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Inspection on 23/05/06 for Liversage Court Residential Care Home

Also see our care home review for Liversage Court Residential Care Home for more information

This inspection was carried out on 23rd May 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Liversage Court provides a comfortable and homely environment for the people who use the service. Residents were enabled to personalise their rooms with their own possessions and furniture. Management and staff recognise the importance of providing opportunities for the people living in the home to join in with activities and entertainment. Dedicated staff time is provided, providing residents with one to one time as well as group activities. The importance of maintaining links with family, friends and the community was also recognised and supported. A number of residents have continued to access facilities in the community, such as the local shops and attendance at church services. Residents were very positive about the meals provided at the home, and stated that they were provided with choice and variety.

What has improved since the last inspection?

Improvements have been made to the medication records, as hand written entries are now checked and signed by two members of staff. Staff have been made aware of the external organisations involved in the protection of vulnerable adults, and all required information maintained on staff files.

What the care home could do better:

In order to provide appropriate and consistent care for the people living in the home, detailed assessments for all residents must be carried out, and care plans must be kept up to date, and amended to reflect any other changes. Without these safeguards, residents are at risk of not having their health and social care needs fully met. Staff induction and mandatory training needs to be managed more effectively, so that all staff are up to date with the mandatory training and complete the induction training within the timescale. A systematic and planned approach to staff supervision would assist in this process, as training needs could be identified and planned for during supervision sessions.

CARE HOMES FOR OLDER PEOPLE Liversage Court Residential Care Home Liversage Street Derby Derbyshire DE1 2LD Lead Inspector Jo Wright Unannounced Inspection 23rd May 2006 08:30 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 Liversage Court Residential Care Home DS0000001986.V293426.R01.S.doc Version 5.1 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. Liversage Court Residential Care Home DS0000001986.V293426.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Liversage Court Residential Care Home Address Liversage Street Derby Derbyshire DE1 2LD 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) 01332 291241 01332 205201 The Liversage Trust Charity Patricia Blurton Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Liversage Court Residential Care Home DS0000001986.V293426.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 6 Day Care places Date of last inspection 19th December 2005 Brief Description of the Service: Liversage Court is a purpose built two-storey building, located in a cul-de-sac close to the city centre of Derby. Liversage Court provides 40 single en-suite bedrooms over the two floors. Residents enjoy easy access around the building, and can access the first floor either by the stairs or the shaft lift. Lounge areas are located on both floors, with a spacious dining area on the ground floor. Residents also have access to well-maintained, secure landscaped gardens that have extensive patio areas with water features. Liversage Court is within easy access to the entire city centre amenities. Information about the service is provided through the Statement of Purpose and Service User Guide, both of which are available in the home. A copy of the Service User Guide is available in each room. Information about the fees was included in the pre inspection questionnaire, which was received on 08/05/06. The fees for Liversage Court are £334 per week. Liversage Court Residential Care Home DS0000001986.V293426.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection, carried out by one inspector, and lasted 8 and ½ hours. A review of the evidence available prior to site visit was undertaken, for example, the pre inspection questionnaire and the notification of incidents, and used to identify areas to be examined during the site visit. The information available was used to identify those residents whose care was to be cased tracked. Records such as care plans (as part of the case tracking process, which is used to help determine how the home meets the needs of individual residents) were examined in depth during this inspection. Time was spent taking with residents, relatives and staff and observing the daily routine. A small selection of bedrooms was viewed during this visit. Other records such as medication records, staff files and service certificates were also examined. There were outstanding requirements from previous inspection reports, which were checked again at this inspection. The registered manager was not on duty during this visit. The inspector received assistance from the assistant manager and the administrator during this visit, and the findings of this site visit were discussed with these members of staff. What the service does well: What has improved since the last inspection? Liversage Court Residential Care Home DS0000001986.V293426.R01.S.doc Version 5.1 Page 6 Improvements have been made to the medication records, as hand written entries are now checked and signed by two members of staff. Staff have been made aware of the external organisations involved in the protection of vulnerable adults, and all required information maintained on staff files. 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. Liversage Court Residential Care Home DS0000001986.V293426.R01.S.doc Version 5.1 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 Liversage Court Residential Care Home DS0000001986.V293426.R01.S.doc Version 5.1 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): 3 and 4 (Standard 6 is not applicable in this home) Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although the admission procedures ensured that residents were assessed prior to or on admission, the records gave not reassurances that these assessments had been carried out. EVIDENCE: Residents spoken with considered that the staff in the home were able to meet their needs, and that they felt well cared for. Care staff had a good knowledge of individual residents needs, and indicated that they were able to meet the needs of the current resident group. Staff were clear about the level of care that they were able to provide and when a resident became too dependent for the care provided at Liversage Court. Care staff thought that more suitable accommodation was found for the majority of residents whose needs had increased when required. During this site visit, the files for three residents were examined in detail. The evidence available did not support that the structured admission process in Liversage Court Residential Care Home DS0000001986.V293426.R01.S.doc Version 5.1 Page 9 place at the time of the last inspection in December 2005 was being followed completely. It was reported that the manager usually carried out an assessment of needs for residents whose admission to Liversage Court was planned. However, it was not clear from the files when these assessments were completed or if they had been completed for all residents admitted to the home. Out of the three files examined, only one had a completed ‘new resident’ assessment and this was dated three weeks after admission. This does not support that the needs of all residents have been properly assessed and recorded. Liversage Court Residential Care Home DS0000001986.V293426.R01.S.doc Version 5.1 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 and 11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although the care of residents was planned and given in a way that respected individuality and privacy, residents were potentially placed at risk through the inconsistent completion of risk assessments and updating of care plans. EVIDENCE: Residents and relatives spoken with considered that the staff working at the home were good, and that they were attentive to individuals’ privacy and dignity needs. Staff were observed routinely knocking on bedroom and toilet doors prior to entering. Dialogue from staff to residents was polite and respectful, and understanding of difficulties with communication and loss of memory. Relatives commented that they were generally satisfied with the care but were not always kept informed about any changes about their family member, and often only found out if they enquired when they visited. During this site visit, the files for three residents were examined in detail. The standard of the documentation seen at the time of the last inspection in December 2005 has not been maintained. Although care plans recorded Liversage Court Residential Care Home DS0000001986.V293426.R01.S.doc Version 5.1 Page 11 individuals’ needs, preferences and abilities, not all of the required documents had been completed, particularly assessments about the areas of risk affecting welfare and safety (pressure area care and falls). The files did not support that residents had been consulted on all aspects of the care planning and review progress, and several residents spoken with could not recall being asked by staff about their needs and areas where they required help. It was not clear from the monthly reviews whether there had been any change to the planned care, or the care plans updated to reflect this. Not all documents in care files were identifiable to the resident i.e. not named, and in many instances not signed and dated either. This does not constitute robust record keeping practice. Attention was paid to individual’s health care needs and referrals were made to community nursing services as required. The records examined and observation of community nursing services visiting residents supported this. Two out of the three residents whose care was case tracked looked after some or all of their own medication. However, the appropriateness to selfadminister their medication had not been risked assessed for both of these residents, and this could result in medication not been managed safely or taken as prescribed. Other matters relating to medication were satisfactory at the time of this site visit. Systems were in place to record the individual’s wishes concerning terminal care and arrangements after death. However, these had not been completed for the residents whose care was case tracked. Liversage Court has experienced the deaths of a number of residents since the last inspection in December 2005, and the Commission has been notified of these as required. Liversage Court Residential Care Home DS0000001986.V293426.R01.S.doc Version 5.1 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A range of suitable activities was being provided, which met the leisure and recreational interests of residents. The meals were good offering both choice and variety and catering for any special dietary needs. EVIDENCE: Residents spoken with were very positive about living at Liversage Court and commented that they enjoyed living there. Residents described the routine as flexible and that they were able to make decisions about how they spent their time during the day. Residents were encouraged to remain as independent as possible and were enabled to go out of the home independently if able. Dedicated staff time for activities was provided on weekdays. This member of staff was new in post, and indicated that they had spend time getting to know each resident and talking about what activities they would like organised. Residents described the range of activities that were provided, and commented that staff respect their wishes when they choose not to join in. Activities included film shows, card and board games. Visiting was unrestricted and a number of residents regularly went out with their families. Information Liversage Court Residential Care Home DS0000001986.V293426.R01.S.doc Version 5.1 Page 13 recorded in resident files supported that activities were taking place, as well as contact with family and friends. The management of Liversage Court has recognised the importance of a varied activity programme. As a consequence there are plans to buy in six week sessions of music and movement, painting and arts and crafts. Staff will be involved in these sessions, so they able to carry on with these activities. This was due to start in June 2006. Residents were encouraged to personalise their rooms as they wished, and were encouraged to bring in their own possessions, including furniture. Information about advocacy services was available in the home. Residents spoken with were very positive about the meals provided at the home. Residents confirmed that they were offered a varied diet that included choices for all meals. New menus had been developed with assistance from a dietician. Residents were aware of the new menus and had been given the opportunity to comment on these. Catering staff indicated that they had sufficient knowledge to meet individual resident’s dietary needs. Liversage Court Residential Care Home DS0000001986.V293426.R01.S.doc Version 5.1 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A satisfactory complaints procedure was in place with some evidence that people felt that their views were listened to and acted up. However, this was poorly demonstrated through records. Staff had a good knowledge and understanding of adult protection issues which protects residents from harm. EVIDENCE: Residents were made aware of the complaints procedure through the Service User Guide, as well as the procedure being on display. Residents spoken with commented that they had had no cause to complain whilst living at Liversage Court. Neither the manager nor the Commission has received any complaints about the care and services provided at Liversage Court. However, a relative was observed raising a number of concerns with the person in charge during this site visit. The person in charge dealt with the concerns appropriately, and stated that it would be recorded in the resident’s file and in the communication book, but not as a complaint. When discussed, the person in charge recognised this as an expression of dissatisfaction, but had not considered recording the information and action taken formally as a complaint. Therefore the records would not demonstrate that people’s concerns were listened to, taken seriously and acted upon. Appropriate procedures were in place to protect residents from harm. Staff training was provided through videos as part of the induction and the Liversage Court Residential Care Home DS0000001986.V293426.R01.S.doc Version 5.1 Page 15 management team have attended training provided by the local authority. Discussion with staff indicated that although they had a good understanding of the internal and external policies. Any incidents were dealt with appropriately. Liversage Court Residential Care Home DS0000001986.V293426.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 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. The standard of the environment was good providing residents with an attractive and homely place to live. EVIDENCE: Residents were provided with a comfortable and homely environment in which to live. Residents commented on the recent redecoration of bedrooms and on how nice these rooms looked. Residents had been enabled to bring in furniture and belongings from home and to furnish the room in the way that they wished. There was evidence to support ongoing investment in the home. Systems for routine maintenance and redecoration were in place. Carpets were replaced as required, and a new carpet in the first floor lounge had recently been laid. Liversage Court Residential Care Home DS0000001986.V293426.R01.S.doc Version 5.1 Page 17 Residents made good use of all of the communal areas, as well as their bedrooms. Several residents commented on the garden areas and on how they enjoyed sitting out in the enclosed courtyard. Kitchenettes were provided close to bedrooms and residents and visitors encouraged to use these facilities. Discussion with staff and observation supported that suitable aids and adaptations were provided for residents, and equipment to assist with moving and transferring residents was available. Generally, Liversage Court provided a safe environment for residents. However, the Fire Officer noted during a recent inspection of the home that a number of doors fitted with self closing devices had been wedged open. This was bought to the attention of the manager at the time of the Fire Officer’s visit. A time scale of 30 days to rectify this situation was included in the Fire Officer’s report. Liversage Court Residential Care Home DS0000001986.V293426.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 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. Staff morale was high resulting in an enthusiastic staff team that works positively with residents to improve their quality of life. EVIDENCE: The people living in Liversage Court benefit from a stable staff team, who have worked together for a number of years. Recently recruited staff commented that they felt well supported by more experienced staff members. Staff were positive in their comments that staffing levels were maintained through the use of agency staff when required. Residents and staff commented that staffing hours were sufficient to meet the needs of the current resident group, and this was supported through observation. Residents were supported by a staff team that was provided with the necessary induction and training, so that they had the skills and knowledge to deliver the care that the home offers to provide. However, as noted during the previous inspection in December 2005, newly appointed staff would benefit from additional management input and oversight to ensure that the induction training is completed on time. Residents living in Liversage Court were protected from potential risk of harm through robust recruitment and selection procedures. Liversage Court Residential Care Home DS0000001986.V293426.R01.S.doc Version 5.1 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, 32, 33, 35, 36 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 was generally well managed, and regularly seeks the views of residents and staff. Inconsistent supervision and attendance at mandatory training did not promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: The manager has been in post for a number of years, and has completed a management qualification. Staff spoken with commented that changes have been introduced during this time, and generally, this was viewed positively. Staff felt that the changes implemented had resulted in an improvement in standards within the home, and they understood the reasons behind the changes, for example, good standard of record keeping, organised activities. Staff were positive about the proposal to employ a laundry assistant and the Liversage Court Residential Care Home DS0000001986.V293426.R01.S.doc Version 5.1 Page 20 activity sessions. Staff indicated that they worked as a team, and supported new staff as well as each other. Formal quality assurance and quality-monitoring systems were in place, which actively sought the views of residents and relatives, in order to inform the running and development of the service. Satisfaction surveys for residents and staff were carried out. The results from the recent staff survey were on display. Regular residents meetings were held, and a representative of the Trustees attends these. Residents spoken with had recently attended a meeting and indicated they had been able to discuss any issues. However, there was little evidence of day to day monitoring of areas such as care plans, medication records, and accidents, which would have identified some of the issues noted during this site visit. Robust systems were in place for the safe keeping of residents monies. The records and the money held on behalf of several residents were cross referenced and found to be accurate. Although systems were in place to supervise staff practice, this was not taking place in a systematic and planned manner. Discussion with staff and records examined indicated that regular supervision was not taking place. The lack of regular supervision was also demonstrated by new staff not completing the induction within the specified timescales and not all staff being up to date with mandatory training. Up to date staff training records were not available during this site visit, as the manager was not on duty. However, a study of the fire training certificate indicated that not all staff, including management, were up to date with this training, despite the availability of this training twice a year. A sample of service/maintenance records was examined (including equipment, gas and electricity services) and there was confirmation that equipment and services are properly maintained. Systems were in place for monitoring and maintaining a safe hot water temperature. Liversage Court Residential Care Home DS0000001986.V293426.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 3 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 2 3 3 3 3 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 3 3 X 3 2 X 2 Liversage Court Residential Care Home DS0000001986.V293426.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 14 Requirement The needs of all residents must be assessed and documented either prior to or on admission to the home. Care plans must be updated to reflect any changes to the planned care as identified in the monthly reviews. Risk assessments relating to pressure area care must be completed for all residents. Care plans must be developed for residents identified as at risk of skin breakdown. Risk assessments relating to falls must be completed for all residents. Care plans must be developed for residents with a history of falls or who have experienced a fall since admission. The appropriateness of a resident to self-administer their medication must be risk assessed and documented. Adequate fire precautions must be maintained at all times. All staff must be appropriately supervised and records available DS0000001986.V293426.R01.S.doc Timescale for action 30/09/06 2 OP7 15 30/09/06 3 OP8 12(1) 13(4) 14(1) 30/09/06 4 OP8 12(1) 13(4) 14(1) 30/09/06 5 OP9 12(1) 13(4) 23(4)(a) 18(2) 30/09/06 6 7 OP19 OP36 19/06/06 30/09/06 Liversage Court Residential Care Home Version 5.1 Page 23 8 OP38 18(1)(a) & (c) to support this. All staff must receive training in the mandatory safe working practices, and accurate training records must support this. 30/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP7 OP7 Good Practice Recommendations All assessments and care plans should be identifiable to the individual resident (named), dated and signed. Care plans should be drawn up with the involvement of the resident, recorded in a style accessible to the resident, and agreed and signed by the resident whenever capable and/or representative (if any). Residents’ wishes concerning terminal care and arrangements after death should be discussed and recorded in their files. All expressions of dissatisfaction with the service should be recorded as complaints, detailing the nature of the complaint, the action taken, the outcome and feedback to person raising the concern. Newly appointed staff would benefit from additional management input and oversight to ensure that the induction training is completed on time. (This is outstanding from the previous report dated 19/12/05) 3 4 OP11 OP16 5 OP30 Liversage Court Residential Care Home DS0000001986.V293426.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Liversage Court Residential Care Home DS0000001986.V293426.R01.S.doc Version 5.1 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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