Inspection on 26/01/06 for Manor Rest Home

This inspection was carried out on 26th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Manor Rest Home 04/12/08

Manor Rest Home 13/02/08

Manor Rest Home 01/03/07

Manor Rest Home 19/06/06

Manor Rest Home 25/07/05

Manor Rest Home 11/03/05

Manor Rest Home 07/12/04

Manor Rest Home 30/03/04

Manor Rest Home 30/10/03

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Manor Rest Home 35 Manor Road Westcliff On Sea Essex SS0 7SR Lead Inspector Mrs Bernadette Little Unannounced Inspection 26th January 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Manor Rest Home DS0000015461.V279931.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. Manor Rest Home DS0000015461.V279931.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Manor Rest Home Address 35 Manor Road Westcliff On Sea Essex SS0 7SR 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) 01702 343590 01702 343590 www.mrh.org.uk Mrs Rebecca Mary Hart Mrs Rebecca Mary Hart Care Home 19 Category(ies) of Dementia - over 65 years of age (1), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (1), Old age, not falling within any other category (19) Manor Rest Home DS0000015461.V279931.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home provides accommodation and personal care for up to 19 Older People over the age of 65 years. The home provides accommodation and personal care for one service user with dementia over the age of 65 years whose identity is known to the Commission for Social Care Inspection. The home provides accommodation and personal care for one service user with a mental disorder over the age of 65 years whose identity is known The home provides accommodation and personal care for one service user with a mental disorder over the age of 65 years whose identity is known to the Commission for Social Care Inspection. 25th July 2005 Date of last inspection Brief Description of the Service: Manor Rest Home provides personal care and accommodation for 19 older people in seven single and six double rooms. Some rooms had en-suite facilities. The home is privately owned. The home was formally two large semi-detached houses that have been converted into one property and is situated in a residential area of Westcliff on Sea. The home is a short distance from bus routes, the main railway station and the seafront. There are two separate lounges and a dining room/conservatory. There is a garden area to the rear of the property with seating for residents, and a parking area at the front. The home has it’s own minibus which is used to take residents on outings. Manor Rest Home DS0000015461.V279931.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second routine unannounced inspection of Manor Rest Home this year. It took place on a Thursday and was undertaken by two inspectors. All areas of the house were looked at, as were records and documents. Time was spent talking with residents, visitors and staff and also looking at the everyday routines of the home. The registered owner/manager was involved in the inspection and advice and feedback was given throughout. The assistance given by residents, visitors and all the people who worked at the home was much appreciated. What the service does well: What has improved since the last inspection? What they could do better: Records in general need to improve. This included those about how residents are to be cared for, and show anything that might be a risk to a resident’s wellbeing hah been thought about carefully. Manor Rest Home DS0000015461.V279931.R01.S.doc Version 5.1 Page 6 Staffing levels must be maintained at adequate minimum levels, including by providing staff for cooking and cleaning. Staff records and checks must be in place for all staff and have all the details that must be kept. Training, and records about it, must be better planned and regular. Continue to address requirements and recommendations which relate to medication and training. The home’s Adult Protection policy and procedures should be revised in line with guidance from the Department of Health, together with appropriate training opportunities for staff. 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. Manor Rest Home DS0000015461.V279931.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 Manor Rest Home DS0000015461.V279931.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): 1, 2, 4, 5 Contracts provided good information for users of the service. Prospective residents and other significant people were supported and welcomed to visit the home prior to admission. EVIDENCE: The Statement of Purpose, sent to the Commission following the last inspection, generally met the standard. It should contain a statement of the home’s aims, objectives and philosophy of care. It should more clearly identify the room sizes and other aspects of the premises that do not meet the National Minimum Standards, for example bathing facilities. Two contracts were sampled. They were available, detailed and signed. This is a positive development from the last inspection. The majority of staff had attended dementia care training. There was limited evidence to show that staff had had training on conditions associated with older people for example sensory impairment or diabetes. The manager said Manor Rest Home DS0000015461.V279931.R01.S.doc Version 5.1 Page 9 that staff NVQ training covered many areas. She confirmed there had been no specific training on behaviour that challenges, a current issue in the home. A visitor spoken with confirmed that trial visits are encouraged and supported. Manor Rest Home DS0000015461.V279931.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, 9, 10. Care plans could better identify each resident’s individual care needs, and how these are to be met by staff to ensure consistent care. While not fully meeting the standard, management of medication was improved. EVIDENCE: Care plans were in place for all residents, including the most recent admission, which is positive. They did not identify all aspects of each resident’s assessed and current needs, including preventative steps/risk assessment tools, or provide staff with detailed instructions on how these were to be managed. Photographs were available for all residents, except those who had made a choice to refuse, and this was recorded. Medication storage was notably improved. There were no omissions on the Medication Administration Recording sheets (MAR). The registered manager was given advice on avoiding the use of hand transcribed MARs. Protocols should be in place for ‘as required’ (PRN) medications. A risk assessment must be in place for a resident who was self-medicating, the practice of which itself is considered positive. Homely remedies needed to be identified as such on the MARs. Eardrops, and a bottle of Lactulose that did not have a pharmacy label and was not on the MAR for a resident, needed to be identified on the Manor Rest Home DS0000015461.V279931.R01.S.doc Version 5.1 Page 11 homely remedies list. Written consent from a GP for homely remedies should also be obtained. The home should obtain a current medication directory. Staff responsible for the administration of medication must be provided with training and updates/competence assessment. Examples of staff respecting resident’s dignity and privacy were seen and heard during the inspection. This important aspect of care is recorded as included in the staff induction programme. Manor Rest Home DS0000015461.V279931.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. Residents experienced a stimulating and varied life at the home with visitors encouraged, various informal activities made available, and good meals. EVIDENCE: Staff were observed undertaking individual activities with residents who did not want to join in with the activities co-ordinator, who had been employed by the home since the last inspection. She is very experienced person who has studied the needs of older people and is employed one day a week for two hours. She explained that an assessment of residents needs was being undertaken with a view to possibly increasing the amount of time she spends at the home. This additional time may be on a one to one basis with some residents, subject to their agreement and the home’s. Residents’ initial assessments of needs and care plans, included details relating to leisure and social interests and records in place to evidence daily activities they had participated in. Areas where activities may be taking place, such as residents’ bedrooms, the conservatory etc, should be more specific in the care plan i.e. reading, listening to music etc. Visitors to the home spoken with confirmed that they were made welcome during their visits and nothing was too much trouble. They visited on different Manor Rest Home DS0000015461.V279931.R01.S.doc Version 5.1 Page 13 days, had no set pattern of visits, and found the same care and support from staff positive and encouraging whenever they visited. Residents’ financial arrangements remain the same as the last visit to the home, with confirmation by the home regarding the pooling of residents’ money. This arrangement referred to the safe keeping of residents’ allowances together in the safe and not surplus monies absorbed into the proprietors’ personal account. Records examined confirmed that there was an adequate arrangement for recording expenditures with receipts to support any outgoings. An audit of residents’ allowances is undertaken every 2-4 weeks. Relatives or legal representatives responsible for residents’ finances, are invoiced and requests made by the home to top up accounts or provide additional expenditure if required. At the time of the inspection none of the residents were looking after their own allowances, although following discussions, some residents could be encouraged to start this process. Since the home’s last inspection, food hygiene training has been further developed through a scheme introduced and supported by the local borough council. “Safer Food, Better Business” concentrates on the new regulations introduced this year and identifies a range of checks and procedures that should be carried out. Senior staff will undertake the course and cascade this down to care staff when completed. Residents spoken with during luncheon said they enjoyed the meal and food in general was of a good standard. Manor Rest Home DS0000015461.V279931.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): 18 Arrangements for the protection of residents are not satisfactory placing them at possible risk of harm or abuse. EVIDENCE: The registered manager confirmed that none of the staff had had training on positive responses and managing behaviour that challenges, although this is a current issue in the home. The home’s policy and procedures for the protection of Vulnerable Adults, makes no reference to the Department of Health (DH) guidance “No Secrets” to ensure the safety and protection of residents. Further information from this document would be beneficial for all staff in understanding what abuse is and the procedures for passing on concerns to the appropriate authority, including the Commission for Social Care Inspection (CSCI). Adult Protection training is being offered to staff when it becomes available. A policy outlining procedures for Whistle Blowing is available to staff together with a copy of the Southend Adult Protection manual. Manor Rest Home DS0000015461.V279931.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25 and 26 Recent investment has significantly improved the appearance of the home creating a comfortable environment, however, some further maintenance is required. EVIDENCE: The home continues to make progress in relation to the décor of the premises with rooms recently being decorated and new furniture purchased for the main lounge. New carpets have been laid in two bedrooms and the conservatory floor is now covered with a laminate material. Flooring previously commented on that was uneven and moved when walked on, has been repaired but may need to be revisited due to movement of the foundations. The proprietor agreed he would look into further remedial work being carried out. A programme of routine maintenance and renewal of fabric is ongoing with a record being kept of work carried out and any damages requiring attention. Manor Rest Home DS0000015461.V279931.R01.S.doc Version 5.1 Page 16 The Essex Fire and Rescue Service confirmed that Room 5 did not have to have a fire exit door and fire precautions in relation to the conservatory were acceptable. Rooms inspected were found to be individually and naturally ventilated and centrally heated. Risk assessments are in place to minimise risk in relation to uncovered radiators/pipe-work and hot water outlets in residents’ bedrooms. Baths had been fitted with pre-set valves to ensure that water temperatures remain as close to 43 degrees centigrade. Work has been carried out on the water supply to the ground floor bath but requires further attention. The proprietor stated that he would contact the company who carried out the work. Work required to be carried out in the home’s laundry area remains outstanding in relation to the walls, flooring and hand washing facilities. Washing machines have the specified programming ability to meet disinfection standards and risk assessments have been carried out regarding Legionella. Manor Rest Home DS0000015461.V279931.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Staffing levels at times were not adequate. Staff recruitment and training records did not show sufficient robustness to safeguard residents and staff. EVIDENCE: Following a concern raised in the last inspection report, the person registered undertook an assessment of staffing hours at the home, and confirmed that the home were some 40 hours short of the minimum level, even assuming that 18 of the 19 residents were low dependency. The previous inspection identified an inadequacy in the staffing level, which at that time was maintained at three care staff on all day, plus domestic staff. This level has further been reduced without any significant reduction in resident numbers or dependency levels. The home now provided two staff between 7am and 8am, three staff between 8am and 2 pm, two staff between 2pm and 3pm, three staff between 3 pm and 9 pm, including the senior carer are on duty. This does not comply with the previous minimum agreed levels. The registered manager stated that her husband would be additional to that time when he is there. There were no ancillary staff and the senior care staff on duty each day undertakes the cooking, which is not conceded the most appropriate deployment of staff. Staffing levels must be reassessed, including the need for ancillary staff, to ensure that the needs of residents can be met at all times. Manor Rest Home DS0000015461.V279931.R01.S.doc Version 5.1 Page 18 An additional member of staff had been employed for two hours once a week for social activities. The deputy manager had achieved NVQ level 2 and a member of care staff had completed NVQ level 3. The registered manager advised that two staff had completed the course and were awaiting their certificates, and that two others had completed the course but that the college and adjudication had lost their work. Original Criminal Record Bureau (CRB) checks were seen for most staff. No records were available for one member of staff sampled. Some files did not show a start date so it could not be ascertained whether appropriate checks had been completed prior to commencement of employment. This includes evidence that all staff starting at the home have a Criminal Record Bureau check/Pova First check carried out for that home prior to employment commencing. The record of training showed no entries of any training for at least three staff working in the home. While certificates were not yet available, the registered manager advised that there had been very recent training for two staff in pressure care and nutrition, for one staff member on adult abuse and booked training on falls prevention and vital signs for three staff, which is positive. It was again disappointing to note that while the home has it’s own moving in handling trainer, staff have not had up-to-date moving and handling training. Advice was provided on the introduction of a staff-training matrix for both mandatory and residents’ specific training needs, which would be highlighted at supervision sessions, and is the basis for the home’s training plan. Manor Rest Home DS0000015461.V279931.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, 35, 36, 37, 38 Training for the registered manager on management aspects and systems would benefit residents, staff and the manager. EVIDENCE: The registered manager advised that she qualified as a nurse 15 years ago and did not feel that she needed to undertake NVQ level 4 training. Advice was provided to the registered manager on taking the management section of the Registered Managers Award. As previously reported under standard 14, records in relation to residents’ finance were inspected and found to be correct. Staff are currently not provided with formal supervisions at Manor Rest Home. The registered manager’s husband stated that she had undertaken the training over a year ago but had not yet implemented the system. Manor Rest Home DS0000015461.V279931.R01.S.doc Version 5.1 Page 20 Records that needed attention have been identified in the report, including for example care plans. Additionally records identified at the last inspection, such as a record of visitors or a record of charges to residents, remained unavailable. Risk assessments in relation to the premises have been completed since the last inspection. The servicing of equipment and tests are carried out on a regular basis with records kept. The following records were in place: • • • • • • • • • 5 year Electrical Installation Certificate – 26/05/05. Hoists – 28/04/05. Stair lift – 19/05/05. P.A.T. – 19/01/06. Fire Officer Visit – 03/05. Risk Assessment re-assessed 07/07/05. Fire Equipment servicing by MPE. Emergency Lighting Tests. Fire Alarm Tests. Gas Boiler – 05/08/05. Manor Rest Home DS0000015461.V279931.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 2 3 X 2 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 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 X 17 X 18 2 3 X X X X X 2 2 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X 3 1 2 3 Manor Rest Home DS0000015461.V279931.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7OP7 Regulation 15(1) Requirement Timescale for action 15/03/06 2 OP7OP7 15(2)b 3. OP8OP8 13(1)c & Sch 3(3) 4. OP9OP9 13(2) Each resident must have a written care plan that includes detailed information for staff to follow to meet and manage all aspects of the residents needs, in terms of their health and welfare. (Previous timescale of 15/09/05 not met). All care plans must be reviewed 15/03/06 regularly and as necessary to match changes in the persons needs. (Previous timescale of 15/09/05 not met). The registered person must 15/03/06 ensure that detailed risk assessments are carried out for residents to identify their needs and support the plan of care, this includes for example pressure area prevention and nutritional needs. (Only this aspect of this standard considered and previous timescale of 15/09/05 not met). The registered person must 15/03/06 make arrangements for the safe recording and keeping of medications in the care home. (The inspection reports of DS0000015461.V279931.R01.S.doc Version 5.1 Manor Rest Home Page 23 5 OP9OP9 13(2) & 18(1)c (i) 6 OP18OP18 13 (6) 7 OP26OP26 13 (3) 8 OP27OP27 18(1)a 9 OP29OP29 19, Sch 2 11 OP30OP30 18(1) & 13(5) 7/12/04, 11/03/05 and 25/07/05 identified this issue as a requirement, and the previous timescales set have not been met). The registered person must ensure that staff employed at the care home are provided with training appropriate to the work they are to perform. This refers to medication training. (Previous timescale of 15/09/05 not met). The registered person must ensure that there are policies and procedures in place to protect residents from abuse. The registered person must ensure that the laundry area is refurbished to prevent the spread of infection and toxic conditions. The registered person must ensure that staff numbers and deployment meet the needs of the residents. (The inspection reports of 7/12/04, 11/03/05 and 25/07/05 identified this issue as a requirement, and the previous timescales set have not been met). The registered person must ensure that the details of all persons working at the home include all the elements required by regulation. (The inspection reports of 7/12/04, 11/03/05 and 25/07/05 identified this issue as a requirement, and the previous timescales set have not been met). The additional outstanding issue of evidence of staffs legal right to work at the home will be considered at a future inspection. The registered person must ensure that all staff are provided with appropriate training for the DS0000015461.V279931.R01.S.doc 15/03/06 01/03/06 01/04/06 01/03/06 01/02/06 15/03/06 Manor Rest Home Version 5.1 Page 24 12 OP36OP36 18(2) 13 OP37OP37 17(2) & Schedule 4 14 OP37OP37 17(2) & Schedule 4 17(2) & Schedule 4 15 OP37OP37 16 work they are to perform, for example training in moving and handling and other basic mandatory training plus resident specific training. (The inspection reports of 7/12/04, 11/03/05 and 25/07/05 identified this issue as a requirement, and these previous timescales have not been met). The person registered must ensure that staff are provided with appropriate supervision. (The inspection reports of 30/03/04, 7/12/04, 11/03/05 and 25/07/05 identified this issue as a requirement, and these previous timescales have not been met). The staff roster must include the name of all persons working at the care home and a record must identify the hours actually worked by them. (Previous timescale of 15/09/05 not met). A record of visitors must be maintained in the care home. (Previous timescales of 01/06/05 and 15/09/05 not met). A record must be kept in the care home, of the care home’s charges to residents, including any extra amounts payable for services not covered by those charges, and the amounts paid for by, or in respect of, each resident.(Previous timescale of 15/09/05 not met). The registration certificate must be displayed in full in the home. (Previous timescale of 01/05/05 and 15/09/05 not met). 15/03/06 01/02/06 01/02/06 01/02/06 01/02/06 Manor Rest Home DS0000015461.V279931.R01.S.doc Version 5.1 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP1OP1 Good Practice Recommendations The Statement of Purpose should include information on the homes aims, objectives and philosophy of care and identify more clearly the physical environment standards met, or not met, by the home in relation to standard 20.1, 20.4, 21.3, 21.4, 22.2, 22.5, 23.3 and 23.10,. A summary of these should appear in the Service User Guide. The home should be better able to evidence it’s ability to meet the needs of residents in staff training on the conditions associated with older people and the home’s specific client group. Protocols should be in place for PRN medications. Risk assessments should be in place to support selfmedication. Homely remedies should be recorded accurately and their safety confirmed by the GP. Staff should have access to a current medications directory. 50 of care staff should achieve NVQ level 2 An assessment should be undertaken of staff training needs The registered manager should achieve NVQ Level 4 training, Registered Manager’s Award. 2 OP4OP4 3 4 5 6 7 8 9 OP9OP9 OP9OP9 OP9OP9 OP9OP9 OP28OP28 OP30OP30 OP31OP31 Manor Rest Home DS0000015461.V279931.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Manor Rest Home DS0000015461.V279931.R01.S.doc Version 5.1 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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