Inspection on 08/08/06 for Rushes House

This inspection was carried out on 8th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Rushes House 06/03/06

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Rushes House 2 St Martins Road Marple Stockport Cheshire SK6 7BY Lead Inspector Sylvia Brown Unannounced Inspection 8th August 2006 11:00 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 Rushes House DS0000065091.V305484.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. Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rushes House Address 2 St Martins Road Marple Stockport Cheshire SK6 7BY 0161 427 7332 0161 456 9985 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) Mrs Mary B Rushe Mrs Mary B Rushe Care Home 17 Category(ies) of Dementia - over 65 years of age (14), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (10), Old age, not falling within any other category (17) Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 17 services users to include: *up to 17 service users in the category of OP (Old age not falling within any other category); *up to 14 service users in the category of DE(E) (Dementia over 65 years of age); *up to 10 service users in the category of MD(E) (Mental disorder excluding learning disability or dementia over 65 years of age). As from the date of registration, there must be no further admissions of Younger Adults (persons under 65 years of age). Six named service users in the category MD (Mental disorder excluding learning disability or dementia). 6th March 2006 2. 3. Date of last inspection Brief Description of the Service: The registered owner, Mrs Rushe, was registered by the CSCI as a fit person to run a care home in 2005. Mrs Rushe is also registered as the manager and is in daily attendance at the home. Rushes House is not a spacious home and is currently undergoing major refurbishment in all areas. Its unusual layout and internal shapes place restrictions on how far the home can be altered, however substantial work is underway to create dining space and provide improved disabled bathing/ showering facilities on the ground floor. The home is registered to accommodate older service users. However, there are a number of younger adults who have mental health difficulties residing at the home. Those residents may remain at the home as long as they desire and as is suitable. Vacancies arising can no longer be offered to people under the age of 65 years. Accommodation is on four floors with a lift serving each area. The home offers both single and double bedroom accommodation. There is currently one lounge which is used by residents who smoke, there is a dining room which offers two additional lounge chairs for non smoking residents. This issue is currently under review and the home is actively encouraging a reduction in smoking. The home is in a pleasant area in the village of Marple. It is close to local shops, parkland and canals. Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit to Rushes House was part of a key unannounced inspection commencing at 11:00am. The inspector looked at all the required key standards to see how the home was meeting them. During the inspection the inspector looked at a number of records including Health and Safety, service user care files, staff files and various other records which are either used to inform people of the services offered and/or used to ensure service users are appropriately cared for and supported. Time was spent talking with service users and looking around the home. One service user invited the inspector to see their room, whilst others invited her in to speak to them as they sat in their rooms. Comment cards were provided to service users, relatives and professional visitors prior to and during the inspection. The comments received have helped the CSCI to gather information from people who use the service. Where appropriate and relevant, their comments have been included within the report. All comments received were positive and demonstrate that service users are, in the main, happy and contented with the support they receive at Rushes House. What the service does well: Rushes House continues to develop a friendly, homely environment for those who live there. Throughout the inspection service users spoke positively about all aspects of the home, which was also confirmed within written comment cards returned to the CSCI. Although extensive upgrading is taking place which has, and will, for some time directly impacts on service users’ living arrangements, they seem to be understanding about the disruptions. One service user’s comment card states, “under the new manager things could not be better, this is a first class home”. Service users were observed to be relaxed and going about their daily routines as they wished. Staff were seen talking to and supporting service users and positive relationships were evident. Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The home needs to make sure that all service users have written care plans in place which detail all care needs and personal preferences for support, regardless of the length of their stay. Such information keeps staff aware of the service users’ needs and enables staff to maintain consistency when providing support. Daily records could be written in more detail and reflect the service users’ daily routines, activities and achievements. Such information enables a more accurate assessment of the service users and of the care they are receiving. Medication administration records were not correctly completed with a number of signatures missing for medication administered. These records must be correctly completed in order to confirm all service users have received their medication at the prescribed frequency. The home should develop a daily activities programme, which service users may join as and when they wish. Arrangements should also be made to ensure those who prefer to not join in group activities get their social interest recorded and met. Social gatherings and occasions, promote service users’ well being and assist in forming friendships. Management and staff should complete up to date adult protection training to ensure they are competent and confident in protecting and acting on service users’ behalf if and when required. The upgrading of the home continues. As a consequence, the CSCI has requested the registered owner/manager to provide a separate development plan which details all the predicted work and upgrading. The plan should include timescales. The upgrading of the home can then be monitored and arrangements made and agreed with the CSCI where delays or extensive disruptions to service users may occur. Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 7 The home must cease wedging doors open and ensure that all fire resistant doors are able to close effectively. The wedging of doors and ill fitting doors place service users at an increased risk in the event of a fire emergency. Safe arrangements should be made and agreed with the fire safety officer when service users wish to have their bedrooms doors retained open. Recruitment and selection procedures must include obtaining statutory preemployment checks. Failure to do so places vulnerable adults at increased risk. All employees must periodically complete practical fire drill training to ensure they are, as far as possible, able to follow best practice in the event of a fire emergency. Where appropriate, service users should know fire safety procedures. 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. Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 & 5 Quality in this outcome area is good. Service users are given relevant information, assessed and able to visit the home prior to being accommodated. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Since the last inspection the home has updated its Statement of Purpose and Service User Guide and submitted copies to the CSCI. The information is sufficient to inform service users of the services offered and standards set by the home and complies with regulations. Service users stated that they received sufficient information about the home to help them make decisions about the home prior to moving in. Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 10 Two service users spoken with described their admission process and confirmed that they were able to visit the home prior to moving in. Records also demonstrated that the registered manager and deputy do go and visit service users prior to admission to assess their needs. The placing authorities also supply the home with an assessment of needs at the time of the referral. Rushes House is registered to support older people (over 65), who may or may not have dementia, and service users under the age of 65 who may have mental disorder. At the time of the inspection the home was complying with its registration and staff continue to have the skills to support the home’s registration categories. Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected 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 adequate. Service users are supported in a dignified and respectful manner. Recording systems require further development to meet the required standard. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The care files of the newly admitted service users were looked at. One care file failed to contain sufficient details about the service user’s needs and preferences for care or details of how they should be met. The service user was spoken with at length and stated they were very well supported and that staff “are good to me”, the service user looked clean, with freshly pressed clothes and styled hair. Observation of staff was that, they were familiar with the service user’s preferences and were, where possible, meeting them. Daily records maintained for a number of service users were basic and failed to record their daily routines, they basically recorded sleeping patterns, meals and continence issues. Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 12 One newly admitted service user stated, though they did not mind sharing a bedroom, they would eventually like a single room. Though the service user stated that the “managers know about this” there was no recorded information about this matter. All returned comment cards stated service users felt very well cared for and supported by staff. All stated they were listened to and that staff usually acted on what they said. One service user stated “since the new manager came to the home, 11 months ago, I have seen a transformation both in myself and the home”. During the site visit service users made positive comments about how they were treated and about the staff who supported them. One service user stated staff were “all very nice and very good”. Staff records confirmed that staff with responsibility for medication administration and management have received appropriate training. Medication administration records identified a number of signature omissions, and indicated that there was no formal monitoring of medication administration processes or records. Such systems should be in place to safeguard service users from mal-administration and identify any errors in a timely manner. There was no list of staff who have responsibility for medication administration or examples of their signature for reference purposes. Throughout the site visit service users were spoken with by staff in a dignified and respectful manner and were addressed by their preferred name. One service user stated “no-one shouts now” and another stated “people are nice to me”. The registered manager confirmed that staff have been made aware of how service users should be treated and that with the change of staff has come a better standard of care and respect for service users. Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected 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 adequate. Some social stimulation and activities are provided for service users. Service users receive a well-balanced and enjoyable diet. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Though, in the main, most service users at Rushes House live quiet lifestyles, the amount of social interaction has improved under new ownership. Service users were observed going out into the community and receiving visitors. Comment cards stated that service users were usually satisfied with activity arrangements. However, it was difficult to ascertain what activities are routinely provided within the home or what opportunities are available for service users to receive support to visit local places of interest. Service users’ records failed to record service users’ interests or participation in activities and though there was no structured programme for staff to follow, there was some evidence of activities being provided within the home. Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 14 Service users had recently joined in to watch the community carnival and had a garden party and barbeque to celebrate the festivities. The registered manager promotes the individualisation of all service users. As a consequence, service users have, as far as possible, control over their own lives. Rising and retiring routines are flexible, as are personal care support routines. Though meal times are set, service users can individually decide when and where to have their meals. One meal time was observed; service users stated that the meal time was enjoyable and that food was always nice. One comment card stated a service user would like more “chips”. However, as part of the care package service users’ weights are monitored and healthy eating is promoted. The registered manager stated that once the new cook has commenced, it is her intention to promote homemade food and cakes which, she stated, service users enjoy more than purchased pre-baked items. The home was in the process of developing a new menu and was consulting with service users regarding their favourite dishes. Service users stated they can have what they like and seconds if wanted. All stated they had no cause to complain about the food served. One staff comment card stated “the food is very nice at the home”. Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be 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. Written adult protection and complaints procedures are in place, but staff still require training in the procedures for the protection of vulnerable adults. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The home has a written complaints procedure in place. Comment cards received from service users identified that they all had someone to talk to should they feel unsafe or had a complaint to make. Of the three relatives’ comment cards returned, two stated that they were not aware of the complaints procedure, though all stated they had no complaints to make. The home’s Adult Protection procedures are appropriate and up to date. The registered manager has yet to attend the Local Authority’s Provider training; And some staff have yet to attend Adult Protection training. The requirements made at the previous inspection regarding these matters are repeated. Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23, 25 & 26 Quality in this outcome area is adequate. Service users live in comfortable surroundings, which continue to be upgraded. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: At the time of the inspection the home was continuing with its upgrading programme, electricians were on the premises rewiring many areas and fitting new lights and plug sockets. Decorators were also in the process of decorating the hallways. The home does appear to be in a chaotic situation which will be unavoidable for some time. However, service users do not seem to mind about the limitations placed on them and are enjoying the benefits of each part of the upgrading as it is completed. Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 17 The registered manager confirmed that in addition to the structural upgrading, each month, fixtures and fittings are purchased for service users’ individual comfort and enjoyment. New lounge chairs were on order and the carpets were being replaced in the last two service users’ bedrooms. Three new beds have been purchased, as have wardrobes and drawers. One service user was so pleased with her new room she invited the inspector to view it. It was evident that she had her own possessions around her and that she was able to arrange her furniture as she wished. Extensive plans are in place to replace toilets with more suitable equipment and adapt them to meet those with a disability. The main kitchen is to be moved to the basement, making more dining space and future plans include, if possible, a conservatory to provide additional seating areas. A number of doors continue to be wedged open and some bedroom doors failed to self-close due to the new carpets. The registered manager is aware that bedroom doors which contain glass panels must be replaced. All comment cards stated the home is always kept clean and fresh. On the day of the inspection the home was free from odours and cleaned to a good standard. The garden, though still in need of upgrading, has received some attention and suitable garden furniture has been purchased which has been enjoyed by service users in the fine weather. All service users spoken with were happy with their surroundings. Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 18 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 adequate. Service users are supported by staff in appropriate numbers who are trained and competent. Robust recruitment and selection procedures are not strictly followed. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Throughout the inspection staff were observed to be carrying out their duties in a pleasant and competent manner. All staff had completed application forms and attended for interview, however new CRB’s and POVA First checks had not been completed prior to employment commencing. Contracts of Employment had been issued and references received. Training information provided confirmed that the registered manager has prioritised staff training since taking ownership and that all essential training has been undertaken and/or planned for. NVQ training continues, one staff member has commenced level 3 training and four of the six new staff have enrolled on level 2 training. Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 19 The home’s rota continues to fail to identify the hours of domestic and cooking staff and/or staff who complete those duties in their absence. Staff comment cards indicated improved morale amongst the staff team. One staff stated “the owner provides a friendly environment”; another “the manager is nice and spends most of her time at the home”. Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 20 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 & 38 Quality in this outcome area is adequate. Rushes House is a well managed home which is run for the benefit of service users. Fire safety practices and training require developing. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The registered provider is experienced and appropriately qualified to run a care home. Her forthright management style is direct and she is clear about her aims to develop the home and how it is to be run. Since taking ownership, it is clearly evident that the home is developing at a satisfactory pace and that service users’ lives and environment are improving as a consequence. Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 21 Training records identify that the registered manager is continuing with her training and is aware of best practice when caring for vulnerable adults. Currently, though service users have stated they are satisfied with the support they receive, the home does not formally consult with them. Service user meetings have not been established and quality assurance procedures have not yet been completed. Health and safety records identified that, in the main, good practice was undertaken to ensure service users’ and staff’s safety, however fire safety records could not confirm that up to date practical fire drill training had been undertaken by all staff. Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 22 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 X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 3 X X 3 X 3 3 STAFFING Standard No Score 27 2 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X X X X 2 Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 23 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 The registered person must ensure that all service users have an up to date plan and that the home can demonstrate how it is meeting their needs. The registered person must ensure that medication administration records are maintained to the required standard. (Timescale of 06/03/06 not met). The registered person must ensure they and all staff complete up to date adult protection training. (Timescale of 01/07/06 not met). The registered person must ensure that a detailed plan of the home’s upgrading is submitted to the CSCI which includes the individual timescales for completion. The registered person must cease wedging doors open. (Timescale of 02/03/06 not met). Timescale for action 01/10/06 2 OP9 13 15/09/06 3 OP18 12 & 13 30/11/06 4 OP19 23 01/10/06 5 OP19 23 01/09/06 Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 24 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. 6 Standard OP19 Regulation 23 Requirement Timescale for action 01/10/06 7 OP27 17 Schedule 4 8 OP29 7,9,19,& Schedule 4 24 9 OP33 The registered person must ensure that the home is compliant with all fire safety regulations, including ensuring staff receive practical fire drill training. (Timescale of 01/05/05 not met). The registered person must 01/09/06 ensure that the home’s rota can demonstrate all duties worked by staff and their hours of working. (Timescale of 06/03/06 not met). The registered person must 01/11/06 ensure it has robust recruitment and selection procedures in place which are followed. (Timescale of 06/03/06 not met). The registered person must 01/10/06 ensure that a quality assurance procedures are completed in accordance with Standard 33 and Regulation 24. (Timescale of 01/01/07 not elapsed). Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP7 OP12 OP22 OP33 Good Practice Recommendations The registered person should develop daily recording to include the care support provided, routines, activities and achievements of the service users. The registered person should ensure that a programme of activities is developed and residents are kept informed of daily events. The registered person should ensure that parts of the home are fitted with a loop system to aid those with hearing difficulties. The registered person should commence formal service users meeting and seek their views and opinions on the service offered to them. Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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. Extracts may not be used or reproduced without the express permission of CSCI Rushes House DS0000065091.V305484.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!