Inspection on 24/11/05 for Rosedale Court

This inspection was carried out on 24th November 2005.

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

Rosedale Court 21/11/07

Rosedale Court 23/11/06

Rosedale Court 20/04/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Rosedale Court Hockley Road Rayleigh Essex SS6 8EP Lead Inspector Ann Davey & Vicky Dutton Unannounced Inspection 24th November 2005 08.00 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 Rosedale Court DS0000064180.V264036.R01.S.doc Version 5.0 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. Rosedale Court DS0000064180.V264036.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Rosedale Court Address Hockley Road Rayleigh Essex SS6 8EP 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) 01268 773180 01268 774025 Runwood Homes Plc Mrs Frances Mary Mallett Care Home 73 Category(ies) of Dementia - over 65 years of age (51), Old age, registration, with number not falling within any other category (22) of places Rosedale Court DS0000064180.V264036.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. To provide personal care to 51 service users with dementia. (DE(E)). To provide personal care with nursing to 22 older people on the first floor. (OP). Total number not to exceed 73 service users. Date of last inspection Brief Description of the Service: Rosedale Court is a large purpose built detached building set back from the main road. The home is approximately 1 mile from Rayleigh town centre. Residents are accommodated on the ground and first floor. The first floor accommodation is fully accessible by lift. All bedrooms have ensuite facilities and there are separate lounge, dining and bathroom areas on each floor. The home has good car parking facilities. There is a garden/patio area to the rear of the building. The grassed area is quite limited. The home is divided into four areas; Jasmine, Primrose and Honeysuckle accommodate older people with dementia care needs, whilst Lavender accommodates older people who have nursing care needs. Rosedale Court DS0000064180.V264036.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of 9 hours. As there were two inspectors, this equated to 18 hours input. The inspection focused mainly on the progress the home had made since the last inspection, although other standards were assessed. A partial tour of the home took place. Staff and residents were spoken with. Records were selected at random and various elements viewed. A notice was displayed in the main entrance advising all visitors to the home that an inspection was taking place with an open invitation to speak with an inspector. A full and detailed ‘feedback was provided during and at the end of the inspection with opportunity for further discussion and/or clarification. A photocopy of the inspectors ‘premises audit’ was given to the home. What the service does well: What has improved since the last inspection? What they could do better: The home has been registered for 8 months. At registration, the Commission was assured that resources would be available to provide adequate care in a safe environment, this was not evidenced at the inspection. The registered provider must ensure that the local management has adequate resources to address the identified shortfalls, bring the home up to registration standard and ensure that it is maintained. The designated nursing facility is clearly under resourced and residents identified care/nursing needs are not being met. Rosedale Court DS0000064180.V264036.R01.S.doc Version 5.0 Page 6 Recording and administration systems within the home need to be consolidated and one methodology should be identified and implemented. 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. Rosedale Court DS0000064180.V264036.R01.S.doc Version 5.0 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 Rosedale Court DS0000064180.V264036.R01.S.doc Version 5.0 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): 1,3,4,5 & 6 Documentation associated with pre admission and admission assessments was adequate. Information is/was available to inform interested parties about what the home can offer or facilitate. EVIDENCE: Pre admission and admission documentation selected at random was appropriate in detail and content. The home has a good selection of information about what the home can offer and/or facilitate, this can be requested or found in the designated visitors room. There was evidence that whenever possible, visits to the home can be arranged before admission. Rosedale Court does not provide intermediate care. Rosedale Court DS0000064180.V264036.R01.S.doc Version 5.0 Page 9 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 Information on most care plans viewed was inadequate. Poor care practices were observed. Health/clinical needs are facilitated. Medication is well managed, but the current practice of lids being left off topical application containers is not acceptable. Daily routines provide residents with limited choice. EVIDENCE: Specific and identified care/nursing needs had not been recorded on care plans. As a consequence, there was no instruction on these documents about how to meet these care/nursing needs. Because of the nature of these needs, the lack of recorded information and instruction could place residents at potential risk. In addition, on other documentation, information was missing, was disjoined, had no ‘follow up’ and did not cross reference with other related care/nursing documentation. A number of residents had ‘2 hourly turning charts’, but on many occasions these records had not been maintained. In addition, many residents had ‘fluid charts’; these too had been poorly completed and/or maintained. It was difficult to assess whether residents had received the care but documentation had not been completed, or the care had not been provided. Full details were given to the manager. Although the home Rosedale Court DS0000064180.V264036.R01.S.doc Version 5.0 Page 10 is registered as one establishment, it was evident that there are 3 quite different recording systems in place. There is no one established systematic and consistent method of recording. Each area (Jasmine, Honeysuckle, Lavender and Primrose) of the home is clearly developing it’s own style. This practice is very confusing and unhelpful to staff who work in all ‘areas’ of the home. Local management must address this issue. The inspectors observed poor and inadequate care practices whereby the dignity, respect and privacy of residents was compromised. Details of these incidents were made known to the manager. In addition, inadequate infection control practices were observed. Although beds had been ‘made’, many were left unkempt, some had stained bedclothes whilst other bedding was noted to bear printed private company’s and hospital logos. The home provides and/or facilities appropriate health and clinical care from outside agencies. The manager reported a good working relationship with the different professional agencies. A visiting community nurse was positive about her working relationship with the home. The medication storage, records and administration procedures on the ‘Jasmine’ area of the home were viewed/sampled and found to be in good order. It was of concern to note that throughout the home, a large number of topical applications (creams & lotions) had been left without lids on in ensuites and on bedside tables. Many were not labelled with a resident’s name. Work routines in the morning require review as it was established that some highly dependant residents are got up by night staff around 6am to ‘help out’ day staff, breakfast doesn’t start until around 8.30am. The home must ensure that residents are fully consulted about when residents wish to get up and work routines must be adapted accordingly. Resident’s wishes should be fully documented on the care plans. On a positive note, residents spoke well of the staff and the care they provide. Apart from some identified poor practice issues, staff were observed to be caring for residents in a sensitive manner. In general staff had a good understanding and appreciation of residents care/nursing needs, although there were a few isolated incidents where clearly staff required more information in order to carry out their work in a safe manner. Call bells were tested and the response time from staff was good. Residents also confirmed that response time was generally good. It was however noted that not all call bells were accessible to some residents who were cared for in bed. Rosedale Court DS0000064180.V264036.R01.S.doc Version 5.0 Page 11 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 Current ‘in house’ resources do not meet the social/recreational needs of all residents. There are established community links. Systems must be developed to enable residents to exercise more choice and control over daily routines. Residents are provided with a good choice at mealtimes. EVIDENCE: Current ‘in house’ staff resources do not meet the identified social, recreational and occupational needs of residents. This is with particular reference to residents using the nursing facility. It was understood that the home hopes to provide additional resources sometime in the future. The current input in the area which provides nursing care is inadequate. The home has good established links with a local church which holds a regular service in the home. The notice board in the visitor’s room contains a good selection of information associated with the community and community links. Many residents were receiving visitors on the day of inspection. Staff were observed to be helpful and courteous in their dealings with family members and visitors. Early morning routines within the home tend to be task orientated, this was especially obviously in the area which provides nursing care. Whilst it is accepted that work practice systems need to be in place, there is no established practice whereby residents are given the choice of when they get Rosedale Court DS0000064180.V264036.R01.S.doc Version 5.0 Page 12 up especially when there are totally reliant on staff assistance. It is not acceptable that residents are ‘got up’ at 6am for the convenience of the home because of lack of staffing resources on the early morning shift (please see ‘staffing section’) Records demonstrated that residents have a good and varied choice of food at mealtimes. Food served on the day looked very appetising and was nicely presented. Tables at breakfast time on ‘Jasmine’ were attractively laid. Residents were very positive and complimentary about the food offered. It is however important that the home records not only the choice of food for each resident, but also the quantity eaten. This is an important part of the recording process. Rosedale Court DS0000064180.V264036.R01.S.doc Version 5.0 Page 13 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 Staff awareness of adult protection procedures requires review. The complaints procedure is on clear display. EVIDENCE: Not all staff spoken with were totally clear about what they should do in a case of suspected abuse. Senior staff or staff left ‘in charge’ in particular must have a clear understanding of what is expected of them by the home. The home’s complaint procedure was on clear display in the home. The home maintains a detailed complaints record system. Residents felt that they would be happy to raise any issues of concern with the manager. The home displays details of an established advocacy scheme should it be needed. Rosedale Court DS0000064180.V264036.R01.S.doc Version 5.0 Page 14 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): 19,20,21,23,24,25 & 26 The home was clean, warm and comfortable. There is adequate orientation and directional signage. Some identified aspects of the environment require attention for the safety, comfort and wellbeing of residents. EVIDENCE: As the home has only been operational for the past 8 months, there is still a ‘newness’ about it. A number of the communal rooms are either still not being used or are underused. Staff reported that there was the lack of a ‘homely’ feel about the home, but were confident that this would improve in time. Many bedrooms were very personalised and those communal rooms used were comfortable. In keeping with a ‘new’ home, the standard of decoration and furnishings is good. Apart from a few identified areas, the management of odour control was also good. On registration, there was a reasonable sized grassed area for residents, however a part of this is now been made not assessable to residents. The home was warm and well ventilated. For operational purposes the home has 4 designated areas i.e. ‘Jasmine’ and ‘Primrose’ on the ground floor and Honeysuckle’ on the 1st floor accommodate Rosedale Court DS0000064180.V264036.R01.S.doc Version 5.0 Page 15 older people who have dementia, whilst ‘Lavender’ also on the 1st floor, accommodates older people who require nursing care. There were a number of identified issues, which need to be addressed for the safety, wellbeing and comfort of residents. These include soiled washing left on the laundry floor, toilet brushes left in faecal water, no established bath cleaning routines, ensuite extractor fans not working, bin lids missing, call bells not accessible to residents, water coming from taps was initially very hot and identified infection control measures/systems require urgent review. Full details and examples were made known to the manager. Rosedale Court DS0000064180.V264036.R01.S.doc Version 5.0 Page 16 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): 27,29 & 30 Staffing levels are not sufficient to provide adequate nursing care. Staff rotas were clear and accurate. Staff recruitment, induction and training files were adequate. EVIDENCE: In the areas that provide residential care, staffing levels on the day were adequate. However, there was clear evidence that there are insufficient staff, both in quantity and competence rostered to provide adequate holistic nursing care. On the day of inspection, the level of day staff had been increased by one carer, but this was not sufficient. The situation is very disappointing because at registration, the Commission was assured by the registered provider that adequate staffing would be on duty at all times. Furthermore, at that time the Commission were assured that additional staffing would be rostered immediately by agency if necessary, if care/nursing needs necessitated this. It was clear that the inadequate staffing levels in this identified area had been obvious to the registered person(s) through their own process of assessing care/nursing needs for some time, but had not been addressed. On the day of inspection an extra member of day care staff had been allocated to this area, but this was still inadequate. There was no evidence that the number of staff allocated to this area at night is adequate (see health & personal care section). The identified care/nursing needs of residents accommodated in this specific area were not being met. It was also noted that some staff are working ‘double shifts’, this is not good practice. Rosedale Court DS0000064180.V264036.R01.S.doc Version 5.0 Page 17 A random selection of staff recruitment records was viewed. In general records were well maintained. The manager was asked to review the process by which references are sought as records identified some anomalies. Details were given to the manager. Induction and staff training files were available for inspection. Staff said that they had good training opportunities. The manager should ensure that staff wear clothing that is in line with the home’s dress code. The inspectors appreciated the helpful and cooperative manner of staff throughout the inspection. Staff in general were attentive to the needs of residents, but due to the limited resources, this was not evident in the area which is designated for nursing care. At weekends there are no administrative staff and the manager works Monday - Friday. The home does not currently employ a deputy manager. There are plan to recruit a deputy manager, but only for 2 shifts per week. This arrangement cannot take place at present because the person identified for the post is a qualified nurse and is needed to provide ‘hands on’ nursing care. The reception is not ‘manned’ and calls have to be put through to one of the ‘areas’. There is no identified designated person left ‘in charge’. This responsibility can fall on a number of people (see management and administration section). Rosedale Court is a large home accommodating 73 residents with a steady stream of visitors. It is recommended that a full review of the situation at weekends be undertaken. Residents were very positive about staff and thought that they were kind and caring. Rosedale Court DS0000064180.V264036.R01.S.doc Version 5.0 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): 31,32,33,35,37 & 38 Local management requires additional staffing resources raise and maintain standards. EVIDENCE: The registered manager is qualified, competent and skilled. However because of the limited resources available, the responsibilities and duties required of the manager are not being achieved. The home is not meeting regulatory requirements and the national minimum standards. Rosedale Court ‘staggered’ their registration process and admitted residents in 4 stages. As a consequence, there are now at least 3 different approaches to the various recording systems in the home. The home is registered as one establishment, yet in nature 3 very separate units exist with their own systems, methods of recording and care practices. This is very confusing and not conducive to a well managed home. The manager agreed that because of Rosedale Court DS0000064180.V264036.R01.S.doc Version 5.0 Page 19 her workload, the area designated for nursing care has been allowed to develop without much management input. This was clearly evident on the day, as the majority of the shortfalls noted were in this area. The ‘staggering’ of admissions has created additional work for the manager, as new staff have had to be recruited, inducted and trained and well as trying to create and establish systems within the home. This has now been hampered by the creation of the ‘3 units’ all with different identities. The situation is disappointing to the Commission as assurances were given by the registered provider prior to registration, that the process would be managed well. Staff said that they had a good working relationship with the manager and found her approach positive and open. There was however a feeling amongst staff that the manager’s workload keeps her away in the office carrying out necessary administrative duties. Staff would very much like to see the manager be ‘freed up’ and spend more quality time with them. Staff reluctantly accept the limitations, as there is no deputy manager. The system whereby residents personal monies and kept and transaction records were sampled. Documentation was in good order and the monies in safe keeping equated with the stated amounts. It is recommended that all receipts be filed in the respective residents records and not kept in one place. It was established that residents cannot have access to their personal monies at weekends because only the administrator and the manager have a key to the safe, and they do not work at weekends. Residents must have access to their personal monies at all times and appropriate arrangements must be made by the home to facilitate this. Rosedale Court DS0000064180.V264036.R01.S.doc Version 5.0 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 2 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 2 2 3 X X 3 2 2 STAFFING Standard No Score 27 1 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 2 X 3 X 2 2 Rosedale Court DS0000064180.V264036.R01.S.doc Version 5.0 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 OP7 Regulation 15 Requirement Timescale for action 31/12/05 2 OP9 13 3 OP14OP10 16 4 OP12 16 The registered person(s) must ensure that all residents have a comprehensive plan of care in place. Care/nursing needs must be identified in full, with detail of how the needs are to be met, how often and who by. Records must be kept to evidence delivery of care. The registered person(s) must 31/12/05 ensure that all medication administration practices are in accordance with guidance. This is with reference to the shortfalls noted concerning topical (creams & lotions) applications. The registered person(s) must 31/12/05 ensure that the privacy, dignity and choice of residents are upheld at all times. This is with reference to personal care being carried out in a dignified manner and residents being able to exercising choice about when they get up in the morning. The registered person(s) must 31/12/05 ensure that appropriate interaction and stimulation is in place and provided for all DS0000064180.V264036.R01.S.doc Version 5.0 Rosedale Court Page 22 5 OP19OP26 OP25OP20 23 residents. This is with particular reference to those residents receiving nursing care. The registered person(s) must ensure that the home, contents and facilities are in a good state of repair, be safe, be available and maintained in accordance with regulatory requirements and the NMS. This is with reference to: Sufficient safe outside grassed areas must be available to residents as agreed at registration. Systems must be in place to address the identified hazards for the safety, comfort and protection of residents. 31/12/05 6 OP27 18 The registered person(s) must ensure that suitably qualified, competent and experienced persons are on duty at all times in such numbers that are appropriate for the health and welfare of residents as agreed at registration. This is with particular reference to: Day and night staffing levels in the area that provides nursing care. (This is an immediate requirement.) Local management team i.e. deputy manager. Local management and administrative cover at weekends. The registered person(s) must ensure that staff receive adequate training and remain competent in respect of the work DS0000064180.V264036.R01.S.doc 31/12/05 7 OP30 18 31/12/05 Rosedale Court Version 5.0 Page 23 tasks they are expected to perform and/or undertake. This is with particular reference to: Staff undertaking personal care duties in a dignified manner. Staff undertaking duties within the laundry area. Staff undertaking housekeeping duties. Staff undertaking duties concerning care plan documentation. The registered person(s) must give serious consideration to the shortfalls identified within this report. Assurances were given at registration (8 months ago) that regulatory and NMS would be maintained. This was not evidenced as detailed within the report. Although a timescale has been given, a full review must start immediately. 8 OP38OP37 OP33OP32 12,13 & 24 31/12/05 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 OP15 Good Practice Recommendations The registered person(s) should ensure that adequate and systematic records are maintained throughout the home concerning the quantity of food eaten and fluid drunk by residents. The registered person(s) should ensure that all senior staff are fully aware of the home’s suspected adult abuse protection reporting procedures. The registered person(s) should ensure that staff do not routinely work ‘double’ shifts. This is not good practice. DS0000064180.V264036.R01.S.doc Version 5.0 Page 24 2 3 OP18 OP27 Rosedale Court 4 OP29 The registered person(s) should ensure that a review takes place of the home’s ‘dress code’ for employees. Rosedale Court DS0000064180.V264036.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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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