Inspection on 21/11/07 for Orchard House Care Home

This inspection was carried out on 21st 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Orchard House Care Home 18/11/08

Orchard House Care Home 18/01/07

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 21st November 2007 09:30 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.V354343.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.V354343.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 debbie@ruddingtonhomes.co.uk 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.V354343.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 satisfactorily resolved) Service users shall be within category OP (26) Service users shall be within category DE (26) 2. 3. Date of last inspection 18th January 2007 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 ten-minute walk. The home is registered to provide care and accommodation for up to twenty-six older people who may also be diagnosed with some form of dementia. Each bedroom accommodates one person and nineteen bedrooms have en-suite facilities. The home has a stairlift for residents that have some mobility problems and are unable to walk the stairs safely. 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 assessed need. Inspection reports are available to residents and other stakeholders by request. Reports of their own quality audits are distributed to residents and relatives. Orchard House Care Home DS0000008728.V354343.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit, as part of the home’s key inspection took place on 21st November 2007. Inspections focus on outcomes for people that use the service. In order to do this the main method of inspection used was ‘case tracking’ which meant three residents were selected and their care was tracked through discussion with them and with staff, checking their care records and observing practice. Altogether, three staff members, four residents and one relative were spoken with during the course of the inspection. A sample of staff records were also looked at to make sure staff get the necessary training and that checks are carried out on staff before they start working at the home. Information about a home that is collected before the inspection is also used to make judgements about a service. This information could include notifications, information from other professionals and users of the service or their relatives, and also from any surveys that are sent out. At the time of writing this report three residents surveys had been returned. Services are now required to fill in a document called an AQAA (Annual Quality Assurance Assessment) in which the registered manager identifies from their own quality monitoring what the service does well at and what they need to improve on. The AQAA was returned before the site visit and was used to plan the site visit and to support judgements made in this report. 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. This helps ensure residents’ needs are understood and met. The views of residents and relatives are valued and obtained through regular meetings and also through questionnaires, which ask for feedback on different aspects of the service. Residents and relatives are aware of the Complaints Procedure and feel assured that their concerns are seriously and acted on. There are three activities co-ordinators and a good programme of activities offered. As well as group activities there are one to one activities including spending meaningful time with residents talking about their past and what is important to them. Orchard House Care Home DS0000008728.V354343.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: 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.V354343.R01.S.doc Version 5.2 Page 7 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.V354343.R01.S.doc Version 5.2 Page 8 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 and 3 (intermediate care is not provided in this home) Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There is a good admissions procedure, which ensures the home is suitable in meeting the needs of its residents and prospective residents have enough information to decide to move there. But contract arrangements do not protect residents’ legal rights and responsibilities in respect of their residency. EVIDENCE: There were copies of pre-admission assessments seen on the files of all three case tracked residents. This assessment is carried out either by the registered manager or the deputy manager. A relative spoken with remembered that the manager visited them to assess her mum’s needs before her mum moved to the home. There were also copies seen of the placing authority’s community assessment, which provides additional information in deciding if the home will be suitable for that person. Orchard House Care Home DS0000008728.V354343.R01.S.doc Version 5.2 Page 9 Both the Statement of Purpose and Service User Guide have been updated and provide information about the services provided in the home. A relative spoken with confirmed that they were given a brochure about the home but they could not remember if a contract had been issued. Signed copies of the statement of fees were seen on case tracked residents’ files but this signed document does not include terms and conditions of residency. This is a separate document and a copy was supplied to the Commission after the inspection. There is no section on this document for the resident / representative to sign to say they agree and understand the terms and conditions. Although it states what notice is required for a resident that wishes to leave it is not clear what notice is required if the home wishes a resident to leave. Orchard House Care Home DS0000008728.V354343.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Medicine management promotes the safety of residents and the staff team treat residents with dignity and respect. Care planning arrangements however are failing to promote residents’ safety and rights and in ensuring their healthcare needs are met. EVIDENCE: Residents spoken with had only positive comments to make about the quality of care and about the staff team that support them. All said that staff members treat them with dignity and respect and staff were described as being “very kind”, “lovely,” and “will do anything for you”. One resident explained how she is now getting help with dressing and bathing and the staff team have respected her wish not to have male care staff assist her with this. The care plans seen for personal care do include individuals’ preferences and wishes, for example, “[the resident] likes to have a bath in our parker bath and also enjoys having a shower with one carer supervising”. This detail is an improvement since the last inspection. The care plans seen do reflect what staff members reported about the needs of case tracked residents. A relative Orchard House Care Home DS0000008728.V354343.R01.S.doc Version 5.2 Page 11 spoken with reported that senior staff members always inform her if her mum is not well or if there are any changes in her condition etc. A resident spoken with that was able to express her own views and would have the capacity to understand the care planning process did not know what care plans are. There was evidence on the resident’s file that the resident’s relative is involved in reviewing care plans, but this is without considering whether the resident is able or wishes to be involved in the development and review of care plans herself and to have overall control of how her care is given. The Annual Quality Assurance Assessment referred to an incident of restraint. It was confirmed at the inspection that this referred to a short period when restraint was used as a measure to prevent a resident from injury due to falls. The registered manager reported that it was decided this measure was not appropriate so it was stopped. There was a document signed by the relative consenting to the use of restraint but there is no mention of any involvement of specialist services in the decision to use restraint. The current falls risk assessment is not explicit enough in what are the measures to minimise the risk of falls and there is no mention anywhere that restraint was ever considered or used. It states that the resident is wearing hip protectors to prevent further injury but even though staff members spoken with reported that the resident is assisted with walking this is not mentioned in the falls risk assessment. The mobility care plan and falls risk assessment were revised in January and two times in March but the only other evidence that care plans are being reviewed is a sheet at the front of the care plan that is dated and signed each month; it does not state whether there have been any changes to care plans or if all care given remains the same. This is despite accident records showing that the resident has had eight falls in the last two months. Making sure care plans are reviewed and that there are adequate risk assessments in place were requirements made at the last inspection. On the care needs assessment for another case tracked resident it identifies the resident as “diabetic but tablet controlled.” This is identified in the kitchen so that the cook is aware of dietary requirements but there is no care plan specifically for the control of diabetes. A staff member was observed administering medication in a safe and dignifying manner. Another staff member spoken with explained how he administers medication including actions he takes to makes sure a medicine is given to the right resident and that medicines are not left stored insecurely. On the afternoon of the inspection some staff members were having training with the community pharmacist. Orchard House Care Home DS0000008728.V354343.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Meeting residents’ recreational needs and maintaining contact with family and friends is managed well in accordance with residents’ personal interests and wishes. There are good arrangements in place for providing wholesome appealing meals. EVIDENCE: The home has three activities organisers, including one that provides activities on Saturdays. Some of the activities include word searches, crosswords, board games, and skittles. One resident said they enjoy the film club while another resident said they like doing drawing. Many of the games have therapeutic benefits and help with co-ordination and cognition. An activities organiser that was spoken with reported that as well as group activities one to one time is spent with residents doing person-centred tasks; tasks that individuals enjoy such as cleaning or talking about the past and job roles. The activities organiser and staff members were observed chatting with residents. The activities organisers are in the process of devising life history books with Orchard House Care Home DS0000008728.V354343.R01.S.doc Version 5.2 Page 13 residents. Relatives have helped with information and provided photos and pictures. Staff members spoken with showed enthusiasm for these books and how it had helped them to understand residents and how their past has shaped who they are today. There is a religious ceremony with hymns and readings once a month and most residents choose to attend. 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. A relative spoken with confirmed that she is always made to feel welcome when she visits her mum. Both the relative and her mum were sitting enjoying a cup of tea together. All residents spoken with said mainly good things about the meals. One resident described the meals as “marvellous” while another resident said that the cook “does [him] a special dinner.” One resident did say that sometimes the sandwiches in the evening are boring but this has already been raised and as a result there has been pizza and kippers. The meal on the day of the inspection looked appetising and all residents were observed to enjoy their meal and mealtime. Orchard House Care Home DS0000008728.V354343.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are assured their concerns are taken seriously and acted on but failing to identify alleged abuse and not following the relevant procedures places residents at risk of harm. 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 been two complaints made by two different residents. Both of these complaints are alleging that a staff member shouts at them. Both residents were informed that the staff member concerned had been spoken with and have been assured this will not happen again. However, neither of these complaints have been treated as allegations and subsequently followed up in accordance with the Safeguarding Adults policy and procedures. Social Services were not informed. The registered manager reports that she interviewed both residents and staff member but there are no records of any investigation that took place. There is Orchard House Care Home DS0000008728.V354343.R01.S.doc Version 5.2 Page 15 evidence on the staff member’s file that the allegations was discussed but with no action taken. Making sure the safeguarding adults procedures are followed was a requirement made at the last inspection. Orchard House Care Home DS0000008728.V354343.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a very homely, comfortable and clean environment. EVIDENCE: On walking around the premises it is apparent that the home is decorated and furnished to a high standard. Bedrooms seen are personalised with residents’ own items such as small furniture, pictures and ornaments. One resident that was spoken with has his own mini fridge to keep drinks and snacks in. 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 and is secure. The home is well lit, clean and tidy and smells fresh throughout. Orchard House Care Home DS0000008728.V354343.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by sufficient numbers of competent and well-trained staff however recruitment practices are failing to adequately protect residents from staff that may be unsuitable to work with vulnerable people. EVIDENCE: All people spoken with during the course of the inspection confirmed that staffing numbers are appropriate. Staff members spoken with commented on having time to talk with residents as part of their duties and residents spoken with said that staff are always available to provide assistance when needed. The Annual Quality Assurance Assessment confirms that fourteen out of fifteen care staff either have the National Vocation Qualification in Social Care or are working towards it. There is a board in the office that is used to record all training courses accessed and to monitor the training needs of staff. On the four staff files selected there were copies of certificates to evidence that mandatory health and safety training and refreshers such as first aid, fire safety and food hygiene are undertaken as well as other courses relevant to meeting the needs of residents, including parkinsons, continence care and dementia. Staff members spoken with talked about what they have learnt from their dementia training and demonstrated an understanding of dementia and how to care for people with dementia. Orchard House Care Home DS0000008728.V354343.R01.S.doc Version 5.2 Page 18 A staff member that had been newly appointed at the time of the last inspection had not had a criminal record bureau check because he came to work in this country from overseas. In line with CRB guidance and regulations this staff member should have still had a CRB check. Eleven months after the last inspection a CRB disclosure has still not been obtained for this staff member. The files of three other staff members- that have commenced work at the home since the last inspection- were checked. Copies of CRB disclosures were seen but for two staff members these were issued after they commenced employment. POVA First Checks were not requested, which is the only way new staff members are permitted to commence employment under supervision, before the return of a CRB check. Two written references had been obtained for all three new staff members before they commenced employment. (Please see section on Management and Administration.) Orchard House Care Home DS0000008728.V354343.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally well run and quality monitoring based on the views of residents helps ensure the home is run in their best interests however recruitment practices compromise the protection of residents, which is not in their best interests. EVIDENCE: Staff spoken with described the manager and deputy manager as being 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 is committed to continuous professional development. On the day of the inspection the manager had been on training on the Mental Capacity Act. Orchard House Care Home DS0000008728.V354343.R01.S.doc Version 5.2 Page 20 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. 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. A relative spoken with confirmed that she has filled in a questionnaire. The results of the surveys are summarised in a report, which is then sent out to relatives and residents. An action plan is also formulated after this exercise, to make changes to the service based on residents and relatives’ views. The most recent report is from September 2007. There are also group support meetings every three months for residents and relatives. The annual quality assurance assessment confirmed that the servicing of equipment and electrical and gas systems are up to date. Fire safety tests and drills are regularly carried out in accordance with fire safety legislation and there is an up to date fire risk assessment. Records kept in the kitchen show that the required procedures are followed for food hygiene and safe handling of food. As mentioned in the previous outcome area, new staff members are commencing employment before the return of a criminal record bureau check. POVA First checks are not being requested in order to allow a staff member to commence employment, under supervision until the return of their criminal record bureau check. Orchard House Care Home DS0000008728.V354343.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 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 3 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 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 1 X 3 X X 3 Orchard House Care Home DS0000008728.V354343.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15(1 and 2) Requirement Where residents are assessed as having capacity in this area they must have the opportunity be consulted in the development and review of their care plans and on how their care and support is given. Care plans and risk assessments must be kept under regular review and amended accordingly, to reflect changes in need, support given and all measures in place to minimise risk. This is to ensure residents’ needs are met and promote their safety and welfare. Keeping care plans under review is an outstanding requirement from the previous inspection, initial timescale 01/03/07 not met. A warning letter is to be issued in respect of this. The use of physical restraint must be the only practicable means to secure the welfare of the resident and the circumstances and nature of DS0000008728.V354343.R01.S.doc Timescale for action 01/02/08 2 OP7 15(2) 01/01/08 3 OP8 13(7) and (8) 21/11/07 Orchard House Care Home Version 5.2 Page 23 restraint must be recorded. This is to uphold residents’ rights and to ensure this measure is used appropriately. 4 OP8 12(1)(a) There must be care plans for specific health conditions, such as diabetes. This is so that these conditions can be monitored and controlled, and will promote good health. Ensure that the relevant procedures are followed in the event of any allegation of abuse. This is an outstanding requirement from the previous inspection, initial timescale 01/03/07 not met. A warning letter is to be issued in respect of this. Ensure all staff members have a criminal record bureau check before they commence employment. This is to ensure residents are cared for by staff members that are suitable to work with vulnerable people. This is an outstanding requirement, initial timescale 01/02/07 not met. A warning letter is to be issued in respect of this. Quality monitoring must include the auditing of recruitment practices, to ensure that improvements are made and that all aspects of the running of the home are in residents’ best interests. 01/01/08 5 OP18 13(6) 01/03/08 6 OP29 19 01/01/08 7 OP33 24 01/02/08 Orchard House Care Home DS0000008728.V354343.R01.S.doc Version 5.2 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 OP2 Good Practice Recommendations All residents should have a contract / terms and conditions that is signed by the resident or their representative to confirm they understand and agree with the terms and conditions of their residency. This is to protect residents’ legal rights and responsibilities. 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. 2 OP7 Orchard House Care Home DS0000008728.V354343.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection East Midland Regional Office Unit 7 Interchange 25 Business Park Bostocks Lane Nottingham NG10 5QG 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.V354343.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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