Inspection on 22/11/06 for Orchard Avenue 10

This inspection was carried out on 22nd November 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

Orchard Avenue 10 05/06/08

Orchard Avenue 10 16/04/07

Orchard Avenue 10 05/04/06

Orchard Avenue 10 08/09/05

Orchard Avenue 10 04/05/05

Orchard Avenue 10 29/11/04

Orchard Avenue 10 15/06/04

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 Orchard Avenue 10 10 Orchard Avenue Whetstone London N20 0JA Lead Inspector Tom McKervey Key Unannounced Inspection 10:00 22 November 2006 nd 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 Orchard Avenue 10 DS0000010473.V310698.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. Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard Avenue 10 Address 10 Orchard Avenue Whetstone London N20 0JA 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) 020 8445 2014 Mrs Mabel Blanche Watkins Mrs Mabel Blanche Watkins Care Home 4 Category(ies) of Old age, not falling within any other category registration, with number (4) of places Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users with mobility difficulties who are unable to use the stairs may not be accommodated on the 1st floor of the home. It is recommended that the number of places for which the home is registered should revert to the original number (3) when a vacancy occurs. 2nd May 2006 Date of last inspection Brief Description of the Service: 10 Orchard Avenue is a private care home, which was initially registered to provide personal care for a maximum of three older people. However, a variation to the homes registration was made to permit a fourth person to be accommodated until a vacancy occurs. The provider/manager lives on site at the home and occupies a first floor bedroom. The homes stated aims are to provide a safe, secure, homely environment for service users, where they will be free from physical, sexual and emotional abuse. The home consists of a detached two-storey property, located in a cul-de-sac / private road, in a quiet residential area of Whetstone, Barnet. There were originally three single bedrooms, all on the first floor. A fourth resident was admitted, and the present configuration is, one single bedroom on the ground floor, and one single and a double bedroom on the first floor. As a result of this change, there is no communal lounge/dining room available to the residents. There is a toilet on the ground floor, and a bathroom with toilet on the first floor. Also on the ground floor, there is a kitchen, leading to a conservatory, where the laundry equipment is located. There is also another small toilet room off the conservatory. A small garden fronts the property and there is a large garden at the rear. There are good public transport links to the area. The fees for the service range from £470 to £578 per week. Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 5 Following Inspecting for Better Lives, the provider must make information available about the service, including inspection reports, to service users and other stakeholders. Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection, which took place over a period of four hours, was carried out as part of the Commission’s inspection programme and to check compliance with the key standards. The manager, a member of staff, and three residents were present during the inspection. The fourth resident was in hospital at the time if this inspection. The inspection process included a full tour of the premises, talking to residents and a member of staff independently, about their experiences of living and working in the home, and reading residents’ files and other documents. The inspector also spoke to a resident’s relative who was visiting the home on the day of the inspection. A discussion was held also with the manager about specific management issues in the home. What the service does well: The residents say that they enjoy living in the home and their relatives speak highly of the care provided. There is a very good relationship between the residents and the staff. There is a relaxed and friendly atmosphere and the premises are well maintained and attractive. Residents are very appreciative of the meals provided and that they are always asked about what they would like to eat. Residents have comfortable, well-decorated rooms and are able to bring their personal furniture and other possessions with them when they move in to the home. Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: A number of requirements made at the last inspection have not yet been met and have been restated in this report, with a new timescale for compliance. In the “Timescale for Action” column, the date in ordinary type relates to the timescale given at the last inspection. The date in bold type relates to the new timescale. Further information about unmet requirements can be found in the relevant standard. Unmet requirements can impact upon the welfare and safety of residents. Failure to comply by the revised timescale may lead to the Commission for Social Care Inspection considering action to secure compliance. Residents’ care plans need to include an assessment of, and guidance about, meeting their mental health needs. A record must be made of each time a resident’s position is changed when they are cared for in bed for long periods. This is to ensure that appropriate procedures are used to prevent pressure ulcers. The manager must obtain Record of Administration of Medicines, (MAR) forms, from the pharmacist, which will allow for proper recording of staff signatures when medication is either administered, withheld or refused. This will better safeguard the safety of the residents. When a bedroom becomes vacant, a sitting/dining room must be provided so that residents can socialise with each other. All staff must attend training in health and safety, and food hygiene. Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 8 The registered provider/manager must either attain NVQ level 4 in management, or appoint another person as manager who either already has the qualification, or will undertake this course. This is to ensure the efficient running of the home. An audit of the quality of the service that includes the views of the residents and other stakeholders must be carried out. The results must be summarised and included in the Service User Guide, so that potential service users can judge the suitability of the home. The staff must have at least six formal supervisions each year to support and develop them in their roles as carers. 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. Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 9 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 Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 10 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 The quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents are given a Statement of Purpose/Service User Guide, which provides appropriate information to enable them to decide if the home will meet their needs. Privately funded residents are given contracts of the terms and conditions of the service to be provided. All residents are thoroughly assessed before, and at the time of admission to the home. EVIDENCE: There is an up to date Statement of Purpose/Service User Guide that describe the service. A named copy is provided in each resident’s room. Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 11 At the time of the inspection, two of the residents were privately funding their care and the local authority funded two others. Annual care reviews had been carried out by the local authority’s care managers. There were contracts of the terms and conditions of the service, which were signed by residents’ representatives. A relative who was spoken to, confirmed that they received a letter each year to inform them when the fees changed. No new residents have been admitted since 2004, but there was evidence in the case files that residents’ needs had been appropriately assessed before, and at the time of admission. Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 12 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 The quality in this outcome group is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. There is a good care plan for each resident’s physical health needs, but their mental health needs have not been assessed nor reflected in their care plans. Some procedures to meet the healthcare needs of the residents are not being documented; for example, how often a person’s position is changed when they are cared for in bed for long periods. Medication is safely administered, but is not recorded adequately. Staff treat the residents with dignity and respect. EVIDENCE: Three residents’ care plans were sampled. They contained assessments of their physical needs and provided guidance for staff to meet these needs. However, there was no reference to the mental health needs of the residents, one of whom was very confused. Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 13 A requirement is made to address this issue. The care plans were being reviewed on a monthly basis. There was evidence that the healthcare needs of service users were being met, for example, hospital and G.P appointments. One resident was currently being treated in hospital. All the residents have pressure-relieving mattresses to prevent ulcers developing. This equipment was working properly at the time of the inspection. One resident in particular spends considerable time being cared for in bed. The inspector was informed that this person’s position in bed was regularly changed and they also sit out in an armchair. There was evidence that this person received very good care and their pressure areas were in good condition. However, a requirement is made to record when this resident’s position is changed. All the residents’ weights are checked monthly. The medication records were examined. None of the residents are able to selfadminister their medication. There is written approval from the G.P for homely remedies, e.g., Paracetemol. Since the last inspection, a record is being kept of the medication supplied to the home and when it is administered. However the forms used, do not allow for the recording of staff signatures or when medication is withheld or refused. A requirement is made to address this issue and a recommendation is made to obtain Record of Administration of Medicines, (MAR) forms, from the pharmacist for this purpose. There was a record of all unused medicines returned to the pharmacy. One of the three residents who were spoken to, was able to converse. They spoke highly of the care they received, and said that all the residents were treated with great dignity and respect. Residents were appropriately dressed, and during the inspection, the staff were observed interacting with them in an appropriate and caring fashion. Since the last inspection, a portable screen had been provided for two residents who share a bedroom. This is to safeguard their privacy. Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 14 Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 15 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 The quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. The residents have a lifestyle appropriate to their needs and abilities and they are able to exercise choice about their lives in the home. There is an open visiting policy. The residents say they are very satisfied with the meals provided and a record is kept of what they eat, to ensure that they have a well-balanced and nutritious diet. EVIDENCE: There is no lift in the home, but the residents who are accommodated upstairs, are able to access the downstairs area and gardens with the support of the staff. The home does not have a communal sitting or dining room, which limits opportunities for the residents to share in joint activities. It is anticipated that this problem will be resolved when the number of residents reverts to three and one of the bedrooms becomes available. Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 16 All the residents are frail and very elderly. One resident who is visually impaired, described various radio and television programmes they liked. They also said that a member of the staff often reads books and newspapers to them. It is recommended that audio books be provided for this resident’s benefit. There is a television in each resident’s room. The inspector noted that the three residents had a very good relationship with each other and visited each other’s rooms to socialise. A relative was spoken to during the inspection. They said they visited the home frequently and could do so at any time. They also said that they were always warmly welcomed by the staff. In a written comment, a relative said,” My mum is happy and very well cared for. The manager and her staff love the ladies in their care and we are very lucky, they go beyond the call of duty.” Residents are able to go to bed and get up when they like and they said that staff always ask them what they would like to wear, what to eat and how they wished to spend the day. There were daily records made of the residents’ activities. One resident said they were happy to listen to church services on the television and radio. There is no planned menu, but residents confirmed that they are asked each day what they wished to eat. Hot and cold drinks are available on request and fresh fruit was available. None of the residents require specific ethnic meals. At the last inspection, a requirement was made for a record to be kept of what residents actually ate in order to check that they have adequate nutrition. The inspector was satisfied with the evidence that this was being done. Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 17 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 The quality in this outcome group is good. This judgement has been made form evidence gathered both during and before the visit to this service. The residents said that they feel safe in the home and are confident that any complaints would be properly addressed. The staff have been trained in, and demonstrated awareness about, adult protection issues. EVIDENCE: The complaints procedure is attached to the residents’ contracts and there is a book for recording any complaints. There is space in the complaints book for recording the response time and the outcome of any investigations. There were no outstanding complaints at the time of the inspection. None of the residents nor the visitor who was spoken to, had any concerns or complaints about the service, but said that they were confident that the manager would address any complaints immediately. They also said that the staff were very caring. In a written comment sent to the inspector, a relative said,” My mother has been with the proprietor for 15 years. We have had no worries about the standard of care provided.” Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 18 The local authority’s adult protection procedure was available in the home, and the staff had attended training in adult protection procedures. A member of staff was able to describe these procedures very well to the inspector. Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 19 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, 20, 24 & 26 The quality in this outcome group is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Residents live in a well maintained, clean and comfortable home. There are serious space limitations in the home, which restricts the opportunities for residents to engage in communal activities and leisure. EVIDENCE: A tour of the premises was carried out, including visits to the residents’ bedrooms. The overall standard of décor and maintenance was good. The manager said that she was seeking quotes to have the entrance hall decorated. The gardens, flowerbeds and hanging baskets were particularly attractive and enhance the overall appearance of the home. Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 20 There is a washing machine and drier in the conservatory. On the first floor, there is a single bedroom and two residents share a double room. The other resident has a single room on the ground floor. The bedrooms were comfortable and well furnished. There was evidence of personal possessions and mementoes, which residents had brought with them when they came to the home. The home has a condition to its registration that when a bedroom becomes vacant, the room must be converted to a sitting/dining room, because there is no other indoor communal space available. Until that time, this requirement will continue to be restated. In the interim, the residents eat in their rooms. The home was very clean and there were no offensive odours. Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 21 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 quality in this outcome group is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. There are sufficient numbers of staff on duty to meet residents’ needs. Staff working at the home have been screened appropriately to protect residents’ best interests. The welfare of residents could be at risk because staff have not been trained in all of the subjects that affect residents’ health and safety. EVIDENCE: The staff group has been together for a number of years and are experienced at caring for older people. At the time of the inspection there were three residents living in the home and one resident was in hospital. The rota identified the staff on duty each day and showed that there is normally two staff on duty during the day and one on waking night duty. This often includes the manager who lives in the home and provides “handson” care. She is also available for advice and assistance if required during the night. Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 22 The staff also do the cleaning and laundry and cook the meals. One member of staff has attained National Vocational Qualification, (NVQ) level 2, and another is currently training for the qualification. At the last inspection, a requirement was made for a reference to be obtained for a member of staff working at the home. This requirement was met and no new staff have been employed. Evidence of some staff training was seen, including moving and handling, pressure ulcer care and adult protection. However, not all staff had completed training in all mandatory subjects; for example, food hygiene. This was a requirement at the last two inspections, and is restated in this report. Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 23 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, 37 & 38 The quality in this outcome group is poor. This judgement has been made from evidence gathered both during and before the visit to this service. Although the provider/manager is experienced at managing the home, she does not have the qualifications required in the National Minimum Standards. A quality assurance audit of the service that includes the views of the residents and other stakeholders has not been carried out. Staff are not having regular, formal supervision to support them in developing their roles as carers. Improvements are needed in some areas of record keeping. The home is generally well maintained and appropriate tests and servicing of the installations are carried out to protect the residents’ health and safety. Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 24 EVIDENCE: The registered provider/manager has very many years experience of running a care home. However, she has no formal qualifications, and she stated that she was unwilling to undertake the National Vocational Qualification, level 4, or equivalent qualification, which is a requirement under this standard. The provider did advertise for a person to manage the home, but this was unsuccessful. This requirement is restated. The Commission for Social Care Inspection had not been informed when a resident had been admitted to hospital. A requirement is made to address this matter. The manager stated that residents either manage their own financial affairs or their relatives do so, and no money is held in the home on their behalf. A quality assurance audit of the service that includes the views of the residents and other stakeholders has not been undertaken. The requirement is restated for this to be carried out and the results to be sent to the Commission for Social Care Inspection and summarised in the Service User Guide. It was evident that formal supervision of staff had not yet taken place to meet the standard of at least six supervisions per year. This requirement is restated. As noted elsewhere in this report, care plans are incomplete, turning charts are not being used and medication is not being properly recorded. Current certificates of safety for the gas central heating, fire equipment and the water systems were seen. The fire alarms are tested weekly, and portable electrical appliances had been tested this year. Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 25 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 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 1 X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 3 1 2 2 Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 26 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 OP7 Regulation 15(1) Timescale for action The registered person must 31/12/06 ensure that the residents’ mental health needs are assessed and included in their care plans. The registered person must 31/12/06 provide a record each time a resident’s position is changed when they are cared for in bed for long periods. The registered person must 31/12/06 ensure that the administration of medicines is properly recorded. The registered manager must 31/01/07 ensure that when a bedroom becomes vacant, a communal sitting/dining room is provided. This requirement is restated from the last inspection. The previous timescale was 31/05/06. The registered manager must 28/02/07 ensure that all staff are trained in food hygiene and health and safety. This requirement is restated from the last inspection. The previous timescale was 31/05/06. Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 27 Requirement 2. OP8 17 Sch 3(3n) 3. 4. OP9 OP20 13(2) 23(2)(g)( h)(i) 5. OP30 18(1)(c) 6. OP31 9(2)(1) The registered manager is 28/02/07 required to attain NVQ level 4 in management. This requirement is restated from the last inspection. The previous timescale was 31/05/06. The registered person must carry 31/03/07 out an audit of the quality of the service that includes the views of the residents and other stakeholders. The results must be sent to the Commission for Social Care Inspection and summarised in the Service User Guide. This requirement is restated from the last inspection. The previous timescale was 31/05/06. The registered person must 31/12/06 provide at least six formal supervisions for all staff per year. This requirement is restated from the last inspection. The previous timescale was 30/06/06. The registered person must 31/12/06 inform the Commission when a resident is admitted to hospital. 7. OP33 24(1)(2)( 3) 8. OP36 18(2) 9. OP38 37 Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 28 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP9 Good Practice Recommendations The registered person should obtain Record of Administration of Medicines, (MAR) forms, from the pharmacist. The registered person should obtain audio books for the resident who is visually impaired. 2 OP12 Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Orchard Avenue 10 DS0000010473.V310698.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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