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Inspection on 09/10/07 for Moor Cottage

Also see our care home review for Moor Cottage for more information

This inspection was carried out on 9th October 2007.

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

Prospective service users are assessed prior to admission and are given opportunity to visit the home beforehand to ensure it meets their needs. The health and personal care needs of people living at the home are well met, promoting health and well-being and ensuring that they receive medication in a safe and consistent manner. Activities are available to service users to provide them with stimulation and contact with family, friends and the community is supported to maintain social links. Food is well prepared and presented attractively to make sure that nutritional needs are met. Procedures and systems are in place to listen to the views of people living at the home and their representatives and training is undertaken by staff to safeguard against the risk of abuse. The home provides staff cover to meet needs and undertakes thorough recruitment procedures, coupled with effective training to ensure staff have the right skills and competencies to support the people who live there.The home is clean, well decorated and adequately maintained, promoting a positive environment for the people who live there. Building work had started to address shortfalls in the building. The management and administration of the home promote continuity and quality of care for the people who live there and ensure that risk is safely managed to reduce the likelihood of injury or harm.

What has improved since the last inspection?

All requirements from the previous inspection were being addressed: An alternative access corridor was included in plans, as part of current building works, to enable better access to rooms in the annexe without the need to go through the kitchen. An occupational therapy assessment was commissioned regarding aids, adaptations and equipment at the home. A fire risk assessment was written regarding locked doors and the stair gate. Health and safety checks were being maintained and risk assessments developed.

CARE HOMES FOR OLDER PEOPLE Moor Cottage High Street Cookham Berkshire SL6 9SF Lead Inspector Chris Schwarz Unannounced Inspection 10:00 9 October 2007 th 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 Moor Cottage DS0000011322.V345951.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. Moor Cottage DS0000011322.V345951.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Moor Cottage Address High Street Cookham Berkshire SL6 9SF 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) 01628 526036 01628 530621 info@moorcottagecare.co.uk www.moorcottagecare.co.uk Mrs Rana Rezajooi Mrs Orcilla Magdelena Aletta van Eck Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Moor Cottage DS0000011322.V345951.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th November 2006 Brief Description of the Service: Moor Cottage is a three storey house located toward the end of the High Street in the picturesque village of Cookham in Berkshire. It is close to village amenities, such as shops, pubs and restaurants and there is a church nearby. A regular bus service running between Maidenhead and High Wycombe stops outside of the home and there is a railway station outside of the village, connecting with mainline services. The home has accommodation for up to 17 people but recently has changed some double occupancy rooms into singles, reducing maximum occupancy to 14. There were 13 people living at Moor Cottage at the time of this inspection, many with local links to the area. The home is set in well maintained gardens and has been decorated and arranged to reflect a country residence, with people enabled to bring in their own furniture and items to personalise their rooms. Work had just begun on creating a conservatory and covered walkway (plus some additional alterations) to improve facilities. Fees ranged from £500 to £900 per week. Moor Cottage DS0000011322.V345951.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was conducted over the course of a day and covered all of the key National Minimum Standards for older people. Prior to the visit, a detailed self-assessment questionnaire was sent to the manager for completion and comment cards were sent to a selection of people living at the home, relatives and visiting professionals. Any replies that were received have helped to form judgements about the service. Information received by the Commission since the last inspection was also taken into account. The inspection consisted of discussion with the manager and other staff, opportunities to meet with people living at the home, examination of some of the home’s required records, observation of practice and a tour of the premises. A key theme of the visit was how effectively the service meets needs arising from equality and diversity. Feedback on the inspection findings and areas needing improvement was given to the manager at the end of the inspection. The manager, staff and people who use the service are thanked for their cooperation and hospitality during this unannounced visit. What the service does well: Prospective service users are assessed prior to admission and are given opportunity to visit the home beforehand to ensure it meets their needs. The health and personal care needs of people living at the home are well met, promoting health and well-being and ensuring that they receive medication in a safe and consistent manner. Activities are available to service users to provide them with stimulation and contact with family, friends and the community is supported to maintain social links. Food is well prepared and presented attractively to make sure that nutritional needs are met. Procedures and systems are in place to listen to the views of people living at the home and their representatives and training is undertaken by staff to safeguard against the risk of abuse. The home provides staff cover to meet needs and undertakes thorough recruitment procedures, coupled with effective training to ensure staff have the right skills and competencies to support the people who live there. Moor Cottage DS0000011322.V345951.R01.S.doc Version 5.2 Page 6 The home is clean, well decorated and adequately maintained, promoting a positive environment for the people who live there. Building work had started to address shortfalls in the building. The management and administration of the home promote continuity and quality of care for the people who live there and ensure that risk is safely managed to reduce the likelihood of injury or harm. What has improved since the last inspection? What they could do better: The statement of purpose is to be revised to contain all required information as stated in schedule 1, to provide people with a fuller range of information about the service and what they may expect of it. Keys to the medication cabinet are to be securely stored, to prevent unauthorised access to medicines. A policy needs to be developed relating specifically to how the home aims to safeguard people from the risk of abuse to ensure that staff and management follow good practice and know what is expected of them. The handrail on the top floor flight of stairs needs to be re-fixed to the wall to provide a safer aid. Copies of reports of monitoring visits from November 06 to October 07 are to be forwarded to the Commission, to demonstrate that regular and effective monitoring takes place at the home. The hoist servicing company needs to be contacted to check whether servicing took place in June this year, to ensure that the equipment is safe to use. Please contact the provider for advice of actions taken in response to this Moor Cottage DS0000011322.V345951.R01.S.doc Version 5.2 Page 7 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. Moor Cottage DS0000011322.V345951.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 Moor Cottage DS0000011322.V345951.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): 1, 3, Quality in this outcome area is adequate. Prospective service users are assessed prior to admission and are given opportunity to visit the home beforehand to ensure it meets their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home had a statement of purpose and service users guide which set out the aims and objectives of Moor Cottage and how it can meet people’s care needs. Copies of the service users guide were kept in people’s rooms for easy access, and helpfully contained the contact details of the Commission for Social Care Inspection and the residents’ representative. The manager was advised to revise the statement of purpose to make sure that it contains all the required details outlined in the regulations, providing people with broader details than at present. A requirement is made to address this. People who completed comment cards felt they had been given sufficient information about the home before deciding to move in. One person said “After receiving a personal recommendation from a friend, my daughter visited and was favourably impressed by the home and the staff she met.” Several of the people living at the home had local links with the area. Moor Cottage DS0000011322.V345951.R01.S.doc Version 5.2 Page 10 A sample of pre-admission information was looked at. One person had been admitted for respite care, with the manager undertaking an assessment of care needs beforehand. Another file related to a recently admitted resident with detailed information provided by a local authority. In both instances, the home had offered accommodation to people whose needs it could meet and in line with its registration certificate. Moor Cottage DS0000011322.V345951.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. The health and personal care needs of people living at the home are well met, promoting health and well-being and ensuring that they receive medication in a safe and consistent manner. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans were in place for each person, containing a photograph, detailed assessment of care needs, evidence of regular reviewing and health related assessments such as nutritional screening, pressure risk indicator and risk from falls. Weights were being monitored regularly. People’s likes and dislikes had been noted and there was information about their language, faith and family/work history. A dependency level assessment was additionally being carried out regularly to track changes to care needs and the manager had put into place a falls register to log any relevant incidents. People completing comment cards indicated that the home provides the care they require and enables them to receive medical support. Relatives added that they are kept informed of health concerns and hospital appointments. Needs arising from diversity were said to be met by people completing comment cards. Moor Cottage DS0000011322.V345951.R01.S.doc Version 5.2 Page 12 A health care professional said that district nursing services are contacted as needed. A doctor said that the home meets people’s health care needs and respects their privacy and dignity adding that one of the things the home does well is providing “A caring, supportive environment.” A relative said that one of the things Moor Cottage does well is “Give the care and support she needs in a “family” environment.” Another person answered the same question with “Responds sensitively to the individual’s needs.” A relative said the home always provides the necessary support and added “Very supportive and care very well, catering for her needs.” Another said that staff support her mother “very well.” One person said “They help my mother lead as independent a life as possible but are always around to help.” A visitor said “Residents always appear to be warm, clean and well nourished and relaxed.” This was evident throughout the inspection. Medication practice was looked at as part of the inspection process. The home uses a monitored dose system of medication administration and all staff records examined provided evidence of good quality training on safe handling and administration of medicines. Comments from the home’s pharmacist were positive, stating “The care home make us aware if there are any medication changes by GP. We discuss any medication problems on a weekly basis” and added that one of the things the home does well is “manages medicines safely and does not hoard unused medicines.” It was noted that staff keep the keys to the medication cabinet in close proximity to it and other people could gain access to medicines as there is no restriction to the keys. A requirement is made to tighten up on this, to prevent unauthorised access. Moor Cottage DS0000011322.V345951.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. Activities are available to service users to provide them with stimulation and contact with family, friends and the community is supported to maintain social links. Food is well prepared and presented attractively to make sure that nutritional needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Most respondents indicated on comment cards that there were always or usually activities available to them, with a minority indicating “sometimes”. A relative said “Before moving to Moor Cottage my mother wasn’t happy leaving the house – now, she has her own wheelchair and regularly goes out for lunch, this is all down to the care, support and encouragement of the staff at Moor Cottage. It’s amazing to see the difference in her and I’m so glad we found Moor Cottage.” A range of activities was being offered to people at the home, including flower arranging (table decorations had been made by residents), bingo, singalongs, old time movies, painting, board games and a knitting club. A vicar visits the home once a month for communion and will see people in private as well. Most people started the day reading newspapers with a cup of tea in their room. One person with visual loss had access to talking books. A resident was Moor Cottage DS0000011322.V345951.R01.S.doc Version 5.2 Page 14 maintaining an orientation board in the lounge, adding the date, weather and any activities. Visitors were free to call at the home. A relative said that she is “Made very welcome at visits – tea etc, birthday teas, Xmas party, phone calls.” Another said “I can phone straight to her room and visit whenever I can – they have no set visiting hours. My mother can also phone me or any of her friends whenever she wishes.” One of the staff’s dog was also a welcome visitor for residents. A well stocked photograph album showed that numerous birthdays had been celebrated with family members invited to birthday teas. The home had a permanent cook who visits residents each day to advise them of the meal options for the day. Food was described as good and the lunch time meal of gammon in sauce or omelette was well presented and enjoyed by residents. Dining tables had been attractively set using table cloths, place mats and fresh flower decorations and some music was put on which people enjoyed and some joined in with. Afternoon tea with home made cake was served to residents around 3.00 pm. Menus showed that varied meals are prepared for people living at the home and choices are available. Moor Cottage DS0000011322.V345951.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. Procedures and systems are in place to listen to the views of people living at the home and their representatives and training is undertaken by staff to safeguard against the risk of abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home had a complaints procedure in place and a residents’ representative who is external to management and the provider is available for people to contact. Her contact details had been added to the service users guide and were additionally displayed in the entrance hall. The home also had a suggestions box and a complaints book left out for anyone to add to. People who completed comment cards were aware of how to make a complaint or who they would approach if they had any concerns. Some mentioned the residents’ representative. Information supplied by the manager before the inspection stated that there had not been any complaints about the home and no adult protection investigations of referrals had been necessary. The Commission has not received any information to the contrary about these findings. Guidance on adult protection/safeguarding adults, had been obtained for the home and staff files showed that adult protection input had taken place within the year and had been provided by a reputable trainer. The home did not, however, have its own policy on how it aims to protect people from abuse and needs to develop this area of practice to ensure that staff and management follow good practice and know what is expected of them. Links to staff Moor Cottage DS0000011322.V345951.R01.S.doc Version 5.2 Page 16 induction, training and recruitment practice were discussed with the manager as suggested areas to include to demonstrate good practice. Moor Cottage DS0000011322.V345951.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): 19,26 Quality in this outcome area is adequate. The home is clean, well decorated and adequately maintained, promoting a positive environment for the people who live there. Building work had started to address shortfalls in the building. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Moor Cottage is a well presented care home in a village location. Communal and individual rooms had been arranged to look homely, non-institutional and with residents encouraged to bring in their own possessions to personalise rooms. Decor was in good condition and floor coverings had been kept clean. No unpleasant odours were evident around the building and domestic staff were keeping the premises clean and hygienic. People completing comment cards said that the home is routinely kept clean and fresh and well maintained. One person added “I appreciate the prompt eviction of any intruding spiders.” A requirement made at the last inspection regarding obtaining an occupational therapy assessment in respect of aids and adaptations, had been addressed. The senior occupational therapist who carried out the assessment concluded that the home had the equipment necessary to cope with the needs of Moor Cottage DS0000011322.V345951.R01.S.doc Version 5.2 Page 18 residents and that the planned building works would enhance facilities by providing a covered, ramped walkway. This would provide alternative access to the annexe, without the need to walk through the kitchen, as presently. Moor Cottage has a large, well maintained garden which people make use of in good weather. The building works include addition of a conservatory which will provide additional sitting space for residents. The only point brought to the manager’s attention was a loose handrail on the top flight of stairs which needs re-fixing. A recommendation is made to attend to this. Moor Cottage DS0000011322.V345951.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. The home provides staff cover to meet needs and undertakes thorough recruitment procedures, coupled with effective training to ensure staff have the right skills and competencies to support the people who live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Moor Cottage was providing sufficient staff to meet care needs, most of which were of a low to medium nature. There were no current staff vacancies and a low turnover of staff over the past year. A domestic worker was being employed part time, covering three days a week, and a cook Monday to Friday. Photographs and names of staff were displayed in the hallway. A sample of recruitment files was looked at and found to be in good order, with all required checks undertaken. There was evidence of staff being provided with a detailed and good quality induction, providing a valuable foundation into good care practice. Training records showed that mandatory and specialist training was in good order and there was good uptake of National Vocational Qualifications. Each file examined provided evidence of staff completing a two part course on dementia care, run by the local authority. One of the people living at the home wrote in a comment card that they received the support they needed and added “Always thoughtful and helpful staff.” Another comment card said that staff are “Always polite and courteous to patients and visitors.” A relative said staff “Always appear to look after all residents well in a caring way”. Another comment was “Orcilla has a very Moor Cottage DS0000011322.V345951.R01.S.doc Version 5.2 Page 20 dedicated team who are caring, helpful and supportive to my mother… I am very impressed by the number of staff on duty and that most of them are qualified nurses.” Moor Cottage DS0000011322.V345951.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): 31,33,35,38 Quality in this outcome area is good. The management and administration of the home promote continuity and quality of care for the people who live there and ensure that risk is safely managed to reduce the likelihood of injury or harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a registered manager who is a qualified nurse and is experienced with care of the elderly. She has also completed a management development course according to information supplied in the pre-inspection self-assessment. The home’s certificate of registration was being displayed and there was evidence of current employer’s liability insurance cover. The provider lives in the vicinity of the home and is a regular visitor according to staff. The manager did not have access to reports of the provider’s monitoring visits although she was able to show a copy of a quality audit completed in July this year which had included speaking with people using the service, relatives and looking at records. A requirement is made for the Moor Cottage DS0000011322.V345951.R01.S.doc Version 5.2 Page 22 provider to send in copies of reports of monitoring visits from November last year to the present time, to demonstrate that these have taken place. The home does not manage the money of anyone living at the home and was not keeping any valuables for safekeeping. The manager was aware that a receipt would be needed if any items were held on behalf of residents. Requirements made at the last inspection regarding health and safety were being met. A sample of records and certificates was looked and – gas safety, electrical hardwiring, lift servicing, portable electrical appliances and servicing of extinguishers – and found to be up-to-date. The home had a fire based risk assessment and contract for disposal of clinical waste. It was recommended that the manager contact the hoist servicing company to check whether they visited in the summer; the need to do this was indicated on the last service report. Moor Cottage DS0000011322.V345951.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 2 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x x 3 Moor Cottage DS0000011322.V345951.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. 1 Standard OP1 Regulation 4(1) Timescale for action The statement of purpose is to 10/01/08 be revised to contain all required information as stated in schedule 1, to provide people with a fuller range of information about the service and what they may expect of it. Keys to the medication cabinet 01/11/07 are to be securely stored, to prevent unauthorised access to medicines. A policy needs to be developed 10/01/08 relating specifically to how the home aims to safeguard people from the risk of abuse to ensure that staff and management follow good practice and know what is expected of them. Copies of reports of monitoring 01/12/07 visits from November 06 to October 07 are to be forwarded to the Commission, to demonstrate that regular and effective monitoring takes place. Requirement 2 OP9 13(2) 3 OP18 13(6) 4 OP33 26 Moor Cottage DS0000011322.V345951.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP19 OP38 Good Practice Recommendations The handrail on the top floor flight of stairs needs to be refixed to the wall to provide a safer aid. The hoist servicing company needs to be contacted to check whether servicing took place in June this year, to ensure that the equipment is safe to use. Moor Cottage DS0000011322.V345951.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Moor Cottage DS0000011322.V345951.R01.S.doc Version 5.2 Page 27 - 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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