Inspection on 26/11/07 for Orchard House

This inspection was carried out on 26th November 2007.

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 House 14/08/06

Orchard House 11/10/05

Orchard House 04/04/05

Orchard House 06/12/04

Orchard House 06/07/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Orchard House Weston Drive Market Bosworth Warwickshire CV13 0LY Lead Inspector Thea Richards Unannounced Inspection 10:00 26 November 2007 th 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 House DS0000001702.V354187.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 House DS0000001702.V354187.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard House Address Weston Drive Market Bosworth Warwickshire CV13 0LY 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) 01455 292988 F/P 01455 292988 CHERHT@aol.com Mr John William Nunn Mrs Barbara Elsie Nunn Mrs Sharon Heather Turner Care Home 30 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (30), of places Physical disability (5), Physical disability over 65 years of age (5) Orchard House DS0000001702.V354187.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No one under the age of 55 years may be accommodated in the home in category PD. Service User Numbers - PD or PD(E) No more than 5 people who fall within categories PD or PD(E) may be admitted in the home when there are already 5 persons within those categories/combined categories already accommodated within the home. 14th August 2006 Date of last inspection Brief Description of the Service: Orchard House is a care home providing personal care and accommodation for 30 older people with a physical frailty and/or mental health needs. The home is part of the Broadoak group of homes owned by the Registered Providers Mr John William Nunn and Mrs Barbara Nunn. Mrs Sharon Turner has been the registered manager for several years. The home is situated close to the centre of the town of Market Bosworth and can be reached by private and public transport. There is parking in the road outside the home. The accommodation is a purpose built single storey home with a lounge, a dining room and a mixture of single and double bedrooms all with en-suite facilities. The home is well maintained and provides a safe, comfortable and homely environment for the residents to live in. Outside, there is a well – maintained patio and garden area with seating and flower beds, which is easily reached for the residents to use in the better weather. Information about the service is provided in the home’s brochure and would be made available in other formats, such as large print if it was needed. The current registration certificate from the Commission for Social Care Inspection is available in the reception area with an up to date insurance certificate. The latest report from the Commission for Social Care Inspection is available for people to read. Orchard House DS0000001702.V354187.R01.S.doc Version 5.2 Page 5 The home can be contacted by telephone or fax. The current fee level is £ 425.00 p.w. The people that live at the home are responsible for any additional charges such as hairdressing personal toiletries, private chiropody, newspapers, magazines, dry cleaning and homely remedies. Orchard House DS0000001702.V354187.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection of a care home for older people, which ended with an unannounced visit to the service. Before the visit we (throughout the report the use of ‘we’ indicates the Commission for Social care Inspection), spent five hours reviewing information received by the Commission for Social Care Inspection (CSCI) since the last inspection on the 14th August 2006. This included the Annual Quality Assurance Audit completed by the home and surveys completed by the residents, their families and the staff. The visit took place on the 26th November 2007 and lasted five hours. During the visit we checked all the ‘key’ standards as identified in the National Minimum Standards. This was achieved through a method called ‘case tracking’. Case tracking means that we looked at the care provided to three of the residents. To achieve this, the residents and their families were spoken with. We spoke with the staff supporting their care and looked at the records relating to their health and welfare. With their permission, the residents’ bedrooms were looked at. We also checked how the home was run and organised. This included looking at staff records, training and how the staff are organised. We looked at health and safety records, menus, minutes of meetings and the quality audit. The policy for handling complaints and how the home dealt with them were looked at. We looked at how prospective residents and their families are given information about the services the home can offer and whether they are suitable for them. During the visit we spoke with two senior carers, staff, the residents and their families. Orchard House DS0000001702.V354187.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? What they could do better: The management of the receipt and administration of the controlled (dangerous) drugs should be improved so that the records are accurate and reflect the medication given to the residents. The manager could check the medication records regularly and record that she has done so to make sure that there are no mistakes made. The activities that are done with the residents could be written in their care plans. The complaints book should be organised to provide a proper audit trail to make sure that complaints are resolved and confidentiality is kept. The complaints policy could be produced in other formats to make sure that as many people as possible can understand it. The home should make sure that the home is kept free from unpleasant odours so that the residents have a pleasant environment to live in. The home should make sure that the water temperatures are being tested correctly, as some variability would normally be expected. Orchard House DS0000001702.V354187.R01.S.doc Version 5.2 Page 8 A training plan could be put in place to make sure that training happens when it should and given to the staff who need it. Formal supervision should take place at the recommended frequency, to give the staff time with their line manager to discuss work and training issues. 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. The summary of this inspection report can be made available in other formats on request. Orchard House DS0000001702.V354187.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 House DS0000001702.V354187.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3. 6 is not applicable in this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ needs are assessed before moving into the home and they are offered the chance to visit the home. They are given enough information to allow them to make an informed choice about the home. EVIDENCE: All of the residents who were ‘case tracked’ had been given a Statement of Purpose, service user guide and a copy of the terms and conditions. The registered provider can make these documents available in alternative formats such as large print and other languages, which makes sure that people can understand the information. Providing a thorough Statement of Purpose & Service Users’ Guide results in good information for the residents, making sure that they they can get the most suitable care. Orchard House DS0000001702.V354187.R01.S.doc Version 5.2 Page 11 The manager visits all prospective residents before they are admitted to the home and completes a pre admission assessment form. These were seen in the files looked at. This makes sure that that the staff in the home have the the right information, so that the residents get the best care. It makes sure that the home can meet the residents needs and that the resident meets someone from the home who they can recognise. This makes the move into care easier to manage for them. The families spoken with confirmed that they were given the opportunity to visit the home before their relative came in. Members of the staff spoken with said that they knew what the residents needs were before they moved in. The current registration certificate from the Commission for Social Care Inspection (CSCI) was displayed in the entrance of the home. The latest report from the CSCI was available in the managers’ office. An up to date insurance certificate was displayed in the entrance hall. Orchard House DS0000001702.V354187.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff meet the care needs of the residents as identified in the care plans and give them privacy and dignity with their care. Some medication practices could be unsafe for the residents. EVIDENCE: All of the ‘case tracked records were found to contain good individual evidence of the care being given to the residents. There are records of the involvement of G.P.s, district nurses, chiropodist, optician and dentist in them, showing that thorough health care is being provided for the residents. The residents and their families spoken with said that they could see the doctor and other health professionals when they needed to. There are records of the residents weight held in the care plans, which makes sure that they are not having an unexplained weight loss or gain. The resident or their families had seen and had agreed with the care plans and those spoken with, said that they had been involved in the review process and were happy with the care being given. Orchard House DS0000001702.V354187.R01.S.doc Version 5.2 Page 13 The daily record of care is up to date which makes sure that the residents receive the right care and the staff are aware of what has happened to them during the day or night. We saw the residents being treated with dignity and respect when staff spoke with them and gave them their care. Staff seen giving care did so in the right way, giving the residents privacy where needed and talked with them whilst giving the care. The staff spoken with were aware of the care needs of the residents and the residents and the families spoken with were happy that all care needs were being met. A comment from a resident was that ‘The staff look after us well. Medication records for the case tracked residents were in order. Senior care staff who have had training give the medicines. The medicine round was seen by the inspector and medicines were administered individually and the residents seen to be taking them. The staff spoken with were knowledgeable about the medicines and where to obtain information. They were also aware of the requirements for the receipt, storage and disposal of medicines. The manager regularly looks at the record sheets, but does not record that she does so. She should consider recording this information to confirm that they are correct. There is a policy for residents handling their own medicines, but there are currently no residents in the home doing so. Residents who need to use oxygen have it provided with the correct health and safety practices in place. The controlled (dangerous) drugs register was looked at and there were several errors found. On one occasion there was only one signature to witness that the medication had been given. On two occasions the medication had been witnessed but the amount that had been given had not been recorded. The staff present told the inspector that there had still been medication in the bottle after it should have been empty, so that it had been given but not recorded. Medication left in a bottle should either be added to the amount in the new bottle or retuned to the chemist. A bottle of medication, which should have had 80mls of medicine in it, had over 200 mls in it. The chemist was visiting the following day to audit the medication and found that a bottle of medicine sent to the home had not been entered in the register as having been received. Orchard House DS0000001702.V354187.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have their social, spiritual and nutritional needs met. Their views are taken into consideration and acted on. EVIDENCE: There was evidence of regular activities being provided for the residents. The residents and the families spoken with were happy with the amount and variety of activity arranged. On the morning of the visit the staff were involved with doing a quiz with the residents, which they nearly all joined in with and enjoyed. In the afternoon there was suitable music playing and the staff were seen to be spending time with the residents. These activities were not recorded in the care plans or in any other files. This should be completed to make sure that all the residents are being offered the opportunity of taking part in activities. Orchard House DS0000001702.V354187.R01.S.doc Version 5.2 Page 15 There were several visitors in the home on the day of the visit and those spoken with were positive about the communication with the manager and said that they were always made very welcome in the home. The inspector saw the welcome given to visitors in the home. The residents have a choice of meals every day and the cook is able to offer the resident’s an alternative choice if there is nothing the resident likes. The inspector spent time the dining room during lunchtime and all the residents spoken with said that they were enjoying their meal and that they always had a choice. The cook has a good understanding of the dietary needs of the residents including diabetic diets. The staff spent time with the residents whilst helping them with their meal. The manager or the deputy sees each of the residents on a one to one basis every day. There are annual quality audits to get the views of the residents and their families. There are regular resident meetings and families are invited to these. The residents and the families confirmed this. Those residents who smoke have been provided with a room to use. There are regular church services in the home and the local priest visits those of the Roman Catholic Faith. These practices make sure that the residents keep their contact with the community and their families and that their views for improvements can be considered. A hairdresser visits the home regularly which the residents enjoy. Orchard House DS0000001702.V354187.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are some systems in place to support and protect residents and staff are aware of the processes. There are some shortcomings in the complaints process, affecting confidentiality and satisfactory outcomes. EVIDENCE: There is a complaints policy in place, which gives the details of how to complain and who to complain to if they needed to. Consideration should be made to produce it in other formats such as large print or other languages, which would make it easier to understand. We looked at the complaints book and it was found to have no record of the date that complaints were received, when any communication had been made or when it was resolved. There were no signatures to show who had received the complaint. There was more than one complaint on a page, which could lead to a lack of confidentiality for the residents and their families. Complaints received since the last inspection on the 14th August 2006 had apparently been resolved satisfactorily. The Commission for Social Care Inspection (CSCI) has received several complaints since the last inspection, which appear to have been resolved. Orchard House DS0000001702.V354187.R01.S.doc Version 5.2 Page 17 The residents spoken with were happy that they would speak to the manager or a member of staff, if they had a problem and that it would be dealt with. Families spoken with on the day of the visit said that they were aware of the procedure to complain and would have no concerns about doing so. The staff spoken with knew how to deal with a complaint, which was given to them. The staff said that they had had training in safeguarding adults as part of their induction process and that it was updated regularly. The records that are held confirmed that this training had taken place. The staff spoken with told the inspector how they would handle such an incident and that they would have no concerns about ‘whistle-blowing’. This makes sure that the residents are safe from any abuse and that any concerns are handled correctly. Orchard House DS0000001702.V354187.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23, 24, 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in a pleasant home, which is run in their best interests. A comfortable, clean and safe standard of accommodation is provided for the residents. EVIDENCE: Orchard House is a purpose built home close to the town centre of Market Bosworth and is part of the Broadoak group of homes. There is a large lounge and a separate dining room, which are well decorated and give the residents a pleasant place to live in. There is a television and music centre in the lounge area. The home is generally well maintained and clean. On the day of the visit there was an unpleasant odour throughout the public areas. Orchard House DS0000001702.V354187.R01.S.doc Version 5.2 Page 19 There is a pleasant patio area and garden, which are very well kept and easy for the residents to get to in the better weather. The bathrooms were clean, tidy and free of any hazards. With their permission, we looked at the case tracked residents bedrooms. They provided good accommodation, which had been personalised with the resident’s belongings. The bedrooms were clean and well maintained. There was evidence of equipment such as hoists having been provided to help in the care and comfort of the residents. The cleaning materials were kept in locked cupboards and the staff have had training in handling dangerous chemicals. The fire records and hot water temperatures were being completed regularly and were found to be up to date. However, all of the water temperatures were shown to be 43c with no variability. 43c is the maximum recommended temperature. There were no further outstanding safety or maintenance issues seen on the tour of the premises. The registration certificate from the Commission for Social Care Inspection was displayed with a current certificate of insurance. The inspection reports are available for people to see. Orchard House DS0000001702.V354187.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ needs are met and their safety protected by the recruitment policy and by the training that is in place. There are enough staff at the home to provide for the residents needs. EVIDENCE: There is evidence of a good skill mix of staff to make sure that the residents have the right care. The duty rota reflected the number of staff on duty. The residents, staff and relatives spoken with felt that there were always enough staff on duty to look after them properly. We looked at three staff files and the required information was complete in all of them. This included evidence of identification, adequately completed application forms, two written references and a Criminal Records Bureau (CRB) check. There were some records of staff training including induction and the staff spoken with confirmed that they received regular training in moving and handling. They said that they had training in first aid, food hygiene and medicine training. Orchard House DS0000001702.V354187.R01.S.doc Version 5.2 Page 21 There was little evidence of training being planned, which could result in training not happening at the correct intervals and for some staff to be missed. The manager should consider putting a training plan in place to show when and who needs training and when it takes place. The home has met the requirement of staff with a National Vocational Award (NVQ) at level 2 or above. The National Vocational Qualification is a qualification for care staff to make sure that they receive the right training in the needs of the resident group whom they are caring for. Orchard House DS0000001702.V354187.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is committed to the best care for the residents through training and communication. EVIDENCE: A Senior Carer was available throughout the visit to the home as the manager had a day off. There was evidence that some staff supervision was in place and the members of staff spoken with confirmed that they had received supervision. However, the frequency of supervision should be increased to meet the levels required by the Care Standards Act. Orchard House DS0000001702.V354187.R01.S.doc Version 5.2 Page 23 The process of formal supervision time gives the staff and their ‘line manager’ the opportunity to have individual discussions about work and training needs. There are regular meetings held with the staff to pass on and exchange information and there are minutes held of them. The one and and manager meets regularly with the residents and their families as well as to one discussions, both to pass information on and to listen to their views opinions. There are annual quality questionnaires sent out to residents their families to gain their views about the home. These practices allow the manager and the responsible person to respond to the residents and the staff’s needs. There are accounts held to manage the residents personal allowances and are being managed correctly with two signatures and the receipts in place. The policies and procedures are in place for the home and are regularly reviewed. They are available for the staff to read to make sure that they know how the residents are to be cared for and protected. There was a prominent notice from Age concern giving the residents information about advocacy services if they needed an independent advocate. This is good practice. Records for the maintenance of fire equipment, fire drills and training were found to be in place and up to date. Orchard House DS0000001702.V354187.R01.S.doc Version 5.2 Page 24 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 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 1 17 X 18 3 3 3 X X 3 3 X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 Orchard House DS0000001702.V354187.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? None 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 OP9 Regulation 13(2) Requirement That the Registered individual makes sure that there is a system in place for the receipt and administration of the controlled drugs and that the staff comply with the system. That the Registered Individual puts in place a complaints book which follows an audit trail with the required dates and signatures, whilst maintaining confidentiality. Timescale for action 03/12/07 2. OP16 22(4) 30/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP9 OP12 OP16 Good Practice Recommendations That the registered manager regularly audits the medication sheets and records the information. That the activities which the residents take part in are recorded. That the Registered individual produces the complaints policy in alternative formats when it is required. DS0000001702.V354187.R01.S.doc Version 5.2 Page 26 Orchard House 4. 5. 6. 7. OP19 OP26 OP30 OP36 That the Registered individual makes sure that equipment that is used to test the water temperatures is checked for its accuracy. That the registered manager makes sure that the home is kept free from offensive odours. That the Registered manager makes sure that there is a system in place to make sure that training takes place at the correct intervals and is given to the correct staff. That the registered manager arranges formal supervision at the recommended intervals. Orchard House DS0000001702.V354187.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 House DS0000001702.V354187.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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