Inspection on 12/05/06 for Queens Oak Care Centre

This inspection was carried out on 12th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Queens Oak Care Centre 18/11/08

Queens Oak Care Centre 29/11/07

Queens Oak Care Centre 01/12/05

Queens Oak Care Centre 15/07/05

Queens Oak Care Centre 04/02/05

Queens Oak Care Centre 19/08/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Queens Oak Care Centre Queens Oak Care Centre 64-72 Queens Road Peckham London SE15 2EP Lead Inspector Pam Cohen Unannounced Inspection 12 & 14 May 2006 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 Queens Oak Care Centre DS0000007045.V292956.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Queens Oak Care Centre DS0000007045.V292956.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Queens Oak Care Centre Address Queens Oak Care Centre 64-72 Queens Road Peckham London SE15 2EP 020 7277 9283 020 7277 9263 sarah.gleeson@excelcareholdings .com 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) Lancewood Ltd Ms Smomo Grace Mboto Care Home 88 Category(ies) of Dementia - over 65 years of age (34), Old age, registration, with number not falling within any other category (54) of places Queens Oak Care Centre DS0000007045.V292956.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. To include no more than 34 service users with Dementia at any one time. The service users at Queen’s Oak Care Centre can be approached as to whether they would like to move to another bedroom, though must be moved at their own will. Staffing levels as agreed must be maintained at all times 1st December 2005 Date of last inspection Brief Description of the Service: Queens Oak Care Centre is a care home with nursing for older people, built in 2001. It is owned by Excel Care, a large care provider with homes in London and other parts of the country. There are four floors and care for service users suffering from dementia is provided on two of them. Care for service users with physical frailty and for service users requiring nursing care are provided on the other two floors. The home is near Peckham town centre, close to shops and all community amenities. There are train and bus routes near the home and some parking space in front of it. All bedrooms are single and all but four are fully en-suite. There is a secure garden at the back. On the day of inspection there were seven vacancies. Queens Oak Care Centre DS0000007045.V292956.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The main inspection took place during the day of the 12th May and was unannounced. The lead inspector was accompanied by a second inspector. The home manager and the facilities manager were available to help throughout the inspection and provided information and documentation as needed. The inspectors also spoke to relatives, service users and staff. There was due to be a relatives’ meeting the next day and questionnaires were left for relatives who attended that. The lead inspector returned on the 14th May when there was more time to speak to service users and their visitors and was also able to speak to the Special Project Manager who was working at the home. She returned on the next day to finish the inspection. What the service does well: What has improved since the last inspection? The organisation is putting a lot of effort into improving standards at Queen’s Oak and have a detailed action plan in place. Information for service users and their families has been updated. Staffing levels are now maintained well and a good induction programme has been put in place for new and recently recruited staff. Procedures for reporting and investigating allegations of abuse were shown to be good. Work has begun on improving care plans and some floors are at a more advanced stage than others. Queens Oak Care Centre DS0000007045.V292956.R01.S.doc Version 5.1 Page 6 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. Queens Oak Care Centre DS0000007045.V292956.R01.S.doc Version 5.1 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 Queens Oak Care Centre DS0000007045.V292956.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The information needed by prospective service users is readily available. Systems are in place to assess service users’ needs before they move into the home. However service users who suffer from dementia can still not be assured that their specialist needs will be met. EVIDENCE: The home has an updated Statement of Purpose and Service User Guide. They are accessible documents written in plain English and contain all information needed by prospective service users and their families. A sample of present service user views should be included. Files seen showed that service users’ needs are assessed before entering the home, however there was no evidence found that most had had confirmation in writing that their needs could be met. Indeed the inspection showed that the assessed needs of service users suffering from dementia are still not being met. The dementia units do not have staff adequately trained in dealing with dementia; also environmental adaptations necessary for orientation and Queens Oak Care Centre DS0000007045.V292956.R01.S.doc Version 5.1 Page 9 stimulation of service users are not in place. There are no activities aimed at this service user group and care plans did not show knowledge of how to deal with the challenging behaviour that can happen when people suffer from dementia. The home does not offer intermediate care. Queens Oak Care Centre DS0000007045.V292956.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service Service users’ health needs are well monitored and necessary action taken, however care plans do not cover all areas needed. Service users are not offered the opportunity to be independent in administering their own medication. Some mistakes in recording medication administration and obtaining repeat prescriptions potentially put service users at risk. Service users cannot be sure they are treated with respect at all times. EVIDENCE: Care plans seen on the nursing floor were good and checks showed that monitoring of health issues, and dealing with any problems that occurred was thorough. A nurse from the Care Home Support team confirmed that she found good practise on this floor. Care plans on other floors were mostly adequate but still have areas of weakness. One service user suffering from dementia demonstrated challenging behaviour from very soon after admission. This was monitored and recorded but no guidelines for dealing with it were drawn up, which meant that neither that service user, other service users or staff were properly protected. The behaviour that dementia brings for individual service Queens Oak Care Centre DS0000007045.V292956.R01.S.doc Version 5.1 Page 11 users is generally not addressed. Care plans do not in the main address the social and emotional needs of service users and as yet there was little evidence on files that care plans are drawn up with service users and their families; relatives who spoke to the inspector and filled in a questionnaire also said they were not consulted on their relative’s care needs. There are no service users who self medicate in the home and no procedure on admission or as part of care planning, to assess if they would like to and are able, to do this. No problems were seen with medication administration and systems for dealing with medication on the ground or second floors. However on the first floor several discrepancies were found in one service user’s medication administration with medication being signed for when it had not been given. This together with an inadequate system with the GP’s surgery for obtaining repeat prescriptions meant that one service user had gone without one of their prescribed medicines for eight days. On the third floor, medication given on the morning to a service user had not been signed for. During the inspection staff were seen to be treating the service users with respect and interaction between staff and service users was good. Service users and relatives who spoke to the inspector were happy with the way staff cared for the service users. However practises seen when serving food did not show respect for service users. Throughout the home, afternoon tea and biscuits was served in cups without saucers and with no plates, leaving service users to have to put biscuits down on furniture near them. Of particular concern was the serving of supper on the ground floor unit for people with dementia. A member of staff used her hands to dish food out and the main course and dessert were served on the same plate with the consequence that service users were eating their ham together with a chocolate muffin Queens Oak Care Centre DS0000007045.V292956.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service Service users recreational needs are not met at the moment. They are able to receive visitors as they wish and spend the day as they wish, although choice and control in the areas of finance and medication is not yet assessed and supported. Service users enjoy the food provided. EVIDENCE: The home has not had anyone in the post of activities organiser for some time since the previous worker left. It has been actively working towards recruiting a new organiser and in the short-term the organisation’s new activities manager will provide some training to carers on carrying out activities. During the inspection some carers were already doing some one to one and small group activities. However in such a large home a full time organiser is needed and work has not taken place on finding out which activities individual service users would want. When asked what they would like to change about the home, a relative said they would like to see their mother involved in activities instead of doing nothing all day. There are no restrictions on visiting and relatives said that they find the staff welcoming. It was seen during the inspection that service users are able to exercise choice as to what they wish to do, whether they wish to be in a public Queens Oak Care Centre DS0000007045.V292956.R01.S.doc Version 5.1 Page 13 space, or spend the day in their room. They are also encouraged to bring their own possessions into the home. The organisation has engaged an advocacy service to work for them and information about this is provided in the service user guide and in the home. At the moment the home is not assessing service users wishes or abilities in handling their own monies. Food provision is good, and service users said that they enjoyed their food. There is choice on the menu and one service user said that he did not like fish in batter on Fridays and so was given smoked haddock which he enjoyed. There is also a menu for service users from ethnic minorities and medical needs are noted. Queens Oak Care Centre DS0000007045.V292956.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users and their families cannot be sure that their complaints are recorded and investigated. Suitable actions have been taken to protect them from abuse. EVIDENCE: The home has a new complaints policy and procedure which is thorough and summarised for service users and their relatives in the service user guide. There are no complaints recorded in the complaints book. However a service user had made a recent serious complaint. Also during discussion it became clear that the deputy manager had dealt with a verbal complaint. Neither of these had been recorded. The organisation has now worked on a suitable policy for dealing with vulnerable adults. Action has been taken to ensure that all staff have either been trained in dealing with vulnerable adults or are on a course due to start in the near future. In the week before the inspection there was a serious allegation made by a service user, the home took prompt and correct action. Queens Oak Care Centre DS0000007045.V292956.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is generally clean and comfortable with adequate personal and communal space and specialist equipment provided as needed. EVIDENCE: The home was purpose built in 2001 and is well sited in terms of transport and local facilities. In most respects it meets the needs of the people who live there. For the past two inspections a concern has been raised as to whether the ground floor is suitable for dementia care; advice of an expert in dementia care has not yet been taken. Specialist equipment is available for service users where needed and a nurse from the Care Home Support Team was enthusiastic about the new standing hoist which had been ordered on professional advice. There is a good amount of communal space in the home and one room is being converted to a therapy/activities room. Consideration should be given to the provision of smoking spaces, to ensure that not too much communal space is Queens Oak Care Centre DS0000007045.V292956.R01.S.doc Version 5.1 Page 16 being given to smoking. The garden is safe and accessible but at the moment there is no garden furniture in it. All rooms are single and most are en suite. The rooms are well furnished but still need two comfortable chairs. On the day of inspection the home was generally clean, but in order to ensure that all areas are kept clean the manager needs a schedule. The kitchen still needs an industrial deep clean of the floor, walls and equipment. Queens Oak Care Centre DS0000007045.V292956.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels are appropriate to meet service users’ needs and recruitment procedures are in place to protect service users. However training records show that staff are not yet receiving adequate training to deal with the differing needs in the home. EVIDENCE: Since the last inspection, robust systems have been put in place, to ensure that staffing levels are correct. At the inspection correct numbers and skills mix of staff were deployed each day. However staffing hours and the rota do not allow time for a staff handover of necessary information about service users, between shifts. There are not 50 of staff trained to NVQ level but the inspector was told that 12 staff are to start an NVQ course in June which will mean that the home more than meets the ratio needed. New staff now receive an induction to NTO level. However there is still no home training plan or individual training plans to ensure that staff receive all necessary training. Inspection of training delivered to staff in the past year, showed that they are not receiving the minimum required of 3 paid days training a year. The files of two recently recruited staff were inspected and all was in order. Queens Oak Care Centre DS0000007045.V292956.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,36,37,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service It is not clear that service users needs are met within the current management hours available in the home. Amongst other issues this means that staff supervision standards are not being met. A quality assurance system to take account of the views of service users and their families is planned. Health and Safety is generally well monitored but an audit of this, together with an audit of the building needs to be undertaken on a regular basis to ensure safety for service users and staff. EVIDENCE: The home manger has the training and experience needed for the post. However, taking into account the size and complexity of the home, together with the number of outstanding and repeated requirements, it is not clear that the two posts of manager and deputy provide sufficient management hours to Queens Oak Care Centre DS0000007045.V292956.R01.S.doc Version 5.1 Page 19 discharge the many management needs of such a large home. The organisation is addressing this in part, by support from line management and from a special project manager. However these extra hours are short term and not permanent. The home has started to put in place a system of quality assurance and this will be assessed at the next inspection. There is still no annual development plan and this is needed. Records showed that some formal supervision of staff is happening, but not all staff giving supervision have been trained in this skill, and the minimum standard of six sessions per year is not yet being met. Throughout the inspection there were difficulties accessing records where needed and this needs to be remedied, especially in areas such as health and safety. Generally, health and safety was in order for systems such as fire equipment and water temperature. However there was no system for auditing these and no audits of the building as a whole. In a building the size of Queens Oak, these safeguards are necessary. Queens Oak Care Centre DS0000007045.V292956.R01.S.doc Version 5.1 Page 20 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 1 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 3 2 3 3 3 3 2 3 2 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x x 2 2 2 Queens Oak Care Centre DS0000007045.V292956.R01.S.doc Version 5.1 Page 21 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 OP4 Regulation 12(1) Timescale for action The registered person must 01/07/06 ensure that staff caring for people with dementia have training in this area. Previous timescales of 31/12/2005 and 30/04/06 not met. The registered person must 01/07/06 ensure that environmental adaptations to orientate service users with dementia are put in place. Previous timescales of 31/12/2005 and 30/04/06 not met. The registered person must 01/07/06 ensure that care plans include guidance for dealing with challenging behaviour when needed. They must be reviewed with the service user and their representative and must incorporate advice from professionals. Previous timescale of 31/03/06 not met. The registered person must 01/07/06 ensure that all care needs of DS0000007045.V292956.R01.S.doc Version 5.1 Page 22 Requirement 2. OP4 12(1) 3. OP7 15(1)(2)( b)(c) 4 OP7 15(1) Queens Oak Care Centre 5 OP9 13(2) 6. OP9 13(2) 7. OP9 12(2)(3) (4)(a) 8. OP10 18(1)(c) (i) 16(2)(m) 9. OP12 10 OP14 12(2)(3) 11. OP16 Reg 17(2) Sch 4 12. OP19 23(1)(a) service users, including social and emotional needs, are included in their care plan. The registered person must ensure that staff adhere to proper procedures for recording of medication administration. The registered person must ensure that there is a procedure agreed with the GP’s surgery to ensure that repeat prescriptions are requested and written promptly. The registered person must ensure that, within a risk management framework, service users can self medicate if they so wish The registered person must ensure that food serving is done in a way which shows respect towards service users. The registered person must consult service users about their social interests and make arrangements to enable them to engage in local, social and community activities. Previous timescales of 30/6/05, 31/10/05 and 31/03/06 not met. The registered person must ensure that service users wishes and abilities to handle their finances are assessed, so that wherever possible service users have charge of their money. The registered person must ensure that all complaints, together with their investigation and the outcome of that investigation, are recorded. The registered person must ensure that professional advice is taken as to whether the ground floor is a suitable environment for a unit for people suffering from dementia. This DS0000007045.V292956.R01.S.doc 30/06/06 30/06/06 31/08/06 30/06/06 01/07/06 31/08/06 30/06/06 01/07/06 Queens Oak Care Centre Version 5.1 Page 23 advice, and any decision taken, should be furnished to the CSCI Southwark Office Previous timescale of 31/03/06 not met. 13. OP24 16(2)(c) The registered person must 01/07/06 ensure that there are two comfortable chairs in each bedroom. Previous timescale of 31/10/05 and 31/03/06 not met. The registered person must ensure that the kitchen is deep cleaned in order to comply with environmental health inspection requirements. Previous timescale of 28/02/06 not met. The registered person must ensure that staff hours allow for a handover between shifts. The registered person must ensure that the home has a training and development plan in order to ensure that persons employed at the home receive training appropriate to the work they are to perform. Previous timescale of 30/04/06 not met. The registered person must calculate the management hours needed to properly run the home, in order to ensure that sufficient management hours are provided. This assessment and calculation must be sent to the CSCI within the target date. The registered person must ensure that there is a system of quality assurance which takes into account the views of service users, their relatives and other stakeholders. Previous timescale of DS0000007045.V292956.R01.S.doc 14. OP26 12(1)16 (2)(j) 30/06/06 15. 16. OP27 OP30 18(1)(a) 18(1)(c) 01/07/06 01/07/06 17. OP31 10(1) 12(1)(a) (b) 01/07/06 18. OP33 24(1(a)(b )(3) 30/06/06 Queens Oak Care Centre Version 5.1 Page 24 31/12/05 not met. Present target date not yet reached 19. OP33 24(1(a(b) The registered manager must ensure that there is an annual development plan. Previous target of 31/12/05 not met. Present target date not yet reached The registered person must ensure that there is a schedule to ensure staff receive formal supervision at least six times a year, from managers trained in supervising staff. The registered person must ensure that records are in good order The registered person must ensure that there is a regular audit of health and safety issues around the home. 30/06/06 20. OP36 18(2) 01/07/06 21. 22. OP37 OP38 17(2) 12(4)(a) (b)(c) 01/07/06 01/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP1 OP3 Good Practice Recommendations It is recommended that a sample of service users views is included in the Service User Guide. It is recommended that the home should confirm in writing to prospective service users that they will be able to meet their needs on admission. It is recommended that the manager have a proper schedule of cleaning in order to be able to properly check that all areas are cleaned regularly. It is recommended that provision of a smoking place is considered in order to properly balance the needs of smokers and non-smokers. DS0000007045.V292956.R01.S.doc Version 5.1 Page 25 3. OP26 4 OP26 Queens Oak Care Centre Queens Oak Care Centre DS0000007045.V292956.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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