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Inspection on 05/04/06 for Orchard Avenue 10

Also see our care home review for Orchard Avenue 10 for more information

This inspection was carried out on 5th April 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The residents say that they enjoy living in the home. There is a very positive 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 how they are asked about what they would like to eat. Residents have comfortable, well-decorated rooms and are able to have their personal furniture and mementoes with them.

What has improved since the last inspection?

Written authorisation has been obtained from two residents` confirming agreement for two residents to share a bedroom. relativesThere is a better system in place for recording and responding to complaints. Some improvement has taken place in the process of recruiting and training staff, although some problems still remain. (See below).

What the care home 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. A Service User Guide needs to be developed to provide residents and their representatives with better information about the service. This should include the views of the residents about the service they receive. To ensure that medication is being properly administered, the amount of medication should be recorded when it is obtained from the pharmacy. This will ensure that the balance remaining is correct at all times, thus safeguarding the health of the residents. In the room shared by two residents, a screen must be provided to safeguard their privacy. Although residents are happy that they can always choose their meals, a record should be kept of what they eat to ensure that their diet is nutritious and well balanced. Because there is currently no indoor communal space for the residents, a bedroom must be converted to provide a sitting/dining room when it becomes vacant. There must be stricter adherence the recruitment of staff, specifically obtaining references from previous employers. In addition, all staff must be trained in the mandatory subjects required by the National Minimum Standards. The registered provider/manager must either attain NVQ level 4 in management, or appoint another person as manager who has the qualification or will undertake this course.

CARE HOMES FOR OLDER PEOPLE Orchard Avenue 10 10 Orchard Avenue Whetstone London N20 0JA Lead Inspector Tom McKervey Key Unannounced Inspection 2nd May 2006 1:00 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 Orchard Avenue 10 DS0000010473.V289744.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. Orchard Avenue 10 DS0000010473.V289744.R01.S.doc Version 5.1 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 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.V289744.R01.S.doc Version 5.1 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. 8th September 2005 Date of last inspection Brief Description of the Service: 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 first floor, and one single and a double bedroom on the ground floor. This followed the advice of the fire service,when two residents with mobility problems, were relocated to the ground floor. Since the last inspection, another resident with mobility problems now shares a room on the ground floor with another resident. 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 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. The home is close to shops and amenties and there are good public transport links. The fees for the service range from £470 to £530 per week. Following “Inspecting for Better Lives”, the provider must make information Orchard Avenue 10 DS0000010473.V289744.R01.S.doc Version 5.1 Page 5 available about the service, including inspection reports, to service users and other stakeholders. Orchard Avenue 10 DS0000010473.V289744.R01.S.doc Version 5.1 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 and ten minutes, 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 all four residents were present during the inspection. The inspection process included a full tour of the premises, talking to residents and staff about their experiences of living and working in the home, and reading residents’ files and other documents A discussion was held also with the manager about specific management issues in the home What the service does well: What has improved since the last inspection? Written authorisation has been obtained from two residents’ confirming agreement for two residents to share a bedroom. relatives There is a better system in place for recording and responding to complaints. Some improvement has taken place in the process of recruiting and training staff, although some problems still remain. (See below). Orchard Avenue 10 DS0000010473.V289744.R01.S.doc Version 5.1 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Orchard Avenue 10 DS0000010473.V289744.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 Orchard Avenue 10 DS0000010473.V289744.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): 1 & 3 (Standard 6 does not apply). The quality in this outcome group is adequate. This judgement has been made form evidence gathered both during and before the visit to this service. Residents are not provided with a Service User Guide, which should provide a summary of information about the service to enable them to decide if the home will meet their needs. All residents are thoroughly assessed before being admitted to the home. EVIDENCE: There is an up to date Statement of Purpose that describes the service provided, but this is not summarised as a guide for new service users. No new service users have been admitted in the past year. The case files of the current residents show that they had full needs assessments by the manager of the home, and where appropriate, a care manager from the referring local authority. Orchard Avenue 10 DS0000010473.V289744.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 The quality in this outcome group is adequate. This judgement has been made form evidence gathered both during and before the visit to this service. Appropriate care plans are in place to guide staff in how to meet residents’ needs. The healthcare needs of the residents are being met and they are treated with dignity and respect by staff. The wishes of residents about their funeral arrangements are documented. The privacy of the residents who share a bedroom needs to be protected by the provision of appropriate screening. A proper format for the recording of administration of medicines is needed to safeguard the residents from potential risk. The wishes of residents about their funeral arrangements are known and recorded. EVIDENCE: Orchard Avenue 10 DS0000010473.V289744.R01.S.doc Version 5.1 Page 11 Three residents’ care plans were sampled. They contained assessments of their needs and the actions for staff to take to meet these needs. The care plans were 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 medically investigated, which includes visits to the hospital for blood tests. There were current records of the district nurse’s visits to treat another resident. A resident who is bed-bound, is provided with an appropriate bed and air mattress. This resident who is non-verbal, appeared to be comfortable and well cared for. The manager was able to describe how she is able to communicate with this resident non-verbally. None of the residents are able to self-administer their medication. There is written approval from the G.P for homely remedies, e.g., Paracetemol. The medication records were examined. A simple book was being used for recording when medication was administered. This is not a sufficiently safe way of recording because there is nowhere to record when a medication is refused or disposed of. In addition, the inspector was unable to determine if the number of tablets being stored was accurate as there was no opening balance when the medication was obtained. Appropriate records should be obtained from the local pharmacy. A requirement is made to address this issue. Three residents were spoken to. They spoke highly of the staff; for example, “staff are very caring and attentive”. During the inspection, a resident was being supported with personal care in the bathroom, which was locked during the process. Staff were observed interacting with residents in a respectful and dignified manner. Two residents now share a bedroom, but it was noted that there was no screen between the beds to protect residents’ privacy. The manager said that there had been one, but it had been damaged, and another screen was being ordered. A requirement is made to address this issue. The case files contained references that the relatives of service users were responsible for funeral arrangements. Orchard Avenue 10 DS0000010473.V289744.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 The quality in this outcome group is adequate. This judgement has been made form 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. Although the residents said they are happy with the meals provided, a record needs to be 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 three of 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. This limits opportunities for the residents to share in activities. The manager said that this problem would be resolved when one of the bedrooms becomes available and the number of residents reverts to three. Orchard Avenue 10 DS0000010473.V289744.R01.S.doc Version 5.1 Page 13 Three residents were spoken to. They said that they enjoyed living in the home. One resident said, “The staff are wonderful. They always ask what I want to eat. I like to go for a walk and they help me.” One resident who is visually impaired, described the radio programmes they liked and how a member of the staff often reads books and newspapers to them. The residents said that their visitors were able to come at any time and they were made welcome by the manager and staff. Visits were recorded in the visitors’ book. 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. The manager said that there was no planned menu, but residents were asked each day what they wished to eat. This was observed by the inspector and was confirmed by the residents who were spoken to. Hot and cold drinks were also available on request. However, a requirement is made for a record to be kept of what residents actually eat in order to check that they have adequate nutrition. There was fresh fruit available. None of the residents require specific ethnic meals. Orchard Avenue 10 DS0000010473.V289744.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 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 adult protection issues to enhance awareness about abuse issues. EVIDENCE: The complaints procedure is attached to the residents’ contracts and there is a book for recording any complaints. There is a space for recording the response time and the outcome of the complaints investigation. None of the residents 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 towards them. The local authority’s adult protection procedure was available in the home, and the staff had attended training in adult protection procedures. Orchard Avenue 10 DS0000010473.V289744.R01.S.doc Version 5.1 Page 15 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, 23, 26 The quality in this outcome group is poor. This judgement has been made form evidence gathered both during and before the visit to this service. Residents live in a well maintained, clean and comfortable home, but lampshades must be provided in the kitchen. There are serious space limitations in the home, which restricts the opportunities for residents to engage in communal activities and leisure. This issue is expected to be resolved when a bedroom becomes vacant. EVIDENCE: A tour of the premises was carried out, including visits to residents’ bedrooms. The overall standard of décor and maintenance was good, but it was noted that there were no lampshades on the lights in the kitchen. A requirement is made about this matter. The manager employs people to maintain the gardens, flowerbeds and hanging baskets, which enhance the appearance of the home. Orchard Avenue 10 DS0000010473.V289744.R01.S.doc Version 5.1 Page 16 There is a condition to the home’s 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. A resident, whose mobility had deteriorated, now shares a downstairs bedroom with another resident on the ground floor. Written permission for this had been obtained from both residents and their relatives. The residents told the inspector that they were happy with this arrangement. The vacated room is now available as a communal sitting room. However, currently, this room is rarely used due to the mobility problems of the residents who live downstairs. Residents’ bedrooms, all of which were visited, were spacious, clean, well furnished and attractive and there was evidence of private possessions. At the time of the inspection, the home was very clean and there were no offensive odours. Orchard Avenue 10 DS0000010473.V289744.R01.S.doc Version 5.1 Page 17 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 poor. This judgement has been made form evidence gathered both during and before the visit to this service. The staff have been trained in some subjects, but in order to ensure the welfare of residents, all staff must be trained in all of the mandatory subjects. Residents’ safety and welfare could be put at risk because of poor recruitment practices. EVIDENCE: The staff group has been together for a number of years and are experienced at caring for older people. The rota now identifies the staff on duty each day. The staff rota showed that there is normally two staff on duty during the day and one on waking night duty. The manager lives in the home and she is available for advice and assistance, if required during the night. Because of the relatively small number of residents (4), the manager is able to provide care duties in addition to her provider/manager responsibilities. Staff also provide cleaning and catering services. One member of staff has attained National Vocational Qualification, (NVQ) level 2, and another is currently training. The records of a new member of staff were examined. There was a completed application form and proof of identity. A Criminal Records Bureau (CRB), Orchard Avenue 10 DS0000010473.V289744.R01.S.doc Version 5.1 Page 18 clearance had been obtained before starting employment. However, although references had been applied for, these had not been returned. A requirement is made to address this. Evidence of training for some staff was seen, including health and safety, pressure sore care and adult protection. However, not all staff had completed training in mandatory subjects; for example, food hygiene. This was a requirement at the last inspection, and is restated in this report. Orchard Avenue 10 DS0000010473.V289744.R01.S.doc Version 5.1 Page 19 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 The quality in this outcome group is poor. This judgement has been made form 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 relevant qualifications. 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 being regularly supervised to support them in meeting the residents needs. The home is generally well maintained. However, residents’ health and safety could be put at risk if out of date food is not disposed of and electrical appliances are not tested regularly. EVIDENCE: Orchard Avenue 10 DS0000010473.V289744.R01.S.doc Version 5.1 Page 20 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. Following a requirement about this issue at the last inspection, a person was employed to manage the home in November 2005, but left the home shortly afterwards. The manager said that to comply with the regulation, she intended to advertise the post. In the meantime, this requirement is restated. A quality assurance audit of the service that includes the views of the residents and other stakeholders has not been undertaken. A requirement is made 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. 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. Although some formal supervision of staff had taken place, the records indicated that this had not been provide for all staff and did not meet the standard of at least six supervisions per year. A requirement is made about this matter. Current certificates of safety for the gas central heating, fire equipment and the water systems were seen. The fire alarms are tested weekly. Portable electrical appliances had not been tested in the past year to ensure the safety of residents. Although food was being stored safely with the temperatures of the fridge and freezer recorded daily, some eggs were out of date, which could affect the health of the residents. Requirements are made to address these issues. Orchard Avenue 10 DS0000010473.V289744.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 1 X X 3 X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 3 2 X 2 Orchard Avenue 10 DS0000010473.V289744.R01.S.doc Version 5.1 Page 22 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 OP1 Regulation 5(1) Requirement The registered person must provide residents with a Service User Guide, which should include a summary of information about the service to enable them to decide if the home will meet their needs. The registered person must ensure that the opening balance of medication is recorded when obtained from the pharmacy. The registered person must provide an appropriate screen to protect the privacy of the residents who share a bedroom. The registered person must provide a record for inspection of meals eaten by residents. The registered manager must ensure that when a bedroom becomes vacant, a communal sitting/dining room is provided. This requirement is restated from the last inspection. The timescale for this requirement has not been reached. The registered manager must DS0000010473.V289744.R01.S.doc Timescale for action 30/06/06 2 OP9 13(2) 30/06/06 3 OP10 16(2)(c) 30/06/06 4 5 OP15 OP20 12(3) 23(2)(g)( h)(i) 30/06/06 31/05/06 5. OP29 7,9,19, 31/05/06 Page 23 Orchard Avenue 10 Version 5.1 Sch 2 & 4 provide complete records of all staff who work in the home, including two references. This is restated from the last inspection. The previous timescale was 30/04/05. The registered manager must ensure that all staff are trained in the mandatory subjects in the foundation programme. The timescale for this requirement has not been reached. The registered manager is required to attain NVQ level 4 in management. This is restated from the last inspection. The new timescale has not been reached. The registered person must carry 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. The registered person must provide at least six formal supervisions for all staff per year. The registered person must ensure that all portable electrical appliances are tested and that out of date food is disposed of. 31/05/06 6 OP30 18(1)(c) 7. OP31 9(2)(1) 31/05/06 8. OP33 24(1)(2) (3) 31/07/06 9 OP36 18(2) 30/06/06 10 OP38 13(4)(a) (b) 31/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000010473.V289744.R01.S.doc Version 5.1 Page 24 Orchard Avenue 10 Standard Orchard Avenue 10 DS0000010473.V289744.R01.S.doc Version 5.1 Page 25 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.V289744.R01.S.doc Version 5.1 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. 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