. Staff and care records were inspected; staff, residents and relatives were spoken with and staff were observed during their day-to-day interactions with residents. All regulatory activity since the last inspection was reviewed and taken into account including notifications sent to the Commission for Social Care Inspection. Sixteen residents completed questionnaires prior to the visit and some of these had additional comments from relatives. Feedback was also obtained from healthcare professionals. The manager completed a pre inspection questionnaire prior to the visit. What the service does well: What has improved since the last inspection? Linden House DS0000011902.V319441.R01.S.doc Version 5.2 Page 6 Record keeping has improved, particularly in the area of medication administration. This provides greater safeguards to residents and reduces the likelihood of errors being made. Improvements have been made to the care planning process and additional information has been included to provide better instructions to staff. However Further improvement is still needed. Redecoration and maintenance is planned and kept under regular review and action is taken to put right repairs appropriately. Several areas of the home had been redecorated since the last inspection to ensure that residents’ comfort and safety is maintained to a good standard. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Linden House DS0000011902.V319441.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 Linden House DS0000011902.V319441.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes Statement of Purpose and Service User Guide provide sufficient information to service users and prospective service users with details of the services the home provides. Prospective service users needs are fully assessed prior to admission so that the individual and the home can be sure that the home is right for them and will meet the person’s needs. All residents receive written contracts and are made aware of their rights. EVIDENCE: Linden House does not provide intermediate care. This standard is therefore not applicable and was not assessed. The files of three residents were examined during the visit to the home. All contained contracts informing them of their rights and of the cost of living at the home. All relatives and residents spoken with said that they had received Linden House DS0000011902.V319441.R01.S.doc Version 5.2 Page 9 sufficient information enabling them to make a decision as to whether the home was right for them and that they had been made aware of their rights’. Assessment documentation was examined for residents admitted since the last inspection. These demonstrated that an appropriate assessment is carried out prior to offering a prospective resident a place at the home. In discussion with residents and relatives and from written records it was evident that people are able to visit the home prior to deciding whether to move in. Residents are initially offered a place at the home for a trial period this enables both the resident and the home to make certain that the home is the right place for them. At the end of this trial period a review is held with all relevant parties and the person can then make a decision whether they wish to remain at the home or not. In discussion with relatives and residents people said that they had chosen the home for a variety of reasons. Some said that the home had been recommended to them. Others said that they had known other people living there and were impressed with the home. Linden House DS0000011902.V319441.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): 7,8,9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvements have been made to the care planning process. However more detail is required within care plans to ensure that care needs are fully addressed. Staff treat residents with respect and dignity and ensure that their health care needs are met. EVIDENCE: The care files of three residents were looked at and all contained written care plans. A requirement had been made following the last inspection of the home that all care plans including those identifying the mental health needs of residents’ detail how the care is carried out. Information has been since added to care plans and they do now provide some additional information and guidance. However care plans need to be more specific and provide more detail regarding the person’s abilities as well as their care needs to ensure that independence is fully promoted. This is especially pertinent where people Linden House DS0000011902.V319441.R01.S.doc Version 5.2 Page 11 require assistance with personal care such as washing and dressing. Care plans also lacked sufficient detail regarding dementia care needs. Despite this, care plans did provide some good and important information such as personal histories and the plans are kept under regular review. The risks to residents from activities of daily living had been assessed and identified. Action plans were in place to minimise these risks and from observation were followed as per care plan. In discussion with staff they demonstrated that they were aware of peoples individual care needs. A relative commented that there had been an improvement in her mother’s personal hygiene and wellbeing since she moved into the home. They commented that this was helped by the fact that the home has regular staff. The relative also commented that staff were good at keeping her informed about her mothers health and general welfare. Records were available to demonstrate that residents have access to a range of services such as GP’s, Dentists, Chiropodists and district nurses. This was supported through conversations with residents. Health care records were well maintained and demonstrated that the home liaised with healthcare services and referred people to specialist services as appropriate. At the last key inspection two requirements were made regarding medication. Satisfactory action had been taken to address these issues. The medication administration records were checked for three residents during the site visit. From examination of these records it was evident that staff were following correct administration recording procedures and medication was stored safely and correctly. The home has a written medication policy and clear procedures. All staff undergo training before being able to administer any medication. Several residents had been prescribed ‘as required’ (PRN) medicines and there was not any guidance to inform staff regarding the use of these. Neither was it referred to in their individual care plan. Consequently the decision to offer PRN medication can sometimes rest upon the member of staff. This will need to be addressed. All residents contacted as part of this inspection commented that they were treated with respect and that their privacy was respected. Residents said that they were always able to meet with their visitors in private if they chose. All shared rooms seen contained privacy screens. Staff were observed during the visit to treat residents with respect and dignity and to respect their right to privacy and also demonstrated this in conversation. Residents have access to a cordless phone if they wish to make calls in private. Linden House DS0000011902.V319441.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): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can receive visitors as often as they please and keep touch with their family and friends. Residents are free to make their own decisions and choices and receive a healthy diet. EVIDENCE: The home provides several organised activities with some of these being provided by outside entertainers such as a pianist. A hairdresser visits the home regularly and was present on the day of the visit. Many residents were observed to access this facility. Large print books are borrowed from a mobile library and are readily available as are newspapers. Residents’ individual interests were documented in their care plans. On the day of the visit a bingo session took place in the main lounge and the majority of residents took part in this with one resident leading the session and staff facilitating. Later on several residents took part in a sing along. Staff were observed to interact well with residents throughout the visit. During a group discussion with thirteen residents the consensus of opinion was that there were sufficient activities and that they had freedom of choice Linden House DS0000011902.V319441.R01.S.doc Version 5.2 Page 13 whether or not to join in an activity and that this right was respected. Residents said that they enjoyed the activities and that they were looking forward to the forthcoming Christmas party. People spoken with individually reiterated this view. Relatives reported that they were always made to feel welcome and could visit as frequently as they wished and at any time. One visitor commented that they visited every day and stayed until teatime and that they liked the fact that they could help their relative to eat their meal. Residents said that they could have visitors as often as they chose. Some commented that visitors were always offered tea and biscuits and that they thought this was particularly good. A record of all visitors to the home is maintained. From observation and discussion with residents and staff it was clear that people are able to make the their own decisions and lifestyle choices. Comments included, “There are no restrictions. I stay up late. The night staff are around so it doesn’t make any difference” and “We are never bossed around. You can get up and go to bed when you want. You can have tea in bed if you choose and just lay there as long as you want”. The inspector saw a sample of menus and these demonstrated that residents are provided with a nutritious, healthy and varied diet. Choices are available and lot of food is home made. Residents are supported to make choices and a daily menu is recorded on a notice board. A record of food residents have eaten is kept. Eleven of the sixteen residents who returned a comment card responded that they always liked the food at the home. Four said that they usually liked it and one responded that they liked it sometimes. All residents spoken with as a group and individually commented that the food was good and relatives reiterated this view. Care plans gave information regarding any support needs that residents had with eating or nutrition. From observation of the midday meal support was provided as per the care plan. Linden House DS0000011902.V319441.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Satisfactory systems are in place for residents to address any concerns or complaints that they may have. Procedures are in place for the protection of residents. EVIDENCE: The home’s complaints log showed that they had not received any complaints since the previous inspection. This was confirmed through conversation with the manager. The home has a clear complaints procedure and this is on display in the home. All residents are provided with this information when they move into the home. Results from resident comment cards showed that twelve of the sixteen respondents were aware of how to make a complaint. Many commented that they would take any complaints directly to the manager. All residents spoken with during a group discussion reiterated this view. Residents all commented that they could, and do speak with the manager and that he dealt with things accordingly. Relatives also confirmed that the homes’ complaints procedure had been explained to them and that they would approach the manager in the first instance. Linden House DS0000011902.V319441.R01.S.doc Version 5.2 Page 15 The home has a clear policy that they do not manage or look after any residents’ money or belongings and this is strictly adhered to. Satisfactory recruitment procedures are followed and this provides safeguards to residents. In discussion with the manager and staff they were able to demonstrate that they were aware of adult protection issues and reporting procedures. Linden House DS0000011902.V319441.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24, 25 and 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 a safe and well-maintained environment. The home is well furnished, homely and comfortable. High standards of hygiene are maintained. EVIDENCE: During the visit to the home a tour of the premises took place. This included looking at several residents’ bedrooms and all communal areas of the home. The home is well furnished, homely and comfortable. Residents have the choice of two lounges and a conservatory and all residents looked relaxed and at home in the environment. All bedrooms seen had been personalised with the person’s own belongings. Call points were installed in all rooms so that residents can summon staff help and residents said that they were encouraged to use these as necessary. All residents spoken with said that the home and Linden House DS0000011902.V319441.R01.S.doc Version 5.2 Page 17 their rooms were kept clean and that they were happy with the standards of hygiene. All residents who completed a comment card reiterated this view. There were no unpleasant odours present. It was evident that the manager and staff take a lot of pride in maintaining a high standard of hygiene and ensuring that infection control procedures are followed. Everyone contacted as part of this inspection commented on the cleanliness of the home. The home is decorated and maintained to a good standard. Since the last inspection all bedrooms and communal areas have been redecorated and the garden has been landscaped. The home employs a maintenance person. Redecoration and maintenance is planned and kept under regular review and action is taken to put right repairs appropriately. Ramps and handrails and other aids are fitted as necessary. The home has a separate laundry area with industrial washers and dryers to ensure soiled clothing is washed at the appropriate temperature. Separate baskets are used for each person’s clean laundry. Linden House DS0000011902.V319441.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are maintained. Staff are caring, friendly and helpful, well trained and appropriately recruited. EVIDENCE: Staff rotas were sent to the Commission for Social Care Inspection prior to the visit. These demonstrated that staffing levels remain constant and are maintained at the same level as at previous inspections. The visit to the home confirmed the rota to be a true reflection of actual staffing levels. The home employs domestic staff as well as care staff and this means that care staff can spend more time attending to residents’ needs. The home has a good level of staff retention and many of the staff team have worked there for a number of years. All residents spoken with were complimentary about the staff and felt that they were given sufficient support with their care needs. Everyone commented that they were friendly and helpful, All sixteen people who returned a comment card responded that the staff listened and acted upon what they said. In discussion with a group of residents all were in agreement that they received enough help and support. Residents commented that they liked the Linden House DS0000011902.V319441.R01.S.doc Version 5.2 Page 19 fact that staff were always there in the background. As one person put it, “They are not in your face”. Relatives equally spoke positively about the staff’s caring attitude. One person said, “ It helps that there are regular staff and always the same people around”. From observation of staff practice the inspector noted that staff related well to residents, in a friendly manner, offering support where necessary. Staff spoken with clearly enjoyed their job and working at the home. Records were made available to demonstrate that staff receive appropriate training. Staff have the opportunity to undertake a range of training relevant to the needs of residents. Refresher courses in all core areas are undertaken regularly. Feedback from a health professional was that, “ Linden House staff are generally very experienced and keen to maximise residents potential. They are willing to discuss issues openly and honestly”. At present just under 50 of staff have completed a NVQ level 2. However several others are currently enrolled on level 2 and others on level 3 courses and it is anticipated that the amount of staff with this qualification will rise to about 64 by June 07. The recruitment files of two new members of staff were examined and these demonstrated that the home was following appropriate recruitment procedures, to safeguard residents. Records were also available to demonstrate that new staff follow a suitable induction period. Linden House DS0000011902.V319441.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and the manager has a good knowledge of residents needs. The manager and staff team have worked hard to comply with previous requirements. Safety is promoted within the home. Record keeping has improved and this provides greater safeguards to residents. EVIDENCE: The manager Mr Baker is fully qualified to manage the home having undertaken his registered managers award and NVQ4 (National Vocational Qualification) in care. Mr Baker demonstrated that he had a good knowledge of residents’ needs and it was clear that residents and staff had confidence in Linden House DS0000011902.V319441.R01.S.doc Version 5.2 Page 21 him. The home is well managed with an experienced deputy manager in post to assist and to ensure the smooth running of the home in Mr Baker’s absence. The home has a good track record of meeting requirements and maintaining a good standard of care. With the exception of care plans all requirements from the previous inspection had been met. It was found that whilst improvements had been made to the care planning process there remains room for further improvement. The home had all necessary policies and procedures in place and these are reviewed regularly. Systems are in place to ascertain the views of residents and relatives. There is however a need for the home to develop its’ quality assurance systems further to ensure that the views of all stakeholders are sought and to enable them to assess whether they are meeting their aims and objectives and to put an improvement plan in place if necessary. The home has a clear policy that they do not manage or look after any residents’ money or belongings and this is strictly adhered to. Record keeping in respect of induction and medication records has improved. In general records are well maintained and stored safely and securely. However there is a need to ensure that photographs are kept on record of all residents. This will prove particularly beneficial should a resident go missing. The health and safety of residents and staff is promoted. Examination of the fire logbook demonstrated that regular and thorough testing of the home’s fire detection and fire-fighting equipment was being carried out. Certificates and service contracts were seen and the inspector was satisfied that all equipment used within the home had been regularly checked and serviced. There were not any concerns with regard to safety within the home environment and staff undertake regular fire training. Linden House DS0000011902.V319441.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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 3 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 3 X 2 X 3 X 2 3 Linden House DS0000011902.V319441.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement All care plans must be reviewed. They must be more detailed and provide specific support instructions and fully address all assessed and identified needs. Written guidance must be produced in respect of any resident prescribed PRN medication. This must be incorporated into their care plan. A photograph of each service user must be held on record. Timescale for action 07/03/07 2 OP7 OP9 13 (2) 31/01/07 3 OP37 17(1)(a) Schedule 3. 07/12/06 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 Linden House DS0000011902.V319441.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Linden House DS0000011902.V319441.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. 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