Inspection on 23/10/06 for Robertson Nursing Home

This inspection was carried out on 23rd October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Robertson Nursing Home 21/10/08

Robertson Nursing Home 20/05/05

Robertson Nursing Home 06/12/04

Robertson Nursing Home 19/08/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Robertson Nursing Home Priorsfield Road Godalming Surrey GU7 2RF Lead Inspector Denise Debieux Key Unannounced Inspection 23rd October 2006 09:15 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 Robertson Nursing Home DS0000017637.V316117.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. Robertson Nursing Home DS0000017637.V316117.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Robertson Nursing Home Address Priorsfield Road Godalming Surrey GU7 2RF 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) 01483 421033 01483 428358 robertsonhomes@ukonline.co.uk Dr J R Colville Mrs Colette Patricia Knight Care Home 41 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (41) of places Robertson Nursing Home DS0000017637.V316117.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th May 2005 Brief Description of the Service: Robertson Nursing Home has provided nursing care for approximately fifty years. The current proprietor has been the owner for the past twenty-eight years. The owner of the home is referred to as the Clinical Director. The property is over a hundred years old and has retained a lot of it’s original character. In the past few decades, extensions have been added, which have provided additional bedrooms and communal space. The property is set in its own grounds and is surrounded by a large mature garden. A range of communal facilities are located through the home which include a sitting room; dining room; library and conservatory. The library provides a quiet room with a range of books. The bedroom accommodation is arranged over two floors, with the provision being mainly single rooms and with up to six rooms which can be used as shared facilities. The registered manager oversees the clinical and care practices and takes responsibility for the administration and practical running of the home. The Clinical Director, training manager and human resources are based at the main office, which is located in Ascot, Berkshire. The Clinical Director visits the home several times a week. The home is able to provide nursing care for up to forty-one older people, 10 of whom may have a diagnosis of dementia. Fees range from £650 - £925.50 per week. This fee does not include chiropody, hairdressing or newspapers. Additional physiotherapy is available on request at a charge £40 per 45minutes This information was provided on 09/10/06. Robertson Nursing Home DS0000017637.V316117.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place over 8 hours and was carried out by Denise Débieux, Regulation Inspector. Mrs Colette Knight (Registered Manager) was present as the representative for the establishment. A tour of the premises took place. Five of the thirty-three service users and seven on-duty staff were spoken with during the visit. In addition, seven service user survey forms, two relatives/visitors survey forms and seven care worker’s survey forms were completed and handed in to the inspector on the day of this visit. Some of the comments made to the inspector and made on the survey forms are quoted in this report. The home had completed a pre-inspection questionnaire and service user care plans, staff recruitment and training records, health and safety check lists, menus, medication records and storage were all sampled. The lunchtime meal was observed and the home was toured. The inspector would like to thank the service users and staff for their time, assistance and hospitality during this visit. What the service does well: What has improved since the last inspection? Robertson Nursing Home DS0000017637.V316117.R01.S.doc Version 5.2 Page 6 The ongoing redecoration programme of the home provides the service users with homely and comfortable surroundings in which to live. 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. Robertson Nursing Home DS0000017637.V316117.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 Robertson Nursing Home DS0000017637.V316117.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): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each service user is only admitted to the home following a comprehensive needs assessment to ensure that the home can meet the service user’s identified needs. The home does not offer intermediate care. EVIDENCE: The inspector was advised that, on the first enquiry from a prospective service user or their representative, the service user will be invited to visit the home and a brochure will be sent out. Following the visit to the home, and if the service user wishes to continue, either the manager or her deputy will visit the service user and carry out a pre-admission assessment to ensure that the home can meet the service user’s needs and wishes. Robertson Nursing Home DS0000017637.V316117.R01.S.doc Version 5.2 Page 9 Four care plans were sampled during this visit. In each case comprehensive pre-admission assessments had been carried out prior to admission to ensure that the home could meet the service users’ identified needs. Service users surveyed felt they had received enough information prior to moving to the home and the relatives surveyed stated that they were satisfied with the overall care provided. Robertson Nursing Home DS0000017637.V316117.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 good. This judgement has been made using available evidence including a visit to this service. Personal care and healthcare support and assistance is planned and was seen to be provided, where needed, in a respectful and sensitive manner. Policies, procedures and practices are in place to ensure the safe administration of medication. EVIDENCE: The care plans sampled during this visit were all based on pre-admission assessments and had been drawn up shortly after the service users’ admission to the home. Care plans sampled were comprehensive and set out actions which need to be taken by care staff to ensure that all aspects of the health and personal care needs of the service users are met. The staff carry out individual risk assessments including the risk of falls, skin breakdown, manual handling and nutrition. Care plans are reviewed on a monthly basis and daily notes are kept that reflect the care given. These daily notes demonstrated that any changes or new concerns are recorded and Robertson Nursing Home DS0000017637.V316117.R01.S.doc Version 5.2 Page 11 promptly acted upon. However, the daily report does not always demonstrate that the service users’ needs are being met in the way they prefer. The inspector was advised that the home is always looking for ways to develop their care planning system. This was discussed during this visit and a recommendation has been made that the home include activities/social care as part of the service user’s care plan, that service users or their representatives sign the care plans to signify their involvement and agreement to the contents, that daily reporting is related more closely to the care plans and that staff sign and date all entries. Of the seven service users who returned comment cards, five stated that they always received the care and support they need and two answered ‘usually’. One visiting relative commented that ‘I am very pleased with the care my relative is receiving.’ The lunchtime medication round was observed and the medication administration records, medication storage, policies and procedures were all sampled and found to be in order. During the tour of the home staff were observed to always knock before entering the service users’ bedrooms and all interactions observed between staff and service users were seen to be caring and respectful. Robertson Nursing Home DS0000017637.V316117.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): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The activities provided by the home are varied, well planned, and include contact with the local community both within and outside the home. However, the activity/social provision needs to be further developed to ensure the needs of all service users are being met. Contacts with family and friends are encouraged. Meals are well-balanced and varied with individual choices and preferences catered for. EVIDENCE: The home employs an activity manager who works 7.5 hours per week. The home’s activity schedule was seen and included group activities on three afternoons per week. These activities include outings to local attractions, garden centres, pubs, theatres and local shops. There is a library at the home, local entertainers provide some entertainment and the home have arranged for a ‘mobile farm’ to visit for an afternoon in the near future. Service users are able to choose which activities they attend or participate in. Of the seven service users who returned comment cards four said that there were always activities arranged by the home that they can take part in, one Robertson Nursing Home DS0000017637.V316117.R01.S.doc Version 5.2 Page 13 answered ‘usually’ and two left the answer blank, with one service user commenting ‘I prefer not to take part’. However, the home is registered for up to ten people with dementia and there are also service users with sensory impairments and physical disabilities. The home need to ensure that more individualised activities are also provided, ensuring that all service users have the opportunity to chose and participate in social and recreational activities which suit their needs, preferences and capabilities. A requirement has been made. There are no restrictions to visiting times and staff support and encourage service users to maintain family links and friendships both inside and outside the home. Relatives surveyed said that the staff welcome them in the home at any time. Menus were sampled and seen to be varied and well-balanced. The lunchtime meal was taking place during the visit and the food was presented in an appetising manner. Ample staff were present and offered help or assistance where needed in a discreet and sensitive way. The atmosphere in the dining room on the day of this visit was convivial and unhurried. Of the seven service users who returned comment cards, four said that they always liked the meals at the home, one answered ‘usually’, one answered ‘sometimes’ and one left this question blank. One service user spoken with said that the chef was very good and often cooked her a baked potato as an alternative to the main dishes on offer at lunchtime, ‘He knows I love baked potatoes.’ Robertson Nursing Home DS0000017637.V316117.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a simple, clear and accessible complaints procedure which includes timescales for the process. Policies and procedures are in place to ensure that service users are safeguarded from harm or abuse but the policy on the protection of vulnerable adults needs revision in line with the local Surrey multi-agency procedure. EVIDENCE: The home has a complaint’s procedure in place that is available to all service users and their relatives and is also included in the service users’ guide. There have been no complaints made to CSCI in the past 12 months. The home also has a ‘Whistle Blowing’ policy in place and basic awareness of the protection of vulnerable adults is included in the home’s induction training. A copy of the latest ‘Surrey Multi-agency Procedure for the Protection of Vulnerable Adults’ is available in the office. The manager and her deputy were very clear on the local Surrey procedure and the steps they would take should there be an allegation of suspicion of abuse. At present, the home’s policy contradicts the Surrey local procedure and a recommendation has been made that this be revised. All service users spoken with and surveyed told the inspector that they felt safe at the home. Robertson Nursing Home DS0000017637.V316117.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The location and layout of the home and gardens are suitable for their stated purpose. An ongoing redecoration programme provides the service users with clean, pleasant and homely surroundings in which to live. Action must be taken to ensure that any maintenance or upkeep issues are identified at an early stage and dealt with promptly. EVIDENCE: Service users spoken with expressed their satisfaction with the accommodation provided at the home. During the tour of the home the premises were seen to be mostly well maintained with service users able to freely access all areas. However, a fire escape door on the first floor was in a poor state of repair and was difficult to open, requiring a strong push and presenting a risk to service users and staff in the event of the need to evacuate the building quickly. The manager felt that the door had swollen following recent heavy rain. On further investigation Robertson Nursing Home DS0000017637.V316117.R01.S.doc Version 5.2 Page 16 the outside of the door was found to have large areas of paint missing, with the wood rotting and filler from previous repairs coming away in the hand. The manager immediately arranged for the maintenance person to take remedial action to ensure that the door would open easily in an emergency. The work was carried out on the door frame with the door opening freely before the inspector left the home at the end of this visit. The inspector was advised that arrangements had been made for the door to be replaced/made good within the next week. In addition and during the tour, at least two upper floor windows at the rear of the home were seen to be in need of work with the peeling paint plainly visible from the ground floor. Requirements have been made. During an inspection last year there were similar findings and a requirement was made that windows be repainted or repaired. The home now need to review their current system for monitoring and maintaining the outside fabric of the home and ensure that an efficient system is put in place so that problems are identified early and rectified promptly. All personal rooms seen were individualised to the service users’ wishes and were seen to contain many personal items and mementos. The gardens are well kept, with separate seating areas provided for the use of service users and their visitors in warmer weather. On the day of inspection the home was found to be warm and bright with a homely atmosphere and a good standard of housekeeping apparent. Six of the seven service users surveyed stated that the home was always fresh and clean, with one answering ‘usually’ and one adding ‘Yes, VERY’. Robertson Nursing Home DS0000017637.V316117.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 adequate. This judgement has been made using available evidence including a visit to this service. The skill mix of the staff meets service users needs but it is recommended that the home review staffing arrangements at times of peak activity. The home has a robust staff recruitment procedure but must make sure that all required pre-employment information and documents are obtained prior to employment to protect the safety of service users. The home has a comprehensive staff training programme which is designed to ensure, as far as reasonably possible, that service users are in safe hands at all times. EVIDENCE: The staff rota evidenced that staff are provided in sufficient numbers to meet the needs of the service users at the home. Of the seven service users surveyed, three stated that staff are always available when needed, three answered ‘usually’ and one answered ‘sometimes’. One service user commented ‘The staff are always on hand when needed’. One relative commented that more staff could be available at meal times to deal with personal care needs. A recommendation has been made that staffing levels at peak times be reviewed. The home has been working towards achieving the minimum level of 50 of care workers qualified to National Vocational Qualification (NVQ) level 2 in care. Of the twenty care workers currently employed at the home, nine have achieved NVQ level 2 in care with one due to complete the course in the near Robertson Nursing Home DS0000017637.V316117.R01.S.doc Version 5.2 Page 18 future. Five of the nine care workers with NVQ level 2 in care have now gone on to work towards their NVQ level 3. During this visit the files of three recently recruited members of staff were sampled. All files were seen to contain proof of identity, two valid references, a completed application form and enhanced Criminal Record Bureau (CRB) and Protection of Vulnerable Adult (POVA) list checks. However, at present the home has not been verifying applicants’ reasons for leaving previous employment with vulnerable adults; are not obtaining full employment histories and some gaps in employment had not been explained or explored. All staff starting work on a POVAfirst check, are supervised pending the return of a satisfactory CRB certificate. The amended Schedule 2 of The Care Homes Regulations 2001 was reviewed with the manager and requirements have been made. Robertson Nursing Homes has a comprehensive induction and ongoing training programme that meets the specifications set out by the Skills for Care organisation. The training logs seen at this visit evidenced that all mandatory training and updates are provided promptly and the training records were well maintained and easy to follow. Additional training is provided that is relevant to the needs of the individual service users at the home. Staff were happy with the training provided by the home with one commenting ‘Training is very good, there are always courses to do which are interesting’ and another that ‘Training is always available.’ Service users spoken with were complimentary about the staff at the home. Of the seven service users surveyed, three stated that staff always listen and act on what they say and four answered ‘usually’. One visiting relative commented ‘I appreciate the friendliness of the staff towards me when I visit’. All interactions observed between the staff and service users were caring and respectful. Robertson Nursing Home DS0000017637.V316117.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 good. This judgement has been made using available evidence including a visit to this service. Service users benefit from the clear management approach at the home providing an open, positive and inclusive atmosphere. The home has an effective quality assurance and monitoring system in place that is based on seeking the views of the service users. Policies and procedures are in place to protect service users’ financial interests. All policies, procedures and practices are in place to ensure, so far as is reasonably practicable, the health safety and welfare of service users and staff. EVIDENCE: Mrs Knight has been the manager of Robertson Nursing Home for eleven years, has been a registered nurse since 1988 and achieved her Registered Manager’s Award in January of this year. Robertson Nursing Home DS0000017637.V316117.R01.S.doc Version 5.2 Page 20 A total of seven care staff questionnaires were returned to the inspector on the day of this visit. From observations made on the day and from comments made on the staff questionnaire it is clear that the home have a close and happy staff team. To the question ‘What is the best thing about working here?’ answers included: ‘I love working here as it is a team effort from trained staff to care assistants.’ ‘Everyone gets on, one big family, the patients are lovely and I enjoy my job.’ and ‘It’s a very relaxed and friendly place to work and the care provided is all team work.’ The home has an effective quality assurance and monitoring system in place that is based on seeking the views of the service users. The registered manager has recently introduced quarterly residents’ meetings, there is a quarterly newsletter for the home, service user surveys are carried out every three months and monthly quality assurance reviews (Regulation 26 visits) take place. The home do not handle financial affairs for service users. Lockable storage is provided in service users’ rooms on request. All required safety monitoring checks, fire drills and safe working practice training and updates have been carried out. Staff were observed to be following appropriate health and safety practices as they went about their work. All interactions observed between the staff and service users were inclusive, caring and respectful. Robertson Nursing Home DS0000017637.V316117.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Robertson Nursing Home DS0000017637.V316117.R01.S.doc Version 5.2 Page 22 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 OP12.3 OP14.1 Regulation 16(1) (m)(n) Requirement The registered person must consult with individual service users about their social interests and the programme of activities provided by the home. All service users must be given the opportunity to chose and participate in social and recreational activities which suit their needs, preferences and capabilities. Particular consideration to be given to those service users with dementia/confusion, sensory impairments and physical disabilities. The registered person must provide adequate means of escape in the event of a fire and ensure that all fire exit doors are well maintained and functional at all times. The first floor fire exit door must be replaced or made good. The registered person must ensure that the premises to be used as the care home are kept in a good state of repair both externally and internally. The registered person must ensure DS0000017637.V316117.R01.S.doc Timescale for action 23/01/07 2 OP19 23(2)(b) 23(4)(b) 23/11/06 3 OP19 23(2)(b) 23/12/06 Robertson Nursing Home Version 5.2 Page 23 4 OP29 19(1)(b) Schedule2 5 OP29 19(1)(b) Schedule2 that a procedure is put in place that enables any maintenance problems to be identified and rectified at an earlier stage. A copy of the procedure to be sent to CSCI, Eashing office. The registered person must not employ a person to work at the care home unless he/she is fit to work at the care home and the registered person has obtained the information and documents specified in paragraphs 1-9 of Schedule 2 of The Care Homes Regulations 2001 (as amended by The Care Standards Act 2000 (Establishments and Agencies) (Miscellaneous Amendments) Regulations 2004). The registered person must check all staff files and make arrangements to obtain any missing information and documents specified in paragraphs 1-9 of Schedule 2 of The Care Homes Regulations 2001 (as amended by The Care Standards Act 2000 (Establishments and Agencies) (Miscellaneous Amendments) Regulations 2004) retrospectively for all staff employed since 26th July 2004. 23/10/06 06/11/06 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 Refer to Standard OP7 Good Practice Recommendations It is recommended that the registered person expand the service user care plans to include: • Social care/activity plans DS0000017637.V316117.R01.S.doc Version 5.2 Page 24 Robertson Nursing Home 2 3 OP18 OP27 Service user/representative signature to indicate their involvement and agreement with the care plan • All staff to sign and date all entries • Daily recording to relate more closely to the actions detailed in the care plans and evidence that needs are being met. It is recommended that the registered person revise the homes procedure on the protection of vulnerable adults to reflect the local Surrey multi-agency procedure. It is recommended that the registered manager review staffing arrangements at peak times to ensure that the needs of all service users can be met. • Robertson Nursing Home DS0000017637.V316117.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Robertson Nursing Home DS0000017637.V316117.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. Re-publishing this information is in breach of the terms of use of that website. 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