Inspection on 01/06/06 for Oaklands

This inspection was carried out on 1st June 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

Oaklands 16/12/08

Oaklands 09/01/08

Oaklands 10/07/07

Oaklands 08/02/07

Oaklands 09/02/06

Oaklands 08/09/05

Oaklands 23/11/04

Oaklands 17/06/04

Oaklands 16/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Oaklands Forest Glade Dunton Hills Laindon Essex SS16 6SX Lead Inspector Carolyn Delaney Unannounced Inspection 1st June 2006 08:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Oaklands Address Forest Glade Dunton Hills Laindon Essex SS16 6SX 01268 491491 01268 543045 oaklands@schealthcare.co.uk 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) Southern Cross Healthcare Services Limited Sallyanne Green Care Home 55 Category(ies) of Old age, not falling within any other category registration, with number (55) of places Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Oakland’s is a large detached, purpose built home on two floors, providing residential accommodation for up to 55 elderly residents. The home is situated in the middle of a modern housing estate. A large attractive garden is located at the rear of the property. There is a rooftop patio on the first floor of the home. Access to facilities in the area can be made by private or public transport. Parking is available to the front of the home. Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced Key Inspection carried out between 08.30 and 18.00 on 1st June 2006. The lead inspector for the service Carolyn Delaney and Inspector Michelle Love carried out the out the inspection. Records including assessments, care plans, daily care notes and risk assessment documents in respect of five people living at the home were examined. A number of ‘Have your say about….’ questionnaires were sent to the home following the inspection so as to obtain residents views. Four residents and three relatives were spoken with during the inspection. The relatives of eleven residents at the home were contacted by post so as to offer them the opportunity to make comments about the services provided by the home. At the time of completing the draft version of this report responses had not yet been received and a summary of the these will be included in the final version of the report. Five members of staff including the homes manager were spoken with and a number of records including duty rota’s and staff recruitment files were examined. A tour of the premises was carried out and the serving of breakfast and lunch were observed. Not all Key Standards as identified in the intended outcomes sections of this report have been inspected during this Key Inspection. Those not assessed at this time will be assessed at the next inspection visit, as they must be inspected at least once every twelve months. Where other standards have not been inspected on this occasion they will have been inspected at the previous inspections. Reports in respect of previous inspections may be accessed via the Commissions website www.csci.org.uk Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 Page 6 What the service does well: What has improved since the last inspection? What they could do better: There are a significant number of areas where the home could do better. The manager must ensure that a detailed assessment is carried out for all new residents before they move into the home so that they can be assured that the home will be able to meet their needs. Staff must ensure that correct and up to date information is recorded about each persons care needs and any risks to their safety and well being so that all staff both permanent and agency have an account of each persons specific needs in order to be able to provide appropriate care. Staff must also carry out their duties in accordance with the information in care plans and risk assessments so that residents receive proper care and treatment. The routines within the home such as carpet cleaning should be arranged so as to disrupt the lives of the residents as little as possible and so as to ensure that residents can use the lounge area during the day. Staff must ensure that residents are well cared for and not left unattended in the foyer without access to drinks. Staff should also take more care when assisting residents at mealtimes so as not to rush residents and to take proper Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 Page 7 action, such as offering alternatives and making proper records when residents refuse, or are too unwell or drowsy to eat their meals. The way in which complaints are handled needs to be reviewed and complainants should be contacted promptly and every effort made so as to resolve issues. More could be done to ensure that the people living at the home are so far as possible protected from abuse, harm and neglect. Staff should be properly trained and supervised so as to ensure that they care for residents in a caring and sensitive manner. While the home is generally kept clean, there are a number of areas where there are persistent unpleasant smells and measures need to be put in place to address this. Staffing levels must so far as it is possible be maintained so as to meet the needs of the people living at the home. The staff duty rota may be used as evidence and must be accurate with details of all staff working at the home. Staff should only be employed at the home once all of the necessary checks have been carried out to determine that the person is suited and has the necessary skills to work in the home. All staff must be properly trained. The home must be better managed so as to make sure that all of the areas of concern and poor care practices are addressed. The Commission for Social Care Inspection has met with the operations managers for Southern Cross who are responsible for the home to discuss the various concerns raised during the inspection. The Commission intends to monitor the home closely and will take further action if it is judged that the home is not meeting the requirements of the Care Homes Regulations. 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. Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 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 Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&4 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Staff do not consistently assess prospective residents needs so as to determine that the home can meet these needs prior to offering the person a place at the home. Staff do not consistently meet residents needs. EVIDENCE: Some pre-admission assessment documents were completed well and clearly identified the person’s care and safety needs. However others did not include sufficient information so as to determine that the home, taking into consideration the needs of the people currently living in the home and the resources available including staffing levels and skills and knowledge that the home could meet these needs. Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 Page 10 In one instance a manager from another Southern Cross home had carried out a pre-admission assessment for a person admitted to the home. There was no evidence to suggest that the manager at Oaklands had reviewed the information in the assessment so as to determine that the person’s needs could be met by the home. A resident of the home who had been admitted to hospital was re-admitted to the home despite confusion as to whether this person now required nursing care. It was also noted that none of this persons care plans and risk assessments had been reviewed and amended in light of the changes to their care needs following discharge from hospital. It was also very disappointing to note that two members of staff when asked about one resident could not tell the inspector this persons name and instead referred to the in terms of their bedroom number. Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Information about residents in care plans and risk assessments is poorly documented and staff do not act so as to ensure that care needs are met and that risks to health and welfare are minimised. EVIDENCE: A number of residents care plans and risk assessment documents were assessed during the inspection. It was very disappointing to note that where risks to residents had been identified that information as to how staff were to minimise these risks was not detailed and that where the level of risks had increased due to changes in the persons condition that this too was not recorded. Some of examples of where good care practices were not evidenced are: Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 Page 12 For one resident who was assessed as having a high risk of developing pressure sores, there was no evidence that staff monitored this and the person subsequently did develop a pressure sore. Where on resident was assessed as having a poor appetite and weight loss there were no records maintained in respect of what staff did so as to encourage dietary intake. It was recorded that this individual had lost over 10kg over a period of four months. Where one resident had been assessed at being at particular risk of falls the care plans and assessment for minimising risk to this person was incomplete and when this person did sustain a number of falls staff did not review the plan of care or risk assessment plan. An Immediate Requirement notice was issued in respect of the serious concerns noted regarding the lack of care and risk management identified during the inspection. According to the information provided by the home five of the eight members of staff who administer medication had not undertaken recent training and it was not clear when they had last received training. Staff were observed to administer medicines to residents at the appropriate times and in accordance with the homes policies and procedures and Medication Administration Records (MAR) were well maintained. However for one resident where it was recorded in the plan of care that they regularly refused medication it was not clear what staff did in the event that medication was refused. Where it was recorded in a care review for one resident who was receiving oxygen therapy that this person had difficulties in turning the cylinder on and off this was not recorded in the care plan and there was no information recorded as to how staff assisted this person so as to ensure the person could have access to oxygen as required. Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 15 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The routines in the home are not flexible so as to best meet the needs of residents. There are insufficient activities provided so as to stimulate residents and prevent boredom and residents are not supported in a satisfactory manner at mealtimes. EVIDENCE: There were no activities made available to the people living at the home on the day of the inspection. Further more the lounge area on the ground floor was inaccessible for most of the morning, as the carpet had been cleaned while residents were having breakfast. A number of residents spent the morning sitting in the homes foyer, many in wheelchairs, which did not appear to be very comfortable. It was not clear that these residents had been consulted about where they wished to spend the morning. Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 Page 14 Staff were noted to offer little attention to residents during this period and despite it being a warm day there were no cold drinks available and one resident asked one of the inspectors to please get a glass of water. Staff when asked could not say what choices of meals was available for residents on the day of the inspection and also said that the home did not have any menus. The chef was spoken with who said that menus are generally available however there had been a problem printing them. On arrival to the home at 08.30 in the morning one resident told an inspector that she ‘was starving’. It was reported by the chef that tea and toast is provided when residents awake but it was not clear at what time or who had received this. Staff were observed serving breakfast in the ground floor dining room. It was noted that residents had been served cereal without milk being made available to them for until the senior member of staff who was administering medication asked other staff to get the milk from the kitchen. The serving of lunch was observed by inspectors in both dining rooms. On the first floor staff were seen to assist residents in a fairly sensitive manner and to encourage residents to eat independently. However the meal was rushed and where residents did not eat all of their meal no record was made in respect of this. For other residents their dessert course was placed on the table in front of them before they had finished their main course. It was also noted that condiments and sauces to compliment the meal were not available. Staff in the dining room on the ground floor were also noted not to assist those less able residents with their meal and where one resident was very drowsy and refused to eat staff took her meal away without offering any alternative or snack and did not record that this person had taken no food at this mealtime. Resident’s comments about the food were mixed, however the majority of those residents who were spoken with said that the food was generally fairly good. Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Complaints are not consistently dealt with in accordance with the homes policies and procedures and complainants do not have confidence in the dealing with their complaints. Staff are not supported nor do they act so as to protect residents from the risk of harm. EVIDENCE: There has been an ongoing complaint since last year. The complainant had contacted the Commission regarding their dissatisfaction with how the concerns raised had been dealt with by the homes manager and the operations manager who at the time of writing this report had left the organisation. Records made available by the home indicated that thirteen of forty members of staff (33 ) of staff had received training in respect of the protection of vulnerable people from abuse or harm within the past year. It is concerning to note that since the inspection that there has been an incident at the home where a resident had alleged that they had fallen during the night and had been left of the floor all night. It was noted at the time of the inspection that there had been no care plans or risk assessments in place for this person. Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 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 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home while generally well maintained is in need of some redecoration and odours are not always dispelled with effectively. EVIDENCE: Resident’s bedrooms, which were viewed with their permission, were noted to fairly well decorated and residents had a number of their own possessions in their rooms. The carpet in some communal areas in particular the hallway was noted to be worn and stained. The homes manager said that this was to be replaced at some stage in the future as part of the homes annual maintenance and renewal plan. The home was noted in general to be clean and free from unpleasant odours. However in two areas of the home very strong odours were detected. The Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 Page 17 home has a regular carpet cleaning programme in place however this does not appear to dispel the odour problem. Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 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, 29 & 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Staff are not consistently recruited, trained or employed in sufficient numbers so as to meet the needs of the people who live in the home. EVIDENCE: There have been a number of instances where the staffing levels at the home have dropped below the minimum agreed levels and these staff were not replaced. The operations manager at this time stated that agency cover would be authorised in these instances, however care staff indicated that this was not always the case. A copy of the staff duty rotas for the month prior to the inspection was requested. This rota was not accurate as it indicated that the homes manager was on duty when it had been reported to the Commission that she had been absent due to illness for a period of three weeks. Furthermore when agency staff were employed at the home their full names were not recorded on the duty rota. Duty rotas indicated that staff did not work excessive hours without sufficient off duty time. Staff recruitment files did not evidence that staff were employed to work at the home in a clear, consistent and robust manner. A number of staff who had not worked in a care setting prior to coming to work at the home had not received Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 Page 19 a sufficient induction programme so as to prepare them for their roles within the home. For others detailed checks had not been carried out in respect of candidate’s previous employment histories and references had not been validated. One member of staff had left the homes employment and was then reinstated after a period of six weeks without any checks having been carried out. Southern Cross had employed two members of staff from Belarus. The homes manager had not been involved in the process so as to make a judgement as to whether they would be suited to work in the home. It was clear that both these members of staff had limited understanding of English language and while Southern Cross has disputed this it was evident to both inspectors and other staff working in the home on the day of the inspection. It was also noted that there was no information available as to the fitness of agency staff employed at the home. The information provided by the home in respect of staff training did not evidence that staff receive appropriate training including mandatory training updates such as moving and handling and fire safety training. Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 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 & 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home is not managed in the best interests of the people who live there. EVIDENCE: There are a number of areas, which require urgent attention as identified within this report. Some of these outside the control of the registered manager such as the issues regarding the employment of overseas staff and the fact that these two members of staff were accommodated in the home, which is unacceptable. The level of service provided by the home is poor and actions must be taken to address this. Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 Page 21 Throughout the inspection there were no health and safety issues observed in terms of the premises or equipment at the home. There was evidence that regular audits were carried out so as to ensure that gas, electrical and mechanical equipment and systems were maintained in safe working order. Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 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 X X 1 1 X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 1 3 X X X X X X 2 STAFFING Standard No Score 27 2 28 X 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X X X X X X 3 Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 Page 23 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 Regulation 14(1) (2) Requirement The registered persons must ensure that people are only offered a place at the home once a detailed assessment of the persons care and safety needs has been carried out and it is determined that the home can meet these needs. The registered persons must ensure that staff are aware of each residents identity and needs. The registered persons must ensure that information about each persons care needs is recorded accurately and that staff care for residents in an appropriate manner in accordance with care plans. The registered persons must ensure that the risks to residents welfare and safety are assessed and managed so as to minimise the occurrence of injury etc. The registered persons must ensure that staff assist and support residents where required in respect of the administration of medication and that DS0000018110.V293262.R01.S.doc Timescale for action 30/07/06 2 OP4 14 30/06/06 3 OP7 15(1) (2) 30/06/06 4 OP8 12 & 13 30/06/06 5 OP9 13(2) 15/07/06 Oaklands Version 5.1 Page 24 6. OP12 23 (2) (g) appropriate action is taken when residents refuse medicines which have been prescribed for them. The registered persons must 10/07/06 ensure that routines within the home are flexible so as to ensure that residents can access communal areas at any reasonable time and that that where access is restricted that residents are accommodated as comfortably as possible within an area of their own choosing. The registered persons must ensure that a range of activities is provided for the people who live in the home, which meets their needs for occupation and stimulation. The registered persons must ensure that people living in the home are supported to take their meals according to their needs and that staff monitor dietary intake is monitored for those people who are assessed as being at risks of weight loss or malnutrition. The registered person must ensure that all complaints and concerns are dealt with and responded to in accordance with the homes policy and procedure and Regulation 24 of the Care Homes Regulations. The registered persons must ensure that the people living at the home are so far as it is possible protected from harm, abuse and neglect. Resident’s individual bedrooms must have a suitable lock fitted. (Repeat immediate requirement from last Inspection 09.09.05). The timescale of 09/02/06 was not assessed during this 20/07/06 7. OP12 16(2) (m) (n) 8. OP15 16(2) (f) 10/07/06 9. OP16 24 10/07/06 10. OP18 13 (2) (6) 05/06/06 11. OP24 16 30/09/06 Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 Page 25 inspection. 12. OP26 16(2) (k) The registered person must ensure that so far as is possible that the home is maintained free from unpleasant odours and that measures are implemented so as to dispel odours as they occur. The registered person must ensure that the duty rota is maintained up to date and accurate in respect of all staff working at the home. This is a repeat requirement & the timescale of 09/02/06 has not been met. 14. OP27 18 (1) (a) The registered person must ensure that staffing numbers are maintained and that they meet residents assessed needs and are appropriate for the Health and Welfare of residents and staff. This is a repeat requirement & the timescale of 09/02/06 has not been met. 15. OP29 19 The registered persons must ensure that all people who work in the home, including agency staff are recruited in a consistent and robust manner with all of the checks as required by legislation carried out prior to them commencing employment at the home. The registered persons must ensure that all staff working at the home receive appropriate training and support. The registered persons must ensure that the home is managed in the best interests of the people who live there and DS0000018110.V293262.R01.S.doc 30/07/06 13. OP27 17 Sch 4 (7) 10/07/06 10/07/06 20/07/06 16. OP30 18(1) (c) 30/07/06 17. OP32 23(3) 01/06/06 Oaklands Version 5.1 Page 26 that staff are not accommodated in the residents home. 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 Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Oaklands DS0000018110.V293262.R01.S.doc Version 5.1 Page 28 - 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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