Inspection on 19/05/06 for Oakcroft Nursing Home

This inspection was carried out on 19th May 2006.

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

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

Other inspections for this house

Oakcroft Nursing Home 07/01/09

Oakcroft Nursing Home 27/03/08

Oakcroft Nursing Home 15/05/07

Oakcroft Nursing Home 15/01/07

Oakcroft Nursing Home 03/03/06

Oakcroft Nursing Home 05/09/05

Oakcroft Nursing Home 31/03/05

Oakcroft Nursing Home 09/11/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Oakcroft Nursing Home Oakcroft 41-43 Culverley Road Catford London SE6 2LD Lead Inspector Pam Cohen Unannounced Inspection 19th May 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 DS0000007037.V295249.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. DS0000007037.V295249.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakcroft Nursing Home Address Oakcroft 41-43 Culverley Road Catford London SE6 2LD 020 8461 5442 020 8698 0636 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) Mr John Moore Mrs G B Moore Ms Rajmati Bachan Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical disability (0) of places DS0000007037.V295249.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 28 patients, frail elderly persons aged 60 years and above (female) and 65 years and above (male) 3rd March 2006 Date of last inspection Brief Description of the Service: Oakcroft Nursing Home provides care for up to 28 older people, up to three of whom may have a physical disability. It caters for respite care as well as longterm care. The home is a detached house with three storeys close to Catford train station and local shops and services. The area is also well serviced by buses to central and south London. There is accessible off road car parking space for up to 6 cars to the front of the building. There is a garden and patio to the rear accessible from the dining room. DS0000007037.V295249.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place during the day of the 19th May. The pharmacist inspector also visited on that day, to inspect medication issues and to follow up on concerns which had been received by the commission. The registered person was in the home in the morning and the registered manager was there in the afternoon. The inspector also spoke to service users, relatives and friends, staff and a nurse from the Care Home Support Team. There were eight vacancies in the home. What the service does well: What has improved since the last inspection? What they could do better: The home needs to ensure that service users are properly assessed before admission, that on admission care plans are drawn up immediately and that all areas of risk are assessed and strategies drawn up for managing them. This includes ensuring that use of wheelchairs and bed rails is assessed. The dementia needs of service users need to be addressed and activities need to be provided for all service users. There needs to be choice provided for the main meal and food must be nutritious and cater for service users’ medical DS0000007037.V295249.R01.S.doc Version 5.2 Page 6 needs. Complaints must be recorded and investigated and the adult protection policy revised. Consideration needs to take place concerning the environment and space that the home provides. Staff training and supervision needs improvement and quality assurance and an annual development plan need to be organised. 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. DS0000007037.V295249.R01.S.doc Version 5.2 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 DS0000007037.V295249.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service Service users do not have a complete assessment of needs, so they cannot be assured that the home can meet all their needs. EVIDENCE: Files for newly admitted service users showed that they had recent Community Care Assessments. There was also evidence that the manager or an RGN went and assessed the service users before admission. However neither assessment fully assessed care needs and the home staff did not assess in enough detail to confirm that the home could meet all aspects of need. The home does not offer intermediate care although it does offer respite care. DS0000007037.V295249.R01.S.doc Version 5.2 Page 9 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service Service users health care needs are well met. However their care plans show no evidence that their social, emotional and personal care needs are properly assessed reviewed or met. They are not protected by proper assessment or management of risk in several areas. EVIDENCE: Two service users admitted 10 and 8 days previous to the inspection, did not have care plans. Other care plans were seen that were not updated in line with service users’ current needs. Care plan reviews seemed to be a paper exercise with no evidence that service users or their relatives were consulted. Most care plans did not address service users’ social or emotional care needs, detail what activities they liked, nor did they contain life histories. There are also a lot of service users in the home who suffer from dementia and their care plans had no sections to show how this affected their needs. Most care plans did not have risk assessments to assess areas of risk and show how these should be dealt with. Only one service user does not have bed rails but there was no assessment to show why these were needed and no risk assessment to DS0000007037.V295249.R01.S.doc Version 5.2 Page 10 show that their use would be safe. Many service users are moved about in wheel chairs and the RGN spoke of “porterage”. However these service users did not have professional assessments to show that they needed wheelchairs, and they did not have wheelchairs that had been assessed as appropriate for them. There were no records of wheelchair maintenance. With the exception of the service users who did not have care plans, the health care needs of service users were mostly well documented, and these health care needs were monitored and professionals consulted where appropriate. A nurse from the Care Home Support team said that she had seen good health care and that service users who had been admitted from hospital very ill had been nursed back to health. She felt that because it was a small home, staff picked up quickly when people were ill and were able to act upon it. Relatives spoken to said that they felt that health care needs were well looked after. The pharmacist inspector found that medication administration was good. She also found that staff consulted with the Care Homes support team as needed. Two service users self medicate to different extents and a self-medication policy is needed to support this. The destruction of medication policy also needs to be updated to reflect current usage. The pharmacist inspector focussed on following up a concern that a recent service user’s medication had been administered covertly; she discussed all aspects of this issue with the manager. She found an unusually large percentage of service users on antidepressants, day time sedatives and three service users on a night time sleeping table, not licensed for long term use. In the main, service users spoken to, said that carers treated them with respect, although one commented that she wished that all the carers would speak to her when giving personal care as it was embarrassing when done in silence. However service users cannot be assured of privacy whenever needed as staff lockers are still sited in one bathroom and one toilet. DS0000007037.V295249.R01.S.doc Version 5.2 Page 11 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): 12,13,14,15 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Service users cannot at the moment access activities that they would enjoy, as these are not assessed or provided. Access for families and friends is good and some aspects of choice enabled, although the choice to have access to money on a day-to-day basis is not yet in place. The provision of food does not offer choice and it is not always nutritious. EVIDENCE: There was no evidence of an activity programme or any activities going on in the home, and service users were seen to be sitting in chairs, in straight lines, all day. Service users said they did nothing but sit all day; relatives confirmed the lack of activities and a nurse who visits the home said that she had only seen “minimal” activities taking place. Visitors are able to visit at any time and confirmed that they are made welcome by the staff. Service users are able to bring in personal possessions and information is made available on advocacy. However the home does not assess the wish or ability for service users to handle their financial affairs or their monies. This has the result that the home does not hold personal allowances for service users and many do not have access to money on a day-to-day basis. DS0000007037.V295249.R01.S.doc Version 5.2 Page 12 Service users asked said that they were enjoying their food, or that it was not bad. A nurse who visits the home said that she has seen staff feeding service users well and patiently and so enabling them to regain their health. However, on the morning of the inspection breakfast was not served until 10am. Supper had been served between 5 and 6 the evening before and a snack offered at about 8.30 which not many service users eat. This leaves a long period between meals. Breakfast was porridge or cereal plus marmalade sandwiches for all. Although the cook said that service users who are diabetic are given diabetic marmalade there was none in the kitchen and a diabetic service user was offered the ordinary type. There were no fresh vegetables at lunch; nutrition over the day was therefore poor. There is no menu offering a choice of food for the main meal. A relative said that his mother has asked for food such as boiled egg for breakfast or salad and has been told this could not be provided. Meal times are not a social experience as they are mostly eaten alone, in the same chair that a service user sits in all day. The kitchen was dirty and the chest freezer was dirty and needed defrosting. Margarine in the fridge was past its sell-by date and food in the fridge and in the freezers was not always labelled properly with the date. . DS0000007037.V295249.R01.S.doc Version 5.2 Page 13 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): 16,18. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service Service users and their relatives cannot be sure that any complaints made are acted upon. They are also not yet protected by a proper policy that details what action will be taken in the event of allegations of abuse. EVIDENCE: There is a complaints policy and at the last inspection it was noted that service users and their relatives had been informed of this. There were no complaints in the complaint book. However during the inspection a serious complaint was found from Social Services on behalf of a relative, that had not been recorded in the book and the manager was not able to find her investigation of the complaint. The manager also said that she did not record verbal complaints or outcomes. At the last inspection improvements were required to the home’s policy for dealing with vulnerable adults but these have not yet been done. Training has been accessed for staff on dealing with abuse or allegations of abuse but the required additions are needed to the policy to ensure service users’ safety. DS0000007037.V295249.R01.S.doc Version 5.2 Page 14 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): 19,23,26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service The home does not have room to meet service users’ needs for communal or private space. The lounge, where service users spend all day, has an unpleasant odour. EVIDENCE: Although Oakcroft Lodge is homely and service users and relatives spoken to were on the whole happy about the facilities, the lay out is not suitable for its purpose in several respects. Firstly the communal space is not adequate. There is one lounge where service users sit all day, most of them having their meals at the same seat as there is not room for tables. On the day of inspection there were two televisions and a radio all on at the same time in the room. There is no space to arrange activities or hold for example, a religious service. The ratio of double to single rooms is high, 16 beds out of the 28 registered are in double rooms. Also there is not enough room for storage with the result that staff lockers are in service users bathrooms and toilets and DS0000007037.V295249.R01.S.doc Version 5.2 Page 15 service users rooms have much space taken up with large amounts of continence pads. Both inspectors and the nurse who visits from the Care Home Support Team. noted the unpleasant smell in the lounge; this smell has been evident for some time. DS0000007037.V295249.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service Staff are deployed in sufficient numbers and service users can feel that they are in safe hands. However it is not clear that staff have had sufficient training to cater for all the complex needs of the service users. EVIDENCE: At the last inspection it was found that there were adequate nursing, care and domiciliary staff deployed for the numbers of service users and this continues to be so. It was also found that more than 50 of staff had completed an NVQ in care. The file of one newly recruited member of staff showed that appropriate checks had been made. Some training is provided for staff, but this is not done in a planned way, with individual training plans based on the needs of staff and service users. Therefore it is difficult to ensure that all training is up to date and relevant, and that all required training has taken place. A previous requirement that there should be training for staff on how to deal with service users’ social and leisure needs has not been met; this is especially important as there is so little social activity happening in the home. DS0000007037.V295249.R01.S.doc Version 5.2 Page 17 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): 31,33,35,36,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service The home is managed by a competent person. A full quality assurance system and annual development plan still needs to be set up. Service users financial interests need to be addressed. Staff need to be supported by regular supervision and appraisal. Health and Safety issues are generally dealt with well. EVIDENCE: The home is managed by a nurse with many years experience in care of older people and an NVQ level 4 in care and management. However, this inspection has showed a continuing inability to implement requirements for minimum standards in the home. The recommendation that there may be a need for additional management support is therefore restated. DS0000007037.V295249.R01.S.doc Version 5.2 Page 18 The home does not yet have an annual development plan, and a quality assurance system is only in the early stage of development and is not yet meaningful. Work has not yet begun on assessment or service users’ wishes and abilities to manage their own finances. Staff spoke to said that they can approach the manager when required for support. However a structured supervision programme which provides at least six supervision sessions a year for staff has not been put into place and annual appraisals are not happening. Health and safety was not fully inspected at this inspection. Systems seen were in order, except where noted elsewhere in this report. DS0000007037.V295249.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 2 x 2 x x 2 x x 2 STAFFING Standard No Score 27 2 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 1 1 x 3 DS0000007037.V295249.R01.S.doc Version 5.2 Page 20 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 OP3 Timescale for action 14(2)(a,b) The registered person must 31/07/06 ensure that all service users’ pre-admission assessments cover all aspects of care needs in the detail needed for the home to confirm that it can meet those needs. 15(1) The registered person must 22/05/06 ensure that all care plans are completed immediately on admission. An immediate requirement was left in relation to two service users who did not have care plans. The registered person must 31/07/06 ensure that any risk areas for service users should be fully assessed and documented. Previous timescales of 31/03/05 and 31/10/05 not met. The registered person must 30/06/07 ensure that no service user is transported in a wheel chair unless the need for this has been assessed by an appropriate professional, the wheelchair has DS0000007037.V295249.R01.S.doc Version 5.2 Page 21 Regulation Requirement 2. OP7 3. OP7 13(4)(b,c) 4. OP7 13(1)(b) (4)(b,c) 5. OP7 14(1)(a) 15(1) 15(1) 15(2) (b,c,d) 16 (2)(m) 6. OP7 OP12 7. OP7 15(1) 8. OP7 14 15(1) been assessed as suitable and the wheelchair is satisfactorily maintained. The registered person must ensure that the care needs of service users suffering from dementia are fully assessed. The registered person must ensure that all service users social and leisure needs assessments are completed in consultation with service users or their representatives and kept under review Previous timescales of 31/01/06 not met. Target date of 30/06/06 not yet met. The registered person must ensure that all service users or their representatives are consulted about the review of their care plans and sign their plan to reflect agreement. Work has started on this requirement and the target date of 30/06/06 has been extended by a month. The registered manager must ensure that individual service users abilities to manage their own personal finances are taken into account in the care planning process. This was the subject of a previous requirement dated 31/01/06 and there is no date that the present target date of 31/05/06 will be met. 31/07/06 30/06/06 31/07/06 31/08/06 9. OP9 13(2) 10. OP9 14(2)(a) (b) The registered person must 31/07/06 ensure that the home has a policy for self-medication and that the policy for destruction of medication is updated. The registered person must 31/07/06 ensure that service users’ medication is reviewed, DS0000007037.V295249.R01.S.doc Version 5.2 Page 22 11. OP10 23.3(a)ii 12. OP12 16(2)(m) (n) 13. OP15 16(2)(i) 14. OP15 16(2)(i) 15. OP15 16(2)(i) 16. OP16 22 17. OP18 13.6 18. OP20 (23)(2) (e)(h)(i) (J) 16(2)(k) 19. OP24 especially in relation to day time and night time sedation. The registered person must ensure that staff lockers and coat hanging facilities sited in a service users’ bathroom are moved. Previous timescales of 31/08/05,31/10/05 and 30/04/06 not met. The registered person must ensure that a programme of activities is developed based on service users’ assessments as required above. The registered person must ensure that there is a choice on the menu for the main meal and service users’ choices are recorded and acted upon. The registered person must ensure that advice is taken from a dietician to ensure that the home’s menu is nutritious and balanced. The registered person must ensure that the needs of service users with diabetes are properly taken into account. The registered person must ensure that all complaints and their investigation are recorded in the home’s complaints book. The registered person must ensure that the adult protection procedure is revised to develop more fully what action must be taken in the event of an allegation being made. Previous timescales of 01/05/04, 31/01/05, 30/06/05 and 30/04/06 not met. The registered person must ensure that adequate communal sitting, recreational and dining space is provided. The registered person must DS0000007037.V295249.R01.S.doc 30/06/06 31/10/06 31/07/06 30/08/06 30/08/06 31/07/06 30/06/06 31/07/06 31/07/06 Page 23 Version 5.2 20. OP27 18(1)(a) 21. OP30 (18)(1) (a,b,c) 22. OP33 24.1 (a,b) 23. OP35 12 (2,3)23(2 m) ensure that the reason for the unpleasant smell in the lounge is located and is permanently removed in order to ensure that satisfactory standards of hygiene are being maintained. The registered person must ensure that training for nursing and care staff is scheduled regarding methods of planning for service users’ social and leisure care needs, and in involving service users in these activities. The target date of 30/06/06 has not yet been reached The registered person must ensure that the manager puts into place a staff training and development plan to ensure the needs of the service users can be properly met. This was the subject of three previous requirements. Dated 31/03/05, 31/07/05 and 30/11/05. There is no evidence that the target date of 31/05/06 will be met. The registered person must ensure that an annual development plan and a quality assurance system for measuring satisfaction with the service is put into place. This was the subject of two previous requirements dated 30/04/05 and 31/12/05. There is no evidence that the target date of 31/05/06 will be met, although a start has been made on a quality assurance system. The registered person must ensure that the home’s policy for service users’ finances are reviewed to take into account the need for service users to manage their own finances if DS0000007037.V295249.R01.S.doc 30/06/06 31/07/06 31/12/06 30/11/06 Version 5.2 Page 24 24. OP36 (18)(2) they so wish and are so able. This will entail providing a lockable space in all rooms and ensuring there are procedures for properly dealing with personal allowances if the service user wishes this to be held for them by the home. Previous timescales of 31/07/05 and 30/11/05 not met. There is no evidence that the target date of 31/05/06 will be met. The registered person must 31/07/06 ensure that all care staff receive supervision and appraisal in accordance with the requirements of this standard. This is the subject of three previous requirements dated 31/07/05, 31/10/05 and 30/04/06. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP9 OP15 OP31 Good Practice Recommendations It is recommended that work begun to furnish each service user with as lockable space, is finished. It is recommended that service users’ food and drink intake between supper and breakfast is monitored. It is recommended that the registered person should consider providing additional temporary or permanent management support, to enable the development of the service, as outlined in the requirements of this report. DS0000007037.V295249.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH 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 DS0000007037.V295249.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!