Inspection on 18/01/07 for Orchard House Care Home

This inspection was carried out on 18th January 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 Care Home 18/11/08

Orchard House Care Home 21/11/07

Orchard House Care Home 26/01/06

Orchard House Care Home 16/03/05

Orchard House Care Home 16/11/04

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 Care Home 46 Easthorpe Street Ruddington Nottingham NG11 6LA Lead Inspector Joanna Carrington Unannounced Inspection 18th January 2007 10:00 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 House Care Home DS0000008728.V328846.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 Care Home DS0000008728.V328846.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard House Care Home Address 46 Easthorpe Street Ruddington Nottingham NG11 6LA 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) 0115 921 7610 Cfnursinghome@aol.com Ruddington Care Homes Mrs Deborah Ann Stevenson Care Home 26 Category(ies) of Dementia (26), Old age, not falling within any registration, with number other category (26) of places Orchard House Care Home DS0000008728.V328846.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The area identified in the garden must be properly secured to ensure that residents are safe and secure. (this condition can be removed once the matter is satisfactorly resolved) Service users shall be within catgory OP (26) Service users shall be within category DE (26) 2. 3. Date of last inspection 26th January 2006 Brief Description of the Service: Orchard House is an adapted and extended period property situated in the village of Ruddington on the outskirts of Nottingham and situated on a bus route. Local amenities including, shops, banks, library and the local doctors surgery are within a 10 minute walk. Up to 26 service users falling within the categories of old age and Dementia can be accommodated at the home in single bedrooms, 19 of which have en suite. The home has a stairlift in place in for service users that have some mobility problems so are unable to safely use the stairs. There are large, attractive gardens to the rear of the property and a car park to the front. The home and grounds are easily accessible to service users. The weekly fees for care and accommodation at the home range from £380 to £650, depending on the accommodation and level of need. Orchard House Care Home DS0000008728.V328846.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over eight hours on 18th January 2007. The main method of inspection was called ‘case tracking’ which meant selecting three residents and tracking the quality of their care by checking records, discussion with them and with staff and observation of care practices. Altogether, two residents, three relatives and two staff members were spoken with during the course of the inspection. Staff records were looked at to make sure staff get the training they need and checks are carried out on staff before they commence their employment. A partial tour of the premises also took place in order to assess environmental standards. Resident surveys and a pre-inspection questionnaire were obtained prior to the inspection and have been used to reach judgements about the quality of care. The registered manager was on sick leave at time of the inspection. The deputy manager was available throughout the inspection for discussion and feedback. What the service does well: When residents move to the home they can be assured that the home will be suitable in meeting their needs because a pre-admission assessment is carried out for all new residents. There is up to date information about the home, which enables prospective residents and their relatives to make a choice about moving there. Residents are treated with dignity and respect and are supported by a staff team that are appropriately trained and get good support from their manager. The recruitment practices are generally robust with all the required checks such as references and criminal record bureau check obtained before new staff members commence their employment. The manager has an open and approachable style and all spoken with confirmed they feel comfortable in expressing any concerns and feel confident that issues are addressed. The views of residents and relatives are valued and obtained through regular meetings and also through questionnaires that are sent out every six months that ask questions about the quality of different aspects of the service. There are two activities co-ordinators and a good programme of activities offered. Residents were seen enjoying wordsearches and a film club on the day of the inspection. Relatives are always made to feel welcome and are invited along to parties and trips out. Orchard House Care Home DS0000008728.V328846.R01.S.doc Version 5.2 Page 6 The environment is of an exceptionally high standard. The décor and furnishings are well maintained and bedrooms are personalised and comfortable. The home is kept clean and hygienic. What has improved since the last inspection? What they could do better: Even though all staff members have now had training on adult abuse one staff member, when spoken with, did not understand their responsibility to report all allegations of abuse to the manager. This is a learning need, which needs to be addressed. When there are violent incidents between residents then these must be seen as issues of adult protection and therefore the Safeguarding Adults procedures must be followed. This means notifying Social Services so that any strategies to protect residents can be agreed and put in place. Care planning documentation needs improving, to ensure that residents’ needs are being adequately and appropriately met. Care plans should include enough detail on the level of support required and the personal preferences of how this support is given. Any restrictions on a residents’ choice must be clearly documented along with evidence of consultation with the resident and relevant healthcare professionals. This is so that residents’ dignity and rights are promoted and protected. Ensuring the safety of residents could be done better if risk assessments are used correctly, which means not only identifying risks but also what measures are needed to reduce that risk. Orchard House Care Home DS0000008728.V328846.R01.S.doc Version 5.2 Page 7 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 Care Home DS0000008728.V328846.R01.S.doc Version 5.2 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 House Care Home DS0000008728.V328846.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Quality in this outcome area is good. There is a good admissions procedure, which ensures the home is suitable in meeting the needs of prospective residents and prospective residents have enough information to decide to move there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All three residents case tracked had copies of their pre-admission assessment on their files. Both relatives spoken with confirmed that the manager visited them to carry out an assessment with their relative-in-care, to ensure that the home is suitable in meeting their needs. Both relatives also confirmed that they were given a brochure about the home and a Service User Guide when their relative-in-care moved in. The Statement of Purpose was seen and contains useful and up to date information about the facilities and services provided in the home. Orchard House Care Home DS0000008728.V328846.R01.S.doc Version 5.2 Page 10 Orchard House Care Home DS0000008728.V328846.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. Medicine management promotes the safety of residents but the lack of detail on care plans does not ensure residents’ needs are met and places residents at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A staff member was observed administering medication following correct procedures, which ensure residents’ safety. The medication administration record is not signed until the drug giver has assisted residents with taking their medicines and the drug trolley was locked every time it is was left unattended. Four medicines in the drugs trolley were audited. The medication administration records were clear and quantities of medicines tallied with records. As recommended at the last inspection, the medication policy has been updated and includes that no medication is to be administered in a covert manner, which was identified as an issue at the last inspection. One of the three residents case tracked did not have any care plans in place even though the resident has been living at the home since October 2006. The care plans of the two other residents did not contain enough information about Orchard House Care Home DS0000008728.V328846.R01.S.doc Version 5.2 Page 12 how their needs are met, for example, a care plan for bathing only states ‘carer to help in and out of bath’. The care plan should state whether for their safety, they are supervised and whether or not the resident wishes to have some assistance with washing. The deputy manager, when asked, reported that the resident is supervised when dressing, but there is no care plan in place for this. The only evidence that care plans are being reviewed is a sheet at the front of the care plan that is dated and signed. This is not an adequate record because it does not confirm whether there have been any changes in need and subsequent amendments to care plans. Risk assessments that accompany care plans are not being used properly because they do not identify ways that a risk can be minimised, to ensure the safety of the resident. For one of the resident’s case tracked there was a risk assessment in place identifying the staff stairs as too hazardous for the resident to use, even though the resident keeps using them. The risk assessment states that the daughter has assured if anything happens to the resident then the home will not be to blame. Where a risk is identified it is the responsibility of the home to ensure relevant measures are put in place to minimise that risk and to ultimately ensure the safety of residents. During discussion with staff it came out that one resident is made to go downstairs, to encourage mobility and for the benefit of his health and continence problems. There are no care plans or risk assessments in place for continence, which should then specify this arrangement along with evidence of consultation with the resident and relevant healthcare professionals. This is required, to indicate that the resident’s wishes and feelings have been taken into account, balanced with promoting the resident’s health and wellbeing. A letter has gone to the provider requiring urgent action in relation to care plans and risk assessments. A resident spoken with said she asks for help when she needs it and “staff are always very good.” Relatives spoken with confirmed that when they visit staff are always around speaking with residents and are seen treating them in a dignifying manner. This was observed during the inspection. Orchard House Care Home DS0000008728.V328846.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14 and 15 Quality in this outcome area is good. Meeting residents’ recreational needs and maintaining contact with family and friends is managed well in accordance with residents’ wishes. There are good arrangements in place for providing wholesome appealing meals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the morning of the inspection two activities organisers were seen doing word searches on a wipeboard with residents. Some care staff joined in and those participating were clearly enjoying the activity. In the afternoon the film club took place and the residents were seen enjoying the Sound of Music on the large flat screen television in the main lounge. The week’s activities are displayed and there is also a newsletter for residents and relatives. During the rest of the week activities include bingo, sing-a-long, games and quizzes, hair and nails pamper sessions, arts, crafts and music to movement. There are trips out and parties, in which relatives and friends are invited to. One relative spoken with said that since her mum had moved to the home their relationship has improved significantly. Relatives confirmed that they are always made welcome when they visit. Orchard House Care Home DS0000008728.V328846.R01.S.doc Version 5.2 Page 14 Staff spoken with gave examples of how they ensure residents are enabled to exercise choice in their day to day lives, such as choosing what they want to eat, when they have a bath, and whether they wish to spend time on their own or in the company of others. There are also resident meetings, so that any views of suggestions can be aired. On the day of the inspection the main meal was Roast Beef, Yorkshire puddings, creamed potatoes, cabbage and carrots. Alternative choices were cheese salad or jacket potato. The meal appeared appetising and residents were seen enjoying it. The menu record showed that meals are nutritious and varied, with a choice always available. Orchard House Care Home DS0000008728.V328846.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. Residents can be assured their concerns and complaints are taken seriously and acted on. Procedures need to be followed, to help ensure residents are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Complaints Procedure is displayed in the hallway, where relatives and visitors can see it. Both relatives and residents spoken with said they would speak with the manager or whoever is in charge at the time to express any concerns. All spoken with stated they had no cause to complain but did confirm that if they did they feel confident their concerns would be taken seriously and acted on. The complaints file was looked at and since the last inspection there have not been any complaints. Staff spoken with and their staff records confirm that external training on adult protection has now been provided. Nevertheless, a learning need was identified during the inspection. When given a scenario and asked how to respond one staff member did not have an understanding of their responsibility to inform their manager when a service user discloses abuse or when bad practice has been observed, and when confidential information must be shared on a need to know basis. The staff member said they would have to consider whether it was true or a lie and if there is a history of false allegations. Orchard House Care Home DS0000008728.V328846.R01.S.doc Version 5.2 Page 16 Incident records were looked at and included two incidents that involved residents fighting resulting in injuries. These incidents are issues of adult protection and should have been followed up using the Safeguarding Adults procedures. Social Services must be informed of such incidents and then involved in identifying strategies to protect residents. The Commission must also be notified, in accordance with the Care Home Regulations. The admission notes for one resident case tracked identifies the resident can be “verbally and physically abusive at times” and on a care plan it states that “staff need to be firm with [the resident], especially every meal time”. This is too vague. Staff spoken with were asked how they know when the resident is agitated and what action they take to defuse a situation. Answers were inconsistent. A more detailed care plan is required to ensure the rights of the resident are protected and that staff know how to respond appropriately. Orchard House Care Home DS0000008728.V328846.R01.S.doc Version 5.2 Page 17 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 and 26 Quality in this outcome area is good. Residents live in a very homely, comfortable and clean environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On a partial tour of the premises it was apparent that the home is decorated and furnished to a high standard. Since the last inspection some bedrooms have been redecorated and re-carpeted. Bedrooms seen are personalised with residents’ own items such as small furniture, pictures and ornaments. The lounge is comfortable and homely and there is a conservatory for residents to use that looks out onto the large and attractive garden, which is accessible to all. The home is well maintained and appeared clean and hygienic throughout. The laundry facilities are appropriate to the needs of residents and all areas where residents are at risk are kept locked. Orchard House Care Home DS0000008728.V328846.R01.S.doc Version 5.2 Page 18 When the home was registered for older people with dementia a condition was imposed that the garden was made more secure. This condition has now been complied with. The pre-inspection questionnaire states that a new fence has been fitted. This condition can now be removed. Orchard House Care Home DS0000008728.V328846.R01.S.doc Version 5.2 Page 19 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 and 30 Quality in this outcome area is good. Residents’ needs are well met by sufficient numbers of trained staff and residents are protected by recruitment practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All people spoken with during the course of the inspection confirmed that staffing numbers are not a problem. Staff members spoken with commented on having time to talk with residents as part of their duties. A relative spoken with said “staff are always very helpful and they will let you know if any problems” and residents spoken with said that staff are always available to provide assistance when needed. The pre-inspection questionnaire states that fifty percent of the care staff team are qualified to at least National Vocational Qualification level 2. There is a board in the office that is used to record all training courses accessed and monitor the training needs of staff. Staff files seen contain certificates of courses attended. Most mandatory health and safety courses such as food hygiene and fire safety are up to date. The staff team are in the process of receiving refresher first aid training. Dementia care training is provided to all staff, which is essential for ensuring the needs of residents are understood. Three staff files were examined and all contained two written references. Two of the three staff files contained evidence of a satisfactory criminal record bureau check. The other one contained a police check from the staff member’s Orchard House Care Home DS0000008728.V328846.R01.S.doc Version 5.2 Page 20 originating country. An employment agency was used to recruit this staff member. Even though this staff member came to work straight from his country the guidance from Criminal Records Bureau is that all staff must still have a check carried out. This is made a requirement in the report. Orchard House Care Home DS0000008728.V328846.R01.S.doc Version 5.2 Page 21 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, 37 and 38 Quality in this outcome area is good. Health and safety and the home in general are managed well and there are good systems in place for monitoring quality underpinned by the views of residents. Notifications to the Commission must improve, to ensure that the home can be effectively regulated, to ultimately safeguard the welfare of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff spoken with described the manager and deputy manager as being approachable and supportive. There was evidence on staff files that regular supervision sessions are held with individuals. The registered manager has achieved the Registered Managers Award and has also been on intensive training in dementia care and the environment. Orchard House Care Home DS0000008728.V328846.R01.S.doc Version 5.2 Page 22 Every six months questionnaires are sent out to relatives and residents, which ask questions on different aspects of the service, including quality of meals, knowing how to complain, access to staff and personal care. Relatives spoken with confirmed these have been received and sent back. Filled in questionnaires were seen and some positive and useful suggestions have been made. It is recommended that the results be reported back to relatives and residents including what action has been taken to address the issues identified. This will fully demonstrate that people’s views are listened to and that the home is run in residents’ best interest. The policy of the home is not to have any responsibility for residents’ monies. Residents spoken with confirmed that their relatives help them in managing their money and have access to their money when they require it. The incidents mentioned under Complaints and Protection outcome area, along with accidents that have resulted in a medical practitioner being called on have not been notified to the Commission. This is required in accordance with Regulation 37 of the Care Home Regulations. Guidance supplied by the Commission was issued during the inspection. The pre-inspection questionnaire indicates that the servicing of equipment and gas and electrical systems are up to date. The fire log was seen at the inspection and showed that all the required fire safety tests and drills are carried out and fridge / freezer and water outlet temperatures are monitored and recorded. Orchard House Care Home DS0000008728.V328846.R01.S.doc Version 5.2 Page 23 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 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 2 3 Orchard House Care Home DS0000008728.V328846.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 OP8 Regulation 15(1)(2) Requirement Ensure all residents have a written care plan in place that cover all aspects of health, personal care and social needs and that the care plan is kept under review. This is to ensure residents’ needs are appropriately and adequately met. For the safety of residents, ensure that where a risk is identified that measures are put in place to minimise that risk, and this is documented in a care plan. This refers to resident MH and the use of the staff stairs. Ensure that the appropriate procedures are followed in the event of any form of abuse / allegation and that all staff members are fully aware of their responsibilities in accordance with these procedures. To ensure consistent, appropriate care and for the dignity of the resident, ensure where care plans identify aggression as a need that there is detailed information on what DS0000008728.V328846.R01.S.doc Timescale for action 01/03/07 2. OP7 13(4) 01/02/07 3. OP18 13(6) 01/03/07 4. OP18 12(1)(a) (4)(a) 01/03/07 Orchard House Care Home Version 5.2 Page 25 5. OP29 19 6. OP37 37 are the signs and what are the strategies for defusing the situation. Ensure all staff, including staff 01/02/07 from overseas, have a CRB check before they commence employment. Ensure all notifications, as 01/02/07 specified under this regulation be made to the Commission without delay, so that the home can be effectively regulated. 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. 4. Refer to Standard OP7 OP18 OP29 OP33 Good Practice Recommendations The monthly reviews of care plans must identify whether any amendments or changes to care plans have been made, and where in the care plan the amendments are. Ensure all staff members are fully aware of their responsibilities to whistle-blow and alert the manager of all allegations and suspicions of abuse. All new staff recruited from overseas must, as well as a police check from their own country, also have a criminal record bureau check undertaken. Devise a report on the feedback from the questionnaires, including what action has been taken in response to the suggestions and views and ensure the report is available to residents and relatives. Orchard House Care Home DS0000008728.V328846.R01.S.doc Version 5.2 Page 26 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 Care Home DS0000008728.V328846.R01.S.doc Version 5.2 Page 27 - 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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