Inspection on 19/04/05 for Orchard Court Nursing Home

This inspection was carried out on 19th April 2005.

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

Other inspections for this house

Orchard Court Nursing Home 18/06/08

Orchard Court Nursing Home 15/02/07

Orchard Court Nursing Home 10/05/06

Orchard Court Nursing Home 20/10/05

Orchard Court Nursing Home 28/09/04

Orchard Court Nursing Home 21/05/04

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

CARE HOMES FOR OLDER PEOPLE Orchard Court Nursing Home Harp Chase Shoreditch Road Taunton, Somerset TA1 3RY Lead Inspector Kathy McCluskey Unannounced 19th April 2005 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 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 Court Nursing Home D53 - D02 S3276 Orchard Court Nursing Home V221459 190405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Orchard Court Nursing Home Address Harp Chase, Shoreditch Road, Taunton, Somerset, TA1 3RY Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01823 351155 01823 352277 Tamaris Healthcare (England) Ltd Mrs Y Evans Care Home with Nursing 44 Category(ies) of Dementia, Dementia over 65, Mental Disorder registration, with number and Mental Disorder over 65 of places Orchard Court Nursing Home D53 - D02 S3276 Orchard Court Nursing Home V221459 190405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Persons of either sex, not less than 60 years, who require care by reason of a progressive mental illness/disorder Not more than 10 persons, not less than 50 years, who require care by reason of a progressive mental illness/disorder. Up to 3 places for personal care Registered for a total of 44 places in Categories DE, MD, DE(E) and MD(E) Date of last inspection 28th September 2004 Brief Description of the Service: Orchard Court is a purpose built home located in a quiet residential area not far from Taunton town centre. The home is registered with the Commission for Social Care Inspection to provide nursing care for up to 44 older people who suffer with dementia or other mental health problems. The home also provides personal care for up to three persons, which is included in the total number of 44. The home is part of Tamaris Healthcare (England) Ltd. The Registered Manager is Yvonne Evans.Orchard Court is arranged over one floor and all areas, including the garden areas, are accessible to wheelchair users. The Gardens are well maintained and provide interesting features, which include a sensory garden area. Orchard Court Nursing Home D53 - D02 S3276 Orchard Court Nursing Home V221459 190405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 1 day (6.5hrs) and was conducted by two inspectors. A tour of the premises took place where a selection of bedrooms and all communal areas were seen. Fifteen service users and three staff were spoken with. The registered manager was available throughout the inspection. A period of time was spent unobtrusively observing staff interactions with service users. Records relating to care, staff and health and safety were examined. What the service does well: Service users benefit from the registered manager’s clear sense of leadership and open and inclusive style of management. The views of service users and staff are actively encouraged and responded to. Staff were very positive regarding the management style and support they received from the registered manager The manager takes appropriate action to ensure that admissions only take place if the home is sure that the assessed needs of a prospective service user can be met. Service users benefit from a safe, clean and pleasant environment. Those service users spoken with who were able to express a view, informed the inspectors that they liked living at the home and enjoyed the food. Service users benefit from a wholesome and varied menu which takes into account the needs and preferences of people living at the home. Special diets are catered for and choices are offered. The home takes appropriate steps to ensure the health and safety of service users, staff and visitors Orchard Court Nursing Home D53 - D02 S3276 Orchard Court Nursing Home V221459 190405 Stage 4.doc Version 1.20 Page 6 What has improved since the last inspection? What they could do better: Contracts – No contracts are available for those service users who are purchasing their care privately and a requirement has been raised that the providers must address. Staff recruitment – one of the three staff recruitment files examined, which related to a member of staff employed from overseas, did not contain the required information. The providers have been required to take immediate action to address this. The other two recruitment files contained all required information on the employees. Social & Psychological needs - The home does not have an activities coordinator and care staff do not have time to meet the social needs of people living at the home. Service uses rarely have the opportunity to have trips out. Outside entertainers visit the home one a month though this is insufficient and would not benefit everybody. During this inspection the inspectors spent time unobtrusively observing staff interactions with service users, although very kind in their approach, interactions were limited. Given the dependency levels of service users living at the home, staff were very much ‘task orientated’ and stated that they did not have sufficient time to spend quality time with service users. It is the judgement of the inspectors from evidence examined that the psychological needs of the service users are not fully be met. Requirements have been raised in this report which the providers must address. Orchard Court Nursing Home D53 - D02 S3276 Orchard Court Nursing Home V221459 190405 Stage 4.doc Version 1.20 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Orchard Court Nursing Home D53 - D02 S3276 Orchard Court Nursing Home V221459 190405 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Orchard Court Nursing Home D53 - D02 S3276 Orchard Court Nursing Home V221459 190405 Stage 4.doc Version 1.20 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 standard(s) 1, 2, 3, 4 & 5 Standard 6 is not applicable as the home is not registered to provide intermediate care The manager ensures that the home can fully meet the assessed needs of prospective service users prior to making a decision about admission. The preadmission process is detailed and well managed. The manager ensures that prospective service users provided with appropriate information which will assist them in making a decision about admission. The registered provider has failed to ensure that privately funded service users are made aware of their fees and terms and conditions of occupancy as contracts were not available. EVIDENCE: The home has produced a Statement of Purpose and Service user guide which is made available to service users, prospective service users and their representatives. The home’s current fee range is between £350.00 and £520.00 and are dependant upon the room to be occupied and the assessed needs of the service user. Orchard Court Nursing Home D53 - D02 S3276 Orchard Court Nursing Home V221459 190405 Stage 4.doc Version 1.20 Page 10 It was concerning to note that contracts were not available for privately funded service users as these had been recalled by the company last year. Whilst the home accepts service users funded by social services, an additional weekly ‘top up’ fee has to be met by the service user or third party to meet the fee range charged. Where service users are eligible for the ‘free nursing care’ element, this is incorporated into the fees and is not refunded to the service user or their representative. Extra charges are met by the service user for personal toiletries, hairdressing, chiropody, clothing and newspapers. The manager ensures that prospective service users are fully assessed and are invited to visit the home prior to a decision being made about admission. The needs of existing service users are also taken into account when considering a prospective service user. To ensure that the needs of a service user can be fully met, service users are admitted initially on a 28 day trial period. Documentation relating to pre-admission assessments were seen in the two care plans examined. Orchard Court Nursing Home D53 - D02 S3276 Orchard Court Nursing Home V221459 190405 Stage 4.doc Version 1.20 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 standard(s) 7, 8, 9 and 10 The home takes appropriate action to ensure the health care needs of service users are met. It was not evident that the psychological needs of service users were fully being met. The home’s procedure for the management and administration of medication was found to be much improved. EVIDENCE: Individual care plans are maintained for service users. Two were examined and were found to be up to date and well maintained. Care plans are compiled from appropriate assessments which include pre-admission assessment, prevention of pressure sores, moving and handling needs, nutrition and dependency. Whilst assessments were up to date and detailed the manager needs to ensure that any equipment used by the service user is appropriately recorded. All service users have access to appropriate health care professionals and the manager ensures that the health care needs of service users are met. The manager seeks the input and advice of other health care professionals as required. Examples were given and include community mental health teams and dieticians. Orchard Court Nursing Home D53 - D02 S3276 Orchard Court Nursing Home V221459 190405 Stage 4.doc Version 1.20 Page 12 Through observation, discussion with the manager, staff on duty, and those service users able to express an opinion, it could not be established that the home was fully meeting the psychological needs of service users. Whilst kind in their manner, staff appeared ‘task orientated’ and there was limited interaction with service users. This was discussed with the manager at the time who agreed to call a meeting with staff to address. The home’s procedure for the management and administration of medication was examined and was found to be much improved. The home uses the Monitored Dosage System (MDS) with pre-printed MAR charts. All records examined were appropriately completed. Medicines were seen to be appropriately stored. Medicines are only administered by appropriately qualified nurses. The manager has taken appropriate action to address the requirements raised at the last inspection. Regular audits are conducted by the manager or her deputy to ensure that appropriate procedures for the management and administration of medication are followed. The home’s last Health Authority Community Pharmacy advice visit was carried out by Boots the Chemist on 20/01/05. Orchard Court Nursing Home D53 - D02 S3276 Orchard Court Nursing Home V221459 190405 Stage 4.doc Version 1.20 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 standard(s) 12, 13, 14 and 15 The arrangements for meeting the psychological and social needs of service users are poor. The home provides a wholesome and varied menu which takes into account the needs and preferences of service users. Arrangements for service users to maintain contact with family and friends is good EVIDENCE: Since the last inspection the activities co-ordinator has left. It was recommended at the last inspection that the home considers increasing the 10 hours a week allocated. This obviously has not been addressed and the inspectors were informed that the company have not advertised this post. Throughout the day the inspectors unobtrusively observed staff interactions with service users. Interactions were limited and no activities or social interactions were seen to take place. The majority of staff time was seen to be taken up with ‘tasks’ and in meeting the physical needs of service users. The majority of service users at the home have high dependency levels and require staff assistance to meet all activities of daily living. Orchard Court Nursing Home D53 - D02 S3276 Orchard Court Nursing Home V221459 190405 Stage 4.doc Version 1.20 Page 14 Staff spoken with stated that they did not have time to spend quality time with service users or to undertake the role of the activities co-ordinator. Given staff’s limited time, service users are rarely offered the opportunity to go out. The manager recognises that this is a problem though is restricted within the confines of staffing levels set by the company. The manager intends to raise staff awareness regarding meeting the psychological and social needs of service users. The manager and chef have devised a 4 week menu which is wholesome, varied and takes in to account the needs and preferences of service users. Care is taken to ensure that soft diets are appealing and wholesome. Menus are regularly reviewed, with choices available and the home intends to seek the views of a dietician. The manager is committed to ensuring that relatives are supported and kept well informed. Visitors are made welcome at any reasonable time in accordance with the wishes of the service user. Orchard Court Nursing Home D53 - D02 S3276 Orchard Court Nursing Home V221459 190405 Stage 4.doc Version 1.20 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 standard(s) 16,17 and 18 The complaints procedure in this home is good with evidence that the views of service users/visitors are listened to and acted upon. The recruitment procedures carried out by the registered provider potentially put the service users at risk. Recruitment procedures followed by the manager are satisfactory. EVIDENCE: The home has a complaints procedure which is clearly displayed in the home. Copies are also found in the Statement of Purpose and Service User Guide. Three complaints have been received by the home since the last inspection. Appropriate action had been taken by the manager to address the issues to the satisfaction of the complainant within the agreed time scale. No formal complaints have been received by the CSCI since the last inspection. Since the last inspection, the registered provider has recruited staff from overseas with more staff planned. The recruitment file for one overseas care assistant already working at the home was examined. No enhanced CRB or POVA checked had been obtained and there was no evidence that references seen had been obtained or checked by the company. One reference was addressed ‘to whom it may concern’. There was no evidence that the lack of employment history from 1986 had been explored. Further information on the home’s recruitment procedures can be found under ‘Staffing’ Orchard Court Nursing Home D53 - D02 S3276 Orchard Court Nursing Home V221459 190405 Stage 4.doc Version 1.20 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 standard(s) 19, 20, 21, 22, 23, 24, 25 and 26 Service users live in a comfortable, safe and clean environment and are able to personalise their own bedrooms. The home’s environment is able to meet the assessed needs of service users. The home provides specialist equipment to ensure the needs of service users are met. EVIDENCE: The home is purpose built on one level. All areas, including the pleasant gardens, are accessible to wheelchair users. There are 40 single bedrooms of which 22 have en-suite toilet facilities. The 2 double bedrooms do not have an en-suite facility. All communal areas and a selection of bedrooms were seen at this inspection. Bedrooms were pleasant and comfortable and it was evident that service users were encouraged to personalise their rooms. Some bedrooms contained items of furniture belonging to the service user. Specialist beds and pressure Orchard Court Nursing Home D53 - D02 S3276 Orchard Court Nursing Home V221459 190405 Stage 4.doc Version 1.20 Page 17 relieving equipment were seen to be in place where there was an assessed need. Bedrooms are decorated when they become vacant. Service users who were able to express a view informed the inspectors that they liked their rooms. The home has four lounges, a large dining room and a sensory room and service users have a choice of where to spend their day, though the majority of service users are dependant on staff to access these areas due to mobility difficulties. At this inspection, service users were observed utilising all communal areas. A number of service users were observed to be in their bedrooms either through choice or due to their assessed needs. It was noted that corridors and some bathrooms would benefit from redecoration as paint on walls and skirting boards was seen to be peeling or chipped. The manager advised that the home’s maintenance person was in the process of addressing in line with the redecoration programme. Progress will be followed up at the next inspection. The standard of cleanliness was very good and all areas of the home seen at the inspection were free from malodours. Domestic staff are employed. Orchard Court Nursing Home D53 - D02 S3276 Orchard Court Nursing Home V221459 190405 Stage 4.doc Version 1.20 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30 The providers recruitment procedures for overseas staff are not robust and do not fully protect service users from the risk of abuse. Appropriate recruitment procedures are followed by the manager at the home. The home is not fully meeting the psychological or social needs of service users within its current level and skill mix of staff. EVIDENCE: Since the last inspection, the company have recruited staff from overseas with more staff planned. The recruitment file for one overseas care assistant already working at the home was examined. No enhanced CRB or POVA checked had been obtained and there was no evidence that references seen had been obtained or checked by the company. One reference was addressed ‘to whom it may concern’. There was no evidence that large gaps in employment history had been discussed/explored. It was concerning that the registered manager is not involved in the recruitment and selection of staff from overseas. Given the psychological needs of service users it is imperative that the manager is able to ensure that staff employed at the home have the skills and/or experience in caring for older people with dementia or mental health problems. A recruitment file for 2 members of staff employed by the manager was examined and was seen to contain all appropriate information, which included CRB and POVA checks. Orchard Court Nursing Home D53 - D02 S3276 Orchard Court Nursing Home V221459 190405 Stage 4.doc Version 1.20 Page 19 As previously mentioned in this report, the activities co-ordinator has left since the last inspection and the providers have not re-advertised this post. Through observation and discussion with staff and service users, it was apparent that staff are unable to undertake this role. Staff stated that they did not have time to spend quality time with service users. Staff interaction with service users was observed to be limited. Orchard Court Nursing Home D53 - D02 S3276 Orchard Court Nursing Home V221459 190405 Stage 4.doc Version 1.20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35, 36, 37 and 38 The home is effectively managed by the registered manager who promotes a clear and inclusive style of management which ensures the needs and wellbeing of service users takes priority and that staff are appropriately supported and supervised. The home’s systems for ensuring the health, safety and welfare of service users and staff have improved since the last inspection. EVIDENCE: The registered manager is Yvonne Evans who is a registered nurse in mental health. Through discussion with staff and Yvonne, it was apparent that she manages the home with a clear and very open and inclusive style of management. She is very much a ‘hands on’ manager who has a very clear understanding of the needs of service users living at the home. Yvonne is also active in ensuring relatives and carers receive the support and information they need. Orchard Court Nursing Home D53 - D02 S3276 Orchard Court Nursing Home V221459 190405 Stage 4.doc Version 1.20 Page 21 Staff spoken with were very positive regarding the support and input they received from the manager. Staff benefit from regular meetings and supervision sessions. Records were seen to support this and staff stated that they could go to Yvonne at anytime. At the request of the service user or representative, the home manages small amounts of ‘pocket money’ for service user. The home does not act as appointee for any service user and this would always be avoided. A selection of financial transactions were examined. These were found to be appropriately completed with receipts available. At the time of this inspection, the home was taking appropriate steps to ensure the health & safety of service users, staff and visitors to the home. The following records were examined: FIRE – Records indicated that appropriate checks were being carried out on the home’s fire detection and fire fighting equipment. Regular training is conducted for all staff. SERVICING – Servicing certificates were seen for the home’s hoists. These were serviced by an outside contractor in accordance with LOLER regulations on 11/01/05. Gas servicing was carried out on 12/10/04 Bedrails are in use for those service users with an assessed need. Regular checks are made by the home to ensure they remain safe. A number were checked by inspectors and no problems were identified. PORTABLE APPLIANCES – Appropriate records were seen which indicated the last test was carried out on 27/09/04. ACCIDENTS – The home maintains appropriate records relating to accidents at the home. The manager analyses these on a monthly basis to identify any traits. Action is then taken as appropriate. Records indicated a high number of un-witnessed falls which the manager has agreed to investigate in more depth. This will be followed up at the next inspection. HOT WATER/SURFACES – All radiators are of a low surface temperature type which reduce the risk of injury to service users. Bath hot water outlets are thermostatically controlled to reduce the risk of scalding. Monthly checks are made to ensure that the temperature does not exceed the HSE recommended limit of 44C. Those checked at this inspection were found to be within the acceptable limits. Orchard Court Nursing Home D53 - D02 S3276 Orchard Court Nursing Home V221459 190405 Stage 4.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 1 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 1 28 x 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 1 3 3 x 3 3 3 3 3 Orchard Court Nursing Home D53 - D02 S3276 Orchard Court Nursing Home V221459 190405 Stage 4.doc Version 1.20 Page 23 NO Are there any outstanding requirements from the last inspection? 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 2 Regulation 5(1)(b) Requirement The registered person must ensure that all service users purchasing their care privately, are issued with a contract which sets out the terms & conditions, fees to be charged and any extras to be met by the service user The registered person must make proper provisions which will enable service users to engage in appropriate activities both in and out of the home The registered person must ensure that appopriate numbers & experienced staff are on duty to ensure that the psychological needs of service users are met The registered provider must ensure that robust recruitment procedures are followed for all staff which meets with all requirements as set out in Schedule 2 and Regulation 19 of the Care Home Regulations 2001. An immediate requirement was issued at the time of the inspection. Timescale for action 06/05/05 2. 12 16(1)(m) & (n) 30/05/05 3. 27 18(1) 30/06/05 4. 18 & 29 13(4)(c ), 13(6) & 19 19/04/05 Orchard Court Nursing Home D53 - D02 S3276 Orchard Court Nursing Home V221459 190405 Stage 4.doc Version 1.20 Page 24 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 Good Practice Recommendations Orchard Court Nursing Home D53 - D02 S3276 Orchard Court Nursing Home V221459 190405 Stage 4.doc Version 1.20 Page 25 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier Taunton TA1 4AL 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 Court Nursing Home D53 - D02 S3276 Orchard Court Nursing Home V221459 190405 Stage 4.doc Version 1.20 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!