Inspection on 24/11/05 for Oak Tree House

This inspection was carried out on 24th November 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Oak Tree House 24/09/08

Oak Tree House 09/10/07

Oak Tree House 27/04/07

Oak Tree House 27/04/06

Oak Tree House 13/06/05

Oak Tree House 04/01/05

Oak Tree House 14/07/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Oak Tree House Lark Rise Brimsham Park Yate South Glos BS37 7PG Lead Inspector Grace Agu Unannounced Inspection 09:02 24 November 2005 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 Oak Tree House DS0000020252.V261833.R01.S.doc Version 5.0 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. Oak Tree House DS0000020252.V261833.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Oak Tree House Address Lark Rise Brimsham Park Yate South Glos BS37 7PG 01454 324141 01454 324151 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) Laudcare Ltd (a wholly owned subsidiary of Four Seasons Health Care Ltd) Mrs Daisy Jean Finlay Matthews Care Home 80 Category(ies) of Old age, not falling within any other category registration, with number (80) of places Oak Tree House DS0000020252.V261833.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. May accommodate up to 80 persons aged 50 years and over who are receiving nursing care Of the total 80 persons, up to 10 persons (who must be 65 years or over) may be accommodated and provided with personal care. Manager must be a RN on parts 1 or 12 of the NMC register. The staffing notice dated 19/8/1999 applies. Date of last inspection 2nd September 2005 Brief Description of the Service: Oak Tree House is a purpose built home, operated by Four Seasons Health Care. Mrs Janet Miller was recently registered as the new Home manager. The home is situated in a residential location, within a quiet cul-de-sac and is accessible to local shops, amenities and bus routes. The property provides bedroom and communal accommodation over two floors for 80 residents. Bedroom accommodation is provided in good-sized single rooms with en-suite facilities. There is level access throughout the home and all areas of the home are accessible via the passenger lift. There are nine communal areas throughout the home, including an activities room. There are a suitable number of bathrooms and toilets with adaptations to meet the care needs of residents in the home. Appropriate equipment is provided for individual use based on assessed identified needs. All rooms have a call alarm system. The home is set in its own grounds with a garden and patio area to the back of the house. Car parking is available for several cars. Visitors are welcome to the home at any time. The home employs two activities organisers who make efforts to provide activities during the week. Oak Tree House DS0000020252.V261833.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection which took place over nine hours and was undertaken to review the care practice to ensure that it is in line with the legislation and that best practice is followed at the Home. It was also undertaken to review the requirements made at the last inspection to ensure that they have been met. In addition, the Inspection was undertaken to follow up an anonymous letter received by the Commission in relation to staff working too many and long hours which was impacting on the health and safety of the residents. Full details in relation to the above concerns can be found in the body of this report. As a part of this inspection one immediate requirement was made in relation to preparing a care plan for an identified residents’ specific needs. A tour of the building was undertaken and a number of records were viewed. Six residents, four staff members and two resident representatives were spoken with on the day. What the service does well: What has improved since the last inspection? Oak Tree House DS0000020252.V261833.R01.S.doc Version 5.0 Page 6 The Home has a new Registered Manager, Mrs Janet Miller. Residents, staff and relatives confirmed that the Manager is making improvements in various areas of the service. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Oak Tree House DS0000020252.V261833.R01.S.doc Version 5.0 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 Oak Tree House DS0000020252.V261833.R01.S.doc Version 5.0 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): 1,2,3,4,5. The Home provides information to prospective residents and their representatives and ensures that the admission process provides safeguards to meet the assessed needs of the residents. EVIDENCE: There is a Statement of Purpose and a Service Users’ Guide at the Home, which contain required information. The Service Users’ Guide is given to all prospective residents and/or their families when they visit the Home to enable them to make informed choice of moving into the Home. Residents are also informed of one-month trial period to enable them to make a decision to stay or find alternative placement. Review of two recently admitted residents showed that one of the residents was assessed at the hospital and the other resident was assessed while on respite at the home to ensure that the home is able to meet their needs. The Oak Tree House DS0000020252.V261833.R01.S.doc Version 5.0 Page 9 two residents confirmed that their relatives were invited by the Home to look round and choose the rooms to be occupied before they moved in. It was agreed that the home must confirm to the residents in writing that the Home is able to meet their needs. Written Terms and Conditions given to their relatives to sign had not been returned to the Home. Oak Tree House DS0000020252.V261833.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11. Whilst the Home offers care and support to residents including at the end of their life, it has not met the health care needs of some identified residents. EVIDENCE: Six care files were reviewed. There was evidence of pre-admission assessments of residents to ensure that their needs will be met. Most of the identified needs on admission had individualised care plans which described how these needs are to be met, these care plans were regularly reviewed. Evidence in the daily report showed detailed entries of how the home is meeting these needs. However, one resident noted, while touring round the building, to be very noisy and agitated was reviewed. The care file contained care plans in relation to depression and anxiety, there were entries on 07/11/05 which stated “banging her chair”; 13/11/05 “agitated morning” and 21/11/05 “noisy at times”. There was no care plan in relation to how staff are to meet the needs Oak Tree House DS0000020252.V261833.R01.S.doc Version 5.0 Page 11 and ensure that other residents enjoy a reasonable and comfortable environment. The Manager stated that the resident was visited by the Community Psychiatric Nurse (CPN) on 17/11/05 and had developed a strategy on how staff are to care for the resident when she is in a challenging mood. It was agreed at a discussion with the Manager that this strategy be incorporated into a care plan to ensure that staff adequately meet her/his needs. Regulation 37 notification sent to the Commission in relation to a resident admitted to the home with pressure sore from hospital, also with viral infections was followed up. Sadly the resident passed away suddenly on the morning of the inspection. However, it was noted that the resident had care plans in place and were regularly reviewed. Evidence showed that the resident was professionally cared for before and after death. All necessary documentations were up to date. There was evidence of other professional visits to the Home to include the CPN, doctors, chiropodist and district nurses. Residents spoken with stated that they are satisfied with the care given to them. One resident stated “all the carers are good, they respect me, they will do anything if I ask them”. Another couple interviewed stated “care is good, staff treat us with respect”. Evidence of residents’ wishes in the event of death was noted in the files reviewed. The Home has a Death and Dying Policy. Oak Tree House DS0000020252.V261833.R01.S.doc Version 5.0 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): 13,14,15. The Home enables the residents to maintain contact with families and local community; it also ensures that choice is provided in respect of meals, mealtime and daily life routine and activities. EVIDENCE: Residents spoken with on the day of inspection confirmed that the home actively supports them to maintain contact with families, friends and representatives. One resident stated that she/he has three sons and that they visit when they can, however, they regularly phone the home to enquire about her/him. Another resident has a daughter who lives locally and visits regularly. A couple spoken with stated that their daughter visits every evening with their grandson, they live locally “we look forward to their visit every day”. There was also evidence from the visitors’ book that residents are visited regularly and that links with the local community are maintained. Evidence of residents’ programme of activities was noted displayed on the board. They include card and gift, 18/11/05, Church service, Christmas party. Other activities noted included Bingo, Puzzle Shop, painting and fashion and fun. Oak Tree House DS0000020252.V261833.R01.S.doc Version 5.0 Page 13 There was individual recorded activities participation for all residents including the residents who prefer to stay in their rooms. A letter of gratitude from relatives of a resident who recently celebrated her/his 104th birthday was noted displayed on the activities board. Staff were noted wearing aprons at lunchtime whilst serving residents with their meals. It was observed that this was served in a courteous respectful and dignified manner. There was a choice of two meals to include fish cake and mash potatoes with vegetables or lasagne with mash potatoes, fresh cabbage and peas. Residents interviewed during and after lunch stated that they enjoyed the meal. One such comment was “the food is good”, “food is better” and “I enjoyed my meal”. The Commission for Social Care Inspection received a notification (Regulation 37) in relation to closing of the main kitchen from 05/12/05 to 10/12/05 to enable the Home to carry out refurbishment of the kitchen including the repair of the kitchen floor. The Home made satisfactory arrangement for preprepared hot meals to be delivered by a food company during this period. On the day of the inspection, residents spoken with confirmed awareness of this work to be done in the kitchen and that letters were sent to residents and their relatives. Kitchen staff and other staff members were aware of the work and the strategies put in place to ensure smooth running of the home during this period. This is commendable. The Manager was contacted on 12/12/05 and she confirmed that there were little or no disruptions and that the work was satisfactory. The Chef stated that one new kitchen assistant commenced work on 19/11/05 and that the staff member had a good induction to enable him to work effectively as a part of the team. Oak Tree House DS0000020252.V261833.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18. Residents are enabled to complain and are confident that their complaint would be listened to. EVIDENCE: A copy of the complaints procedure was noted displayed at the main entrance and lounge on the first floor. This document contained information about the Commission for Social Care Inspection to enable the residents to contact the Commission if they had any concerns or complaints, which were not satisfactorily resolved by the Home or the Organisation. The complaint book was reviewed. It was noted that a complaint made by a relative on 11/11/05 in relation to poor quality convenience food was little fresh vegetables and the resident’s request for ham but was given corned beef was responded to by the Regional Operations Manager. The Home had not received a feed back from the family in relation to the response; however, the Manager stated that, she had spoken to a family member who seemed satisfied with the explanation. The Commission for Social Care Inspection also received a letter of concern from Social Services in relation to poor quality of care given to a resident at the Home whilst she/he was on admissions. The concern stated that the resident fell and broke two fingers, this was not detected until the resident was transferred to another care home. A satisfactory explanation was received by Oak Tree House DS0000020252.V261833.R01.S.doc Version 5.0 Page 15 the Social Services; a copy was received by the Commission. The Social Service and the Commission were satisfied with the process and the matter was drawn to a close. Residents and relatives spoken with confirmed that they would complain to the Manager or staff member if they had any complaints and staff members showed awareness of how to enable the residents to complain. The Home has South Gloucestershire guidance on the Protection of Vulnerable Adults from Abuse. The Organisation procedure for reporting incidences of abuse was also noted at the Home. Staff interviewed demonstrated awareness of the Whistle Blowing Policy and would report any bad practice to the management without fear of reprisal. Evidence from newly appointed staff showed satisfactory documentation required by the Regulations to protect residents from abuse. The Home checks Personal Identification Numbers (PIN) of all Registered Nurses with the Nursing and Midwifery Council (NMC) before commencement of employment and periodically. One resident spoken with stated that she voted by postal vote at the last election. Oak Tree House DS0000020252.V261833.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22,26. The environment is well maintained, however, the home failed to provide two residents with clean a bedroom and safe specialist equipment. EVIDENCE: No changes had occurred in relation to the home’s suitability for its stated purpose. The residents were noted very relaxed in the lounge and enjoying each other’s company. Some residents were noted participating in activities and some were noted in their bedrooms. However, whilst touring the building one resident was noted sitting in a recliner chair with torn armrest and rough edges. This was brought to the attention of the Manager and a requirement was made for the chair to be repaired or replaced to ensure that the resident is protected from injury. Oak Tree House DS0000020252.V261833.R01.S.doc Version 5.0 Page 17 In addition, a resident’s room was noted to be unclean with an unpleasant odour. A requirement was also made for the room to be cleaned and regularly maintained to ensure that the resident enjoys a clean and pleasant room. The laundry area was noted to be clean with good flooring and ventilation. The laundry staff met on duty stated that residents’ clothes are usually marked to ensure that clothes are not missing, however, unmarked clothing are kept separately and relatives are encouraged to visit the laundry in the event of missing clothing. The staff members stated that they have attended Infection Control, Control of Substances Hazardous to Health (COSHH) and Protection of Vulnerable Adults training. Oak Tree House DS0000020252.V261833.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. The residents enjoy a warm relationship with competent staff. There are adequate numbers of staff on duty to meet the needs of the residents. EVIDENCE: The Commission for Social Care Inspection received an anonymous concern on 11/10/05 in relation to some staff working too many and long hours, resulting in tiredness and putting residents’ health and safety at risk. The concern was investigated by the Commission, was substantiated and was discussed with the Manager before and on the day of inspection. The Manager stated that identified staff members have been informed that they can only work within their contracted hours and must not take on extra hours. A follow up letter was sent to the Manager on 05/12/05 highlighting the concerns and reminding her of the need to ensure that the above does not happen in future for residents’ health and safety. On the day of inspection, the staff rota reviewed showed that the home had extra care staff on duty above the minimum staffing levels set by the Health Authority under previous legislation. Staff interviewed confirmed that staff work within their contracted hours and that there are adequate numbers of staff on duty to meet the needs of the residents. Oak Tree House DS0000020252.V261833.R01.S.doc Version 5.0 Page 19 Residents spoken with confirmed that staff treated them well, respected their choice and dignity and they attend promptly when they rang the call bell for assistance or in an emergency. One resident stated “staff treat you with great respect”. Staff training records evidenced that staff have attended fire safety, abuse, manual handling, food hygiene, first aid, infection control and Control of Substances Hazardous to Health (COSHH). The Manager also stated that four night care staff have achieved National Vocational Qualifications (NVQ) at Level 2, two staff have recently completed NVQ Level 2, one staff member is due to complete NVQ Level 2 next week and five care staff are to commence NVQ 2 shortly. This shows that the Home is working towards achieving the required minimum ratio of 50 trained members of care staff (NVQ Level 2) by 2005. There is a recruitment policy at the home to support the Manager in relation to ensuring that suitable staff are recruited to meet the residents needs. Records of two newly appointed staff showed that required information was obtained before commencement of employment. Evidence seen included two satisfactory references and current satisfactory Criminal Records Bureau (CRB) disclosure and proof of identity. Two residents spoken with at the Home stated that they felt safe at the Home. The Manager stated that the home is making efforts to ensure that all staff who have not attended Abuse Training receive the training shortly to ensure that residents are adequately protected and that staff are aware of procedure to follow if they were concerned about residents’ care. Staff spoken with confirmed that they received appropriate induction before they attended to the residents independently. Oak Tree House DS0000020252.V261833.R01.S.doc Version 5.0 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,35, 36,37,38. The Manager provides clear leadership throughout the Home with staff demonstrating understanding and awareness of their roles and responsibilities. However, insufficient supervision of staff does not fully protect the residents. EVIDENCE: Oaktree Care Home is managed by a well-qualified first level Registered Nurse. The Commission recently registered Mrs Janet Miller to manage Oaktree after a successful “Fit Person’s Interview”. Mrs Miller has attended various trainings and had relevant experience in different settings before joining Oaktree to enable her to provide support for the staff in meeting the needs of residents. Oak Tree House DS0000020252.V261833.R01.S.doc Version 5.0 Page 21 Residents, staff and relatives spoken with on the day of the inspection made positive comments about Janet’s ability to manage the Home whilst she has only been in post for 6 months, staff commented that improvements have been made in relation to different aspects of the service. One resident interviewed stated that “Jan is good”, “I would talk to her if I have any concerns”. A couple spoken with stated that the Manager responded promptly in relation to the radiators that were not working in their rooms. The Manager provided them with temporary heaters and arranged for the engineer to attend and repair the radiators the next day. Evidence from records reviewed showed that health and safety checks are in place to protect the residents. These records include fire safety checks, electrical inspections, gas safety, portable appliance testing, and liability insurance, accident and maintenance record. It was also noted that staff have attended regular fire drills. However, from the records reviewed and staff interviewed, it was noted that staff have not received appropriate and regular supervision. Staff records seen and evidence from staff interviewed showed that registered nurses have not attended supervision sessions and some care staff have received supervision once within this year. A requirement that staff receive regular supervision was made to ensure that residents are protected and that their needs are being met. The Manager stated at a discussion that the home has various ways of auditing services provided at the Home to include care plan reviews, regular monthly visits by Four Season’s Health Care representatives (Regulation 26) and care home audit. The Manager also stated that a residents’ meeting is proposed to take place shortly to enable the residents to air their views about the services provided at the home. It was agreed that the home also develop questionnaires to include relatives and other health professionals for a feedback on the services provided at the Home. The home has policies and procedures to include Protection of Vulnerable Adults from Abuse, Complaints, Medication, Health and Safety and staff training. These policies are reviewed as necessary. Confidential information and residents’ records and monies were seen securely locked away. Oak Tree House DS0000020252.V261833.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 X 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 X X 2 X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 2 3 3 Oak Tree House DS0000020252.V261833.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. 4. 5. Standard OP36 OP26 OP26 OP8 OP22 Regulation 18 16 23 15 23 Requirement Ensure staff are appropriately supervised. Keep a resident’s room free from offensive odour Deep clean or provide alternative flooring in a resident’s room. Prepare a care plan for an identified resident’s need. Repair or place a piece of equipment identified in the communal area. Timescale for action 24/12/05 24/12/05 24/12/05 24/11/05 24/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Oak Tree House DS0000020252.V261833.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Oak Tree House DS0000020252.V261833.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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