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Inspection on 13/11/06 for Mamsey House Nursing Home

Also see our care home review for Mamsey House Nursing Home for more information

This inspection was carried out on 13th November 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.

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

Mamsey House Nursing Home provides a very good level of nursing and personal care to all residents including highly dependent residents and to those who are unable to express their needs. There is a dedicated, friendly and motivated staff group who ensure that Residents have all their needs met and ensure residents access a full variety of services. Comment cards and service users spoken with confirmed that there was always someone to help if they were unwell. Residents like the friendly and caring staff. 100% of relatives who returned comment cards confirmed that they feel welcomed at the home and are confident that their relatives are in good hands. The home had enlisted the support of an Age Concern Advocate to assist vulnerable service users to complete comment cards. This is good practice. There is a varied and well-organised activities programme within the home. It is good practice that this aspect of home life is delivered by a team that includes an activities co-ordinator and care staff. The inspector was able to see a range of craft work made by service users. Staff encourage residents to maintain contact with friends, family and the local community. Bus Trips are arranged and Specialist activities are also arranged to meet the needs ofresidents. The home is clean, tidy, very well maintained and equipped to ensure Residents have a homely place to live and are helped to maintain as much independence as possible. Mamsey House is an efficiently run and organised home. Routines are flexible depending on the needs, choice and requests of the residents. The staff group are actively involved in maintaining the high standard of care. This is done by ensuring they are `up to date` with the current trends and practices in health care and listening to new ideas and ways to improve the delivery of care.

What has improved since the last inspection?

A refurbishment of the home has commenced. New carpets have been purchased. Recommendations from the last inspection have been fully met. Creams are now dated on opening. A new system of reviewing care plans has been put in place. The supply of medication has been changed. The new company provides a range of training and support.

What the care home could do better:

Overall this is a good home. The contracts provided to service users who are fully funded should give an indication as to how the fees required are to be met when external funding has been provided. On the day of inspection a new member of staff was duty before the CRB result had been received. This is not home policy.

CARE HOMES FOR OLDER PEOPLE Mamsey House Nursing Home Priest Street Williton Somerset TA4 4NJ Lead Inspector Shelagh Laver Unannounced Inspection 9th November 2006 09:30 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 Mamsey House Nursing Home DS0000003270.V318851.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. Mamsey House Nursing Home DS0000003270.V318851.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mamsey House Nursing Home Address Priest Street Williton Somerset TA4 4NJ 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) 01984 633712 01984 632281 Clinida Care Ltd Mrs Barbara Mary Kinzett Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33), Physical disability over 65 years of age of places (33) Mamsey House Nursing Home DS0000003270.V318851.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Elderly person of either sex, not less than 60 years, who require general nursing care. Up to 3 beds for personal care Date of last inspection Brief Description of the Service: Mamsey House Care Home is a converted vicarage with an additional purpose built extension. The home is registered to provide general nursing care and personal care to older people. Accommodation is arranged over two floors of the original building and on one floor in the extension. The extension was registered in 1998. All rooms are for single occupancy and vary in size. All rooms except one have en suite facilities; this room has a wash-hand basin only but is adjacent to a disabled toilet facility. Communal areas comprise of two dining areas, a lounge and activities area. Residents are also able to sit in the entrance of the home to watch the comings and goings’. The home has been adapted to meet the needs of residents who require nursing and personal care. There is independent wheelchair access to the main entrance and level access to some of the grounds. There is a ramp leading from the lounge to the patio where residents can enjoy the well-maintained gardens in finer weather. There is a fishpond, garden seating gazebo and raised flowerbeds. The home is set close to a main road a few hundred yards from the village of Williton and the local shops. The home has dedicated administration staff and a nurse Manager. There is a Registered Nurse on duty 24 hour a day. Mamsey House Nursing Home DS0000003270.V318851.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was concluded with a visit to the home by one inspector on November 2006. The manager Barbara Kinzett had returned a pre-inspection questionnaire and comment cards had been sent to service users and relatives. The inspector spoke to service users and staff and made a tour of the environment. Records relating to recruitment, training and maintenance were reviewed. This was a positive inspection demonstrating that service users and their relatives continue to be pleased with the care provided at Mamsey House. A service user summed up with “I am very content much of the time.” “They give me a sense of family.” One relative wrote “I am impressed with the standard of care and cleanliness of the home..the general friendliness and helpfulness of the staff.” What the service does well: Mamsey House Nursing Home provides a very good level of nursing and personal care to all residents including highly dependent residents and to those who are unable to express their needs. There is a dedicated, friendly and motivated staff group who ensure that Residents have all their needs met and ensure residents access a full variety of services. Comment cards and service users spoken with confirmed that there was always someone to help if they were unwell. Residents like the friendly and caring staff. 100 of relatives who returned comment cards confirmed that they feel welcomed at the home and are confident that their relatives are in good hands. The home had enlisted the support of an Age Concern Advocate to assist vulnerable service users to complete comment cards. This is good practice. There is a varied and well-organised activities programme within the home. It is good practice that this aspect of home life is delivered by a team that includes an activities co-ordinator and care staff. The inspector was able to see a range of craft work made by service users. Staff encourage residents to maintain contact with friends, family and the local community. Bus Trips are arranged and Specialist activities are also arranged to meet the needs of Mamsey House Nursing Home DS0000003270.V318851.R01.S.doc Version 5.2 Page 6 residents. The home is clean, tidy, very well maintained and equipped to ensure Residents have a homely place to live and are helped to maintain as much independence as possible. Mamsey House is an efficiently run and organised home. Routines are flexible depending on the needs, choice and requests of the residents. The staff group are actively involved in maintaining the high standard of care. This is done by ensuring they are ‘up to date’ with the current trends and practices in health care and listening to new ideas and ways to improve the delivery of care. What has improved since the last inspection? What they could do better: Overall this is a good home. The contracts provided to service users who are fully funded should give an indication as to how the fees required are to be met when external funding has been provided. On the day of inspection a new member of staff was duty before the CRB result had been received. This is not home policy. Mamsey House Nursing Home DS0000003270.V318851.R01.S.doc Version 5.2 Page 7 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. Mamsey House Nursing Home DS0000003270.V318851.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Mamsey House Nursing Home DS0000003270.V318851.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12345 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are thoroughly assessed prior to admission. Service users and their relatives are provided with sufficient information before moving into the home. All service users have contracts. EVIDENCE: The service has produced a Statement of Purpose and service users or their relatives are welcomed into the home to review accommodation and to talk to the manager and staff before moving in. Mamsey House Nursing Home DS0000003270.V318851.R01.S.doc Version 5.2 Page 10 There is a comprehensive assessment tool that is designed to collect a range of information including foot care, oral care, family involvement and history of falls. This ensures staff within the home gain a full picture of the residents before they are admitted to the home. The administration of contracts and funding arrangements is organised and thorough. The contracts supplied to the service user do not contain sufficient information to enable them to see how they are funded. This would be good practice. Mamsey House Nursing Home DS0000003270.V318851.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are protected by the homes policies and procedures for dealing with medications. The care planning system means that the health and social needs of Residents are fully planned and delivered. Service users are treated with respect and their privacy is upheld. EVIDENCE: All service users seen on the day of inspection looked very well cared for. Very frail service users and those being cared for in bed appeared warm, pain free and peaceful. Mamsey House Nursing Home DS0000003270.V318851.R01.S.doc Version 5.2 Page 12 Care plans confirmed that the staff ensure pain levels are under control and the General Practitioner and family are informed of changes in condition. Specially designed ‘turn charts’ are used to ensure frail residents are regularly moved to prevent pressure sores. Observation confirmed this specific care was being given and there were no service users with pressure damage in the home. There are plans to change the care planning system in the near future. There were some gaps in the review dates of care plans during the summer but all are now being fully reviewed and up-dated. Records and discussion with staff and service users confirmed that NHS services are accessed and that staff contact the General Practitioner and other multi disciplinary health care professionals promptly. A GP clinic is held at Mamsey House on a weekly basis in addition to emergency calls. Dental and chiropody services can be accessed in the home. Links have been established with the Continence Nurse specialist through an established link nurse. Staff were seen to knock on doors before opening, however residents have chosen to have their doors open. A private telephone line can be installed if required. Bathrooms are clearly labelled when in use and doors are fully closed when care is being provided. Comment cards from relatives sent to the inspector were very complimentary about the care their family received. Quote Thank you cards seen on the day of inspection read “Mamsey House enabled ……to enjoy a level of health and tranquillity that had evaded her for many months.” “She could not have wished to spend the last part of her life in a more friendly place.” Mamsey House Nursing Home DS0000003270.V318851.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are able to make choices about how they spend their days. Social activities are creative, well managed and varied. Links with the community and families and friends are supported well at the home. Residents enjoy the food provided. EVIDENCE: Comment cards sent to the inspector and observation on the day confirmed that service users are able to chose how they spend their time. Discussion with service users, staff and the manager confirmed the activities programme continues to be full and varied at the home. Trips are enjoyed by those service users who are able to access the homes’ minibus. One service user said “ I love going out and about.” Mamsey House Nursing Home DS0000003270.V318851.R01.S.doc Version 5.2 Page 14 Another listed the places she had been “zoo, farm, garden centre, teas….”. Christmas was mentioned in comment cards as something to look forward to in the home. “I like the children singing, the lovely food…we have fun here….” The inspector spoke with the member of staff who organised the craft activities. The discussion showed that the importance of crafts as a social event and the benefits gained by others on the edge of activity groups was fully understood. The enthuisiasm and creativity of staff was heartening. There were pictures of other activities including visits from the donkies and a fashion show is advertised in the near future. A tour of the building confirmed that residents are able to bring in personal possessions with them. Most rooms have attractive country views. Service users said the food continued to be very good. Residents are offered three full meals a day and snacks are available at all other times. Residents who were being assisted with their meals were done so in a discreet unhurried, sensitive manner. Records were kept of what was offered and taken by the more frail residents. Nutritional assessments were seen in care plans and conversations were heard demonstrating monitoring and concern for a service user who is not eating. Environmental Health Office checks have been satisfactory. The kitchen area appeared well managed. Service users are offered daily choices of meals and a menu card is completed. On the day of inspection one choice was sausages, mashed potatoes and beans. The manager said it not her choice but she monitored the success of a menu choice by the amount of waste which at this meal was negligible as it was a favourite. The menu card indicates a range of seven special diets that can be catered for including soft, reducing and high fibre. A cooked breakfast choice is available. The manager is currently investigating malnutrition in care homes and is reviewing research and best practice to further develop this aspect of care in the home. The dining areas were both attractively presented, which provides an attractive setting and helps meal times become a social event. Mamsey House Nursing Home DS0000003270.V318851.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): 16 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Mamsey House complaints procedure allows Residents and Relatives to be confident that their concerns are listened to, taken seriously or acted upon. Service users are protected from abuse. EVIDENCE: Discussion with the Manager confirmed that there have been no complaints regarding Mamsey House since the last inspection. The Commission for Social Care Inspection have not received any complaints regarding Mamsey House. A complaints procedure is displayed within the Service User Guide and entrance hall. This includes contact details and timescales. A complaints register is kept within the office areas and details of action taken and follow up information. Residents spoken to stated that they would speak with the manager if they was unhappy or had worries. Observation confirmed that Manager has displayed notices throughout the home so staff are aware of how to contact the Commission for Social Care Inspection if abuse is suspected. Staff at the home have access to a set of policies which include prevention of abuse and whistle blowing. Mamsey House Nursing Home DS0000003270.V318851.R01.S.doc Version 5.2 Page 16 The home has a copy of Somerset county council vulnerable adult policy. Mamsey House Nursing Home DS0000003270.V318851.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): 19 20 21 22 23 24 25 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Mamsey House provides a safe comfortable home in which residents are able to stay as independent as possible. The home has a good standard of décor, furnishings and fittings, which provide a comfortable pleasing environment for residents to live in. EVIDENCE: Mamsey House Nursing Home is accessible, safe and well maintained. A programme of routine maintenance was being performed by the maintenance man. The gardens are attractive and well maintained. The home was clean and tidy and free from offensive odours on the day of inspection. Mamsey House Nursing Home DS0000003270.V318851.R01.S.doc Version 5.2 Page 18 The home has two comfortable dining rooms, one lounge downstairs with level access onto a patio area, and a small quiet upstairs lounge. Some residents chose to stay in their rooms or within the entrance hall so they could watch the ‘comings and goings’. All furnishings are domestic in style and of good quality. The communal rooms are well lit. Some carpets have already been replaced and there are plans to recarpet communal areas in the near future. The home is a non-smoking home however a service user has been admitted who smokes his pipe. Currently he is smoking outside the door however with the onset of colder weather an alternative solution must be found for him. The premises were clean and free from unpleasant odours. The homes staff manage the control of infection to a high standard. There are hand-washing facilities throughout the home. Gloves and aprons are available for staff to use and there are safe systems for the disposal of waste for example foot operated flip top bins are used and the home has waste collection contracts. There are sluice facilities. A rota designates a staff member on each shift to ensure the sluice s are clean and odour free. Following the last inspection dates of opening are recorded on all creams. The manager is ordering smaller pots of cream to ensure they are used within the recommended time spans. There appeared to be adequate supplies of clean linen and towels in the home. Mamsey House Nursing Home DS0000003270.V318851.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): 27 28 29 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users needs are met by the numbers and skill mix of staff on duty. Staff are trained and competent to do their job. The home has recruitment policies and procedures that protect service users. EVIDENCE: Rotas confirmed that adequate numbers of nursing, care and ancillary staff are on duty. 10 of the 22 care staff on duty have an NVQ 2 and 2 more have almost completed their qualifications. 5 care staff and 5 catering staff are commencing training in the near future. The home employs an experienced RGN as a trainer who is able to provide tailor made sessions to meet the needs of carers in the home. Training is delivered in a flexible and creative manner utilising a range of training opportunities. The Manager confirmed that all staff were up to date with mandatory training. There are three manual handling trainers who are regularly up-dated and fire wardens who ensure fire drills and staff up-dates are maintained. The home diary shows a range of short in-house training sessions from visiting specialists including on wound dressings, nutrition and Mamsey House Nursing Home DS0000003270.V318851.R01.S.doc Version 5.2 Page 20 continence promotion. Staff also leave the home for training for example medication training and CSCI study days. Staff receive a thorough induction and following assessment can become key workers. Recruitment procedures are sound and thorough. Mamsey House Nursing Home DS0000003270.V318851.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): 31 32 33 34 35 36 37 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Manager continues to manage the home well. Maintenance regimes promote the health and safety of service users. There are reliable administration and finance in place. EVIDENCE: Mamsey House Nursing Home is owned by Clinicare Ltd. The organisation has clear lines of accountability and is directed by a retired local General Practitioner. Mamsey House Nursing Home DS0000003270.V318851.R01.S.doc Version 5.2 Page 22 The clinical management for the home is provided by the Manager, who is an experienced Registered General Nurse. She is assisted by an experienced deputy and team of Registered Nurses. There is a strong team approach that has enabled the home to continue running smoothly during a recent illness of the manager. The Manager keeps updated though study days, peer discussion and keeping up to date with changes in health care practices. Discussion with staff within the home confirmed all staff are aware of making sure residents are happy with the care they receive. The Chef confirmed he had adequate funding to provide the menus enjoyed by service users. A monthly newsletter informs service users of forthcoming activities and special events and other news. The Manager continues to be a key driving force in the home and continued to maintain contact even when ill. The most recent quality questionnaire was completed by visitors in October. It indicated that all 22 visitors considered the care to be either excellent or good. 12 of the 22 visitors felt the home was excellent. Staff appraisals and supervision sessions are undertaken by the manager. Understandably these are currently a little behind schedule. The inspector discussed the possibility of spreading the responsibility for supervision by involving other staff whilst acknowledging the managers wish to be involved in this key activity. All records seen on the inspection were is good order and stored securely. All equipment within the home was seen to be in good order. Fire extinguishers and hoists service records confirmed required servicing had been undertaken.. Mamsey House Nursing Home DS0000003270.V318851.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 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 18 3 3 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 3 3 3 3 3 Mamsey House Nursing Home DS0000003270.V318851.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP2 OP12 Good Practice Recommendations Contracts should indicate where contributions for fees are coming from so that service users are clear how they are being funded. Arrangements should be made for the pipe smoking service user who has been admitted to enable him to smoke in comfort in the cold weather. Mamsey House Nursing Home DS0000003270.V318851.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: 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 Mamsey House Nursing Home DS0000003270.V318851.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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