Inspection on 30/05/06 for St Aubyns

This inspection was carried out on 30th May 2006.

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

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

Other inspections for this house

St Aubyns 11/07/07

St Aubyns 28/02/06

St Aubyns 11/08/05

St Aubyns 04/03/05

St Aubyns 29/07/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE St Aubyns 35 Priestlands Park Rd Sidcup Kent DA15 7HJ Lead Inspector Maria Kinson Unannounced Inspection 30th May 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address St Aubyns DS0000006771.V291506.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Aubyns DS0000006771.V291506.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service St Aubyns Address 35 Priestlands Park Rd Sidcup Kent DA15 7HJ 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) 020 8300 4285 020 8300 4285 Mr Dilipkumar Tanna Mr Kirtikumar Tanna ** Post Vacant *** Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39) of places St Aubyns DS0000006771.V291506.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. An additional five (5) day care places for people falling into the above Service User Categories 28th February 2006 Date of last inspection Brief Description of the Service: St Aubyn’s Nursing Home is situated in a residential area of Sidcup, near to a mainline rail station, bus routes and Sidcup town centre. The home was first registered in 1988. The building was extended in 1995 and is registered with the Commission for Social Care Inspection to provide nursing care for thirtynine older people. There are nineteen single bedrooms and ten shared bedrooms in the home. Twenty-two of the bedrooms have en-suite facilities. Service users have shared use of the dining room and two lounges. There is a garden at the back of the property and limited parking at the front of the home. St Aubyns DS0000006771.V291506.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken by two inspectors on 30th May 2006 between 10.00am and 17.00pm. The inspectors spent most of their time talking with residents, staff and visitors. All of the communal areas and a selection of bedrooms were inspected. Care, medication, health and safety and staff records were examined. The acting manager had made good progress with the previous requirements and recommendations but further work was required to meet some standards. An immediate requirement was issued during the inspection in respect of staff recruitment records. The Registered Person was required to audit staff records to ensure that adequate documentation and checks had been undertaken for staff working in the home, by 28.06.06. What the service does well: Feedback from relatives was good. All of the relatives that responded to the questionnaire sent out by the commission were satisfied with the overall standard of care provided in the home. Relatives said that staff were “friendly and helpful”, “obliging, cheerful and attentive”, “professional and competent”. Residents said that staff respected their privacy and dignity and responded promptly to requests for assistance. The manager obtained information about residents health and welfare needs prior to admission. This enabled staff on duty to provide appropriate care as soon as the resident entered the home. Staff had established good working relationships with other health care professionals in the community. Access to health care services was good with regular visits from a GP and Physiotherapist. The home had an easy to follow complaints procedure. Senior staff responded promptly to relatives concerns and requests for information. The home had not received any complaints since the last inspection. St Aubyns DS0000006771.V291506.R01.S.doc Version 5.1 Page 6 Staff that were undertaking vocational training had a good understanding of abuse and were clear about the action they should take if they witnessed or were told about an allegation of abuse. Adequate records were maintained about money handed to staff for safekeeping. The home was clean, tidy and odour free. Domestic staff worked hard to maintain a high standard of hygiene in all parts of the home. Residents were satisfied with the variety and quality of food provided in the home. Although meal times were very busy care staff managed to ensure that residents received the food they had requested and support where necessary. What has improved since the last inspection? The manager and staff had worked hard to address previous requirements and recommendations. Care documentation had been reviewed and updated. The management of medication had improved and further changes were in progress to provide safer systems for the administration of medicines. The provision of activities had improved. It was apparent from discussions with residents that regular activities and events were taking place in the home. Written information about the service had been updated and copies of contracts for residents were kept in the home. The menu had been amended to include a second meal choice. Residents said they were able to choose what they ate. Some improvements were noted with health and safety issues. Fire drills were taking place and moving and handling equipment was inspected more frequently. Sharps containers were assembled and used appropriately. An administrator had been appointed and new computer equipment had been installed. This will provide increased support for staff and the manager. St Aubyns DS0000006771.V291506.R01.S.doc Version 5.1 Page 7 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. St Aubyns DS0000006771.V291506.R01.S.doc Version 5.1 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 St Aubyns DS0000006771.V291506.R01.S.doc Version 5.1 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, 2 and 3. Standard 6 does not apply to this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information provided for residents about the service had improved. The arrangements for admitting new residents into the home were satisfactory. EVIDENCE: The home had updated the Statement of Purpose and Service User Guide. A personal copy of the Service User Guide had been provided for residents. Both of these documents included all of the information listed in The Care Homes Regulations. Copies of contracts were kept in the home for residents and relatives to view. Pre admission assessments were seen on the files viewed. Some files also included multi-disciplinary reports and assessments. St Aubyns DS0000006771.V291506.R01.S.doc Version 5.1 Page 10 St Aubyns DS0000006771.V291506.R01.S.doc Version 5.1 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 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care documentation had improved but wound care records must include more detail. Resident’s health care needs were assessed and met. The management of medication had improved and further changes were planned. Resident’s privacy and dignity was maintained. EVIDENCE: Four sets of records were inspected. Care documentation had improved. All of the records were reviewed regularly and included risk assessments and care plans to show how assessed needs were to be met. Although residents with wounds had care plans and wound evaluation records, some of the documentation did not include adequate information about the management and condition of the wound. For example one care plan did not include the size of the wound, the frequency of dressing changes or the current condition of the wound. See requirement 1. The manager was starting to introduce St Aubyns DS0000006771.V291506.R01.S.doc Version 5.1 Page 12 core care plans that staff could individualise. The manager hoped this would prompt staff to provide adequate detail and reduce the amount of time spent on paperwork. Access to health care services was good with regular input from the general practitioner and other professionals. Written feedback was obtained from two Care Managers that were in regular contact with the home. Both of the respondents were happy with the overall care provided. Residents told the inspectors that they were assessed for new spectacles and received treatment from a Chiropodist. The manager said that a new system to manage medication was due to be introduced on 05.06.06. During the inspection Boots the chemist, who will be supplying the home with medication, provided training about the new system. In view of these planned changes the inspectors only reviewed the requirements and recommendations from the last inspection. Most of the issues identified by the Pharmacy inspector had been addressed but some of the hand written entries on medication charts seen had not been countersigned by a second person and the system used did not provide sufficient information for a full audit trail to be carried out. Implementation on of the new system should resolve these issues. See requirement 2. Staff were observed interacting with residents in a courteous and polite manner. None of the residents indicated that they had any concerns about the way staff treated them. St Aubyns DS0000006771.V291506.R01.S.doc Version 5.1 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 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for activities had improved but more effort was required to ensure that all residents had access to regular occupation and stimulation. Activity staff must receive training to enable them to provide a varied and appropriate programme of activities for all residents. Residents and relatives were satisfied with the overall care provided in the home. The choice and quality of food provided in the home was good. EVIDENCE: The provision of activities had improved. Staff assessed resident’s social needs but some care plans seen did not indicate how identified needs were to be met. For example one care plan stated that the resident was not able to join group activities but no alternative arrangements were made to meet the resident’s needs. Activity staff said that they arranged activities on a day-to-day basis based on resident preferences. Records indicated that the following activities had taken place, preparing for special celebrations such as Easter, St Patrick’s Day, St Georges day, bingo, music and movement and film sessions. A diary was maintained about the activities that had taken place. This indicated that the same four residents were involved in a large percentage of the activity St Aubyns DS0000006771.V291506.R01.S.doc Version 5.1 Page 14 sessions. During the inspection one of the day care residents led a bingo session supported by staff. Two social care professionals that were in regular contact with the home said “It would be good to see more activities provided” and “I am told that the home has an activities coordinator but have never observed an activity taking place while visiting the home”. The staff responsible for facilitating activities had not received any training for their role. See requirement 3. Written comments were received from nineteen relatives. The majority of responses were positive and comments made by relatives included “the staff are kind to my mum and really make a fuss of her”, “ St Aubyn’s staff have been a great support”, “ physically my mum is wonderfully cared for” and “In our opinion we could not ask for better care anywhere”. Discussions with residents indicated that they were able to choose where and how they spent their day. Lunch was observed in the main dining area. Residents confirmed that they were able to choose the dish of their choice from the menu. This was also evident during the lunch period when residents were seen with different meals. All of the residents spoken to enjoyed the food provided in the home and assistance was provided where necessary. St Aubyns DS0000006771.V291506.R01.S.doc Version 5.1 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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were adequate procedures in place to respond to complaints and to protect residents from abuse. EVIDENCE: The home had not received any complaints since the last inspection. The complaints procedure was displayed on the wall in the ground floor corridor and was included in the Service User Guide. Six relatives that responded to the questionnaire sent out by the commission indicated they were not aware of the homes complaints procedure. This issue was discussed with the acting manager who agreed to display the procedure in a more prominent position in the home. Staff that had undertaken vocational training had a good awareness of adult protection issues and said they would report concerns or allegations of abuse to senior staff. Some members of staff were not familiar with the homes whistle blowing procedure. See recommendation 1. St Aubyns DS0000006771.V291506.R01.S.doc Version 5.1 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, 24 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Parts of the décor in the home looked tired and worn. Although this does not pose a risk to residents it does not create a pleasant environment for residents. All parts of the home were tidy and odour free but a number of carpets were stained. EVIDENCE: All of the communal areas and a sample of bedrooms were viewed. The home was generally clean and odour free. Issues identified during the previous inspection had not been addressed. This included holes in the plasterwork, chipped paintwork and damaged borders. The Registered Providers had advised the commission during a meeting that a redecoration programme would be undertaken in the home during 2006. The inspector was told that one bedroom would be left vacant for the duration of the work. Some of the St Aubyns DS0000006771.V291506.R01.S.doc Version 5.1 Page 17 carpets were stained and one of the windows in the main lounge on the ground floor was misted. Some of the bedroom furniture was worn and chipped and a number of pillows were flat and lumpy. The acting manager said that new pillows had been purchased and further supplies would be obtained if necessary. The registered person said that some of the furniture would be replaced during the redecoration programme and the laundry would be redesigned to improve ventilation and access for cleaning. The garden was a little overgrown in parts. See requirement 4, 5 and 6. St Aubyns DS0000006771.V291506.R01.S.doc Version 5.1 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 and 30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The arrangements for staffing the home had improved but there was little evidence of staff training and staff recruitment practices were poor. EVIDENCE: The home has a stable team of staff but was still using agency staff regularly to cover staff sickness and annual leave. The acting manager advised the inspectors that the home would soon have a full staff establishment of trained nurses as some of the overseas nurses had completed their adaptation programme. It was still not clear on the duty roster when care staff were undertaking day care or care home shifts. The manager agreed to use a code to identify this on future rosters. See requirement 7. Residents and relatives said that staff were helpful and polite and were responsive to requests for assistance. See standard 13. Ten percent of care staff had attained an NVQ level 2 in care and eight staff were currently undertaking this training. The home was actively working toward meeting the standard set by the Department of Health for 50 of care staff to achieve this qualification. St Aubyns DS0000006771.V291506.R01.S.doc Version 5.1 Page 19 The home’s recruitment procedure did not provide adequate protection for residents. Four staff files were examined. Some of the files did not have adequate references, up to date criminal record disclosures or POVA first checks. One file did not include proof of identification and two files did not include a recent photograph of the employee. None of the files seen complied fully with regulations. An immediate requirement notice was issued to the Registered Person. The Registered Person was required to ensure that all of the information required by regulations was obtained from staff and kept on file. See requirement 8. There were no training records to view in the home. Staff said they had undertaken some training since the last inspection. See requirement 9. St Aubyns DS0000006771.V291506.R01.S.doc Version 5.1 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, 33, 35, 36 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Support for the acting manager had improved. Adequate procedures were in place to safeguard residents personal money. Health and safety issues were mostly well managed but some concerns were identified. Information required by regulation was not consistently supplied to the commission. EVIDENCE: The Registered Persons were continuing their efforts to recruit a new manager for the home. A requirement was made at the last inspection for the Registered Person to supply the commission with monthly updates about the progress made to recruit a new manager. To date the commission has received one written report. Regular updates must continue to be supplied to St Aubyns DS0000006771.V291506.R01.S.doc Version 5.1 Page 21 the commission. A temporary administrator had been appointed to assist the manager. The acting manager had made good progress with meeting the previous requirements and recommendations. Staff said the manager was approachable and helpful. The timescale for implementing a quality assurance system had not lapsed. This standard will be assessed during a future inspection. See requirement 10. A small amount of personal money was kept for one resident. The financial records for this resident were satisfactory and the resident countersigned the record when receiving money from staff. Care staff were receiving supervision but this did not include individual time to discuss their role or personal development. There was no evidence to show that trained staff were receiving supervision. See requirement 11. The commission had received one regulation 26 report in the period since the last inspection and one report was provided on the day of the inspection. To assist the commission to monitor progress made with meeting requirements it is vital that these reports are supplied regularly. See requirement 12. The accident book was examined. Five residents had sustained minor injuries since the last inspection. The daily care records for one resident indicated that they had been found on the floor on six occasions. None of these accidents were recorded in the accident book. A selection of health and safety records were examined. All of the records seen were found to be satisfactory. A number of residents were moved around the home in wheelchairs without footplates. One resident did indicate that this was their choice and staff confirmed that this was recorded in the care plan. The hot water temperature in the first floor bathroom was 47 degrees centigrade. When water temperatures are in excess of 44 degrees centigrade there is a risk of burns. The records of in house safety checks for hot water temperatures and window restrictors lacked detail. See requirement 13. St Aubyns DS0000006771.V291506.R01.S.doc Version 5.1 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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 2 X 2 St Aubyns DS0000006771.V291506.R01.S.doc Version 5.1 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 care plans include up to date information about the management of wounds. The Registered Person must ensure that all handwritten medication administration records are checked and countersigned by a second member of staff. Records of receipt and administration of medicines must enable a complete audit trail to be carried out. The Registered Person must ensure that staff receive training appropriate to the work they perform. Activity staff must receive training for their role. The Registered Person must ensure that the home and grounds are adequately maintained and decorated. Restated requirement, as the previous timescale of 07.04.06 was not met. The Registered Person must ensure that stained carpets are cleaned or replaced. DS0000006771.V291506.R01.S.doc Timescale for action 18/08/06 2. OP9 13 21/07/06 3. OP12 18 15/09/06 4. OP19 23 18/09/06 5. OP19 23 18/08/06 St Aubyns Version 5.1 Page 24 6. OP24 16 7. OP27 19 8. OP29 19 9. OP30 18 10. OP33 24 11. OP36 18 12. OP37 26 The Registered Person must ensure that residents are provided with comfortable pillows. The Registered Person must ensure that day care shifts are recorded separately to nursing home shifts. Restated requirement, as the previous timescale of 07.04.06 was not met. The Registered Person must ensure that adequate documentation is obtained prior to allowing staff to commence work in the home. (An immediate requirement notice was issued at the time of the inspection in respect of this issue). The Registered Person must ensure that a record is maintained of all training undertaken by staff including induction training. Restated requirement, as the previous timescale of 07.04.06 was not met. The Registered Person must introduce an effective quality assurance system that includes consultation with service users and their representatives. The timescale to meet this requirement had not lapsed at the time of this inspection. The Registered Person must ensure that all staff receive formal supervision. Restated requirement, as the previous timescale of 21.04.06 was not met. The Registered Person must supply the Commission and the Registered Manager with a copy of the report that he is required to prepare under regulation 26 of The Care Homes Regulations DS0000006771.V291506.R01.S.doc 18/08/06 21/07/06 28/06/06 21/07/06 21/07/06 21/07/06 21/07/06 St Aubyns Version 5.1 Page 25 13. OP38 13 2001. Restated requirement, as the previous timescales of 01.06.05, 01.11.05 and 07.04.06 were not fully met. The Registered Person must ensure that: • All accidents are recorded in the accident book • Hot water temperatures are maintained close to 43 degrees centigrade • Wheelchairs have footplates fitted unless there is written evidence that this is not in the resident’s best interest. 21/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP18 Good Practice Recommendations The Registered Person should ensure that all staff are familiar with the homes whistle blowing procedure. St Aubyns DS0000006771.V291506.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 St Aubyns DS0000006771.V291506.R01.S.doc Version 5.1 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. 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