CARE HOMES FOR OLDER PEOPLE
St Marys Haven St Marys Street Penzance Cornwall TR18 2DH Lead Inspector
Paul Freeman Unannounced Inspection 25th September 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 Marys Haven DS0000008905.V309895.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. St Marys Haven DS0000008905.V309895.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service St Marys Haven Address St Marys Street Penzance Cornwall TR18 2DH 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) 01736 368585 F/P 01736 368585 The Presentation Sisters Vacant Care Home 26 Category(ies) of Dementia - over 65 years of age (3), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (3), Old age, not falling within any other category (26) St Marys Haven DS0000008905.V309895.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. Service users to include up to 26 adults of old age (OP) Service users to include up to 3 adults aged over 65 with dementia (DE[E]) Service users to include up to 3 adults aged over 65 with a mental illness (MD[E]) Total number of service users not to exceed a maximum of 26 Date of last inspection 31st January 2006 Brief Description of the Service: St Marys Haven is a residential care home registered to accommodate twentyseven residents over sixty-five years of age. The home is also registered to accommodate three older people who experience dementia. Sanctuary Housing Association along with the home is run by the Presentation Sisters of Penzance and the Sanctuary Housing Association owns the building. Within the grounds is another registered home for nine residents, a day centre for up to fifty older people as well as a group of terraced flats. St Marys Haven is an inter-denominational home working in a Christian atmosphere. Opportunities are provided for regular Christian services, Catholic, Anglican and Methodist Ministers may also attend to the spiritual needs of the service users. St Marys Haven is located near the town centre of Penzance and has access to local amenities with good transport links. The home is furnished and maintained to a good standard and is accessible for people who experience disabilities. A passenger lift is also provided at the home to allow easy access throughout. Communal space is situated on the ground and first floors. There are twentyone single rooms and three shared rooms and a high percentage of the bedrooms have en-suite facilities and been personalised by the occupants. Currently the registered managers post is vacant and the providers have recently nominated a new responsible individual to act on their behalf in respect of the operation of the care home. St Marys Haven DS0000008905.V309895.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. A planned unannounced key inspection took place on 25 September 2006. The purpose of the inspection was to consider the work that had been undertaken on the requirements and recommendations set at the last inspection on 31 January 2006 and to inspect other core standards. Therefore some of the key standards considered included assessment of resident’s needs, care planning, staffing arrangements and safe working practises. The manager, residents and staff were consulted about the services and facilities provided. The environment, records and documents were also considered. Written information from the providers about the services and facilities provided was also taken into account. The current weekly fees for residents is £325. The current management arrangements at the home are temporary following the unexpected death of the registered manager Sister Francis. Sister Francis had devoted many years to providing a good standard of care for residents and will be missed by everyone concerned with the home. What the service does well:
Each prospective resident is assessed to make sure the providers are able to meet their needs. Residents are invited to participate in the assessment. The view of relatives or representatives and professional involved with the person are also taken into account. Each resident also has a care plan that describes their needs and summarises the care and support required. The providers have recently introduced a new format for recording the plans that provides staff with better information and guidance. Residents are positive about the care and support they receive and said they were always treated with dignity and respect. Good arrangements are in place to meet residents’ health needs and medical services are promptly accessed. Trained staff administers medicines safely and residents are able to administer their own medication when it is safe to do so. St Marys Haven DS0000008905.V309895.R01.S.doc Version 5.2 Page 6 Residents experience a varied and stimulating life style and are able to participate in a range of activities that are provided at the home. Residents spiritual needs are also well catered for. Residents said they are able to decide upon their own patterns of daily living and were satisfied about the arrangements in place. A varied and nutritional menu is in place that reflects the residents needs, preferences and choices and promote their health. Positive arrangements are in place to deal with any concerns or complaints residents may have and to protect residents from abuse. Residents said there are no barriers to raising any issues or concerns and they are confidant these will be dealt with in an efficient and satisfactory manner. The home is maintained to a high standard and the furniture, furnishings and fitting are domestic in nature wherever possible. The layout of the home is satisfactory, generally accessible and comfortable. The home is regularly maintained and a programme of redecoration is in place. Residents said that any faults that occur are dealt with promptly and were very complementary about the standard of work and efficiency of the maintenance staff employed at the home. Residents said they were very satisfied with the facilities provided and all were very pleased about their individual bedrooms that are also maintained to a good standard and many have been personalised by the occupant. Residents stated they were also very satisfied with the good standard of hygiene and cleanliness that is maintained. Sufficient number of staff is on duty each day and night to meet the needs of residents and provide a safe place to live. Two waking staff is on duty overnight and are able to call upon a senior staff member if emergencies occur. Residents were very satisfied with the manner in which the staff undertake their duties and found staff to be responsive, reliable and efficient. Residents said they were able to direct their own care and the staff is readily available when they are required. The staff is suitably trained and new staff members undertake an induction programme to make sure they can provide the care and support required. The providers have appointed an interim manager to run the care home until a Registered manager has been recruited. One of the Trustees has also been appointed to act as the responsible individual for the care home. In addition an independent person has been put in place to meet the requirements of regulation 26. The appointed person makes regular unannounced visits to the care home to make sure good standards are maintained. St Marys Haven DS0000008905.V309895.R01.S.doc Version 5.2 Page 7 There are also a number of policies and procedures in place to promote safe working practices and a safe environment for the residents and staff. In addition any situations that could be a risk to residents or staff are assessed and a suitable action plan is put in place where necessary to safeguard residents and staff. What has improved since the last inspection? 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 Marys Haven DS0000008905.V309895.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 St Marys Haven DS0000008905.V309895.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): 3 and 6. The outcome group is good. This judgement is reached on information received prior to and at the time of the inspection. Prospective residents are adequately assessed to make sure the facilities and services are suitable to meet their need, preferences and choices. EVIDENCE: Each prospective resident needs is assessed to make sure the services and facilities are suitable to meet the needs of the person concerned. The prospective resident is invited to participate in the assessment and their relatives or representatives are also consulted. The views of professionals involved with the individual are also taken into account. The assessments summarise the individual’s needs and indicate any individual choices or preferences. In certain instances it is recommended that more detailed information is in place to make sure a comprehensive picture of the care and support required is in place.
St Marys Haven DS0000008905.V309895.R01.S.doc Version 5.2 Page 10 The providers do not offer a dedicated rehabilitation or intermediate care service. Every reasonable is however taken to support residents to be as independent as possible. St Marys Haven DS0000008905.V309895.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 and 10. The outcome group is adequate. This judgement is reached on information received prior to and at the time of the inspection. The care plans require more information to make sure that sufficient information, direction and guidance is provided to staff. EVIDENCE: Each resident has a care plan that summarises their needs and provides staff with direction, guidance and information about the care and support required. The providers are in the process of improving the care planning records in order that staff can be provided with detailed information that safeguards health and well being. Good arrangements are in place to promote residents health and medicines are administered safely.
St Marys Haven DS0000008905.V309895.R01.S.doc Version 5.2 Page 12 The new arrangements have improved the information and guidance available to staff. They also make sure that clear guidance is provided for residents that are not able to direct their own care. Some of the care plans that have not changed to the new format do not adequately address the care and support required and therefore provides insufficient guidance to staff. The new care planning arrangements should address the shortfalls. The care plans are regularly reviewed in order that an up date picture of residents needs, preferences and choices is in place. Residents said they were very satisfied with the care and support they received and stated that good standards of care and support were provided at all times. Residents also stated staff treated them with dignity and respect at all times. It is evident that positive and trusting relationships have been established between residents and staff. Good standards are maintained in meeting residents’ health needs and medical services are promptly accessed when required. Residents said there health needs were well catered for and there was no delay in accessing services when needed. Satisfactory and secure arrangements are in place to store and administer medicines safely. Residents are able to administer their own medication when it is safe to do so but where staff assist suitable records are maintained. The staff administering medication has been appropriately trained and a suitable policy and procedure to guide and direct the staff has been established. Medicines that are no longer required are safely disposed of and appropriate records are in place. Where required medicines are stored in a secure refrigerator and appropriate records are maintained. St Marys Haven DS0000008905.V309895.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 and 15. The outcome group is good. This judgement is reached on information received prior to and at the time of the inspection. Residents experience a varied and stimulating life style and are able to determine their patterns of daily living. Flexible visiting arrangements are in place and a varied menu is provided that promotes the residents health. EVIDENCE: Residents said they were satisfied with the lifestyles they experienced and were able to decide upon their own patterns of daily living. A range of activities is provided each for the residents who wishes to participate but some of the residents choose to make their own arrangements. Visiting arrangements are flexible and visitors said the staff always provided a warm welcome. Residents are also able to decide where they meet with their visitors. There are no barriers to residents accessing the local community when it is safe to do so. Community groups also attend the care home on occasions to entertain the residents. Residents spiritual needs are also well catered for.
St Marys Haven DS0000008905.V309895.R01.S.doc Version 5.2 Page 14 A varied and nutritional menu is in place that reflects the residents’ needs, preferences and choices. The care home operates a flexible menu to make sure that residents have the widest choice possible. The kitchen is suitably equipped and the equipment and services are regularly serviced and maintained. The kitchen staff is appropriately trained and satisfactory health and safety practises are in place. Minor works are planned in the near future to make sure that good standards of health and hygiene are in place. Residents said they were very satisfied with the food provided and the manner in which their choices and preferences are met. St Marys Haven DS0000008905.V309895.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 and 18. The outcome group is good. This judgement is reached on information received prior to and at the time of the inspection. Positive arrangements are in place to protect residents and respond to any complaints or concerns. EVIDENCE: A satisfactory policy and procedure for dealing with complaints is in place and the providers have received no complaints since the last inspection on 31 January 2006. One anonymous concern has been received by the Commission regarding care issues that were investigated by the provider. The conclusions are that the concerns were unfounded. Residents said there are no barriers to raising any issues; concerns or complaints and they are confidant that any issues will be dealt with efficiently and in a satisfactory manner. Satisfactory arrangements have been established to protect residents from abuse and a suitable policy and procedure is in place to guide and direct staff if any concerns arise. Any allegations are reported to the appropriate authorities and where appropriate a formal investigation takes place. St Marys Haven DS0000008905.V309895.R01.S.doc Version 5.2 Page 16 Suitable whistle blowing arrangements are in place for staff and this makes sure that staff can report any concerns to a third party if they feel unable to raise the matter with the providers. This provides further protection for the residents. St Marys Haven DS0000008905.V309895.R01.S.doc Version 5.2 Page 17 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 and 26. The outcome group is excellent. This judgement is reached on information received prior to and at the time of the inspection. A good standard of accommodation is provided that is homely and comfortable for residents. High standards of cleanliness and hygiene are in place at all times which promote residents’ health and welfare. EVIDENCE: A smaller care home and a day centre for older people are located on the same site. The three facilities share a garden but this has limited access given the steps that lead to this area. Limited car parking facilities are also provided and visitors are often required to park outside the facilities. The home is situated close to the centre of Penzance. Therefore a wide range of shops, amenities and services are nearby. The home is maintained to a high standard and the furniture, furnishings and fitting are domestic in nature. The layout of the home is satisfactory, generally
St Marys Haven DS0000008905.V309895.R01.S.doc Version 5.2 Page 18 accessible and comfortable. The home is regularly maintained and a programme of redecoration is in place. Residents said that any faults that occur are dealt with promptly and were very complementary about the standard of work and efficiency of the maintenance staff employed at the home. Residents said they were very satisfied with the facilities provided and all were very pleased about their individual bedrooms that are also maintained to a good standard. Many have been personalised by the occupant. There is also a range of disability equipment in order that residents’ independence is promoted. The equipment also promotes safe working practises and the residents’ health and well being. Individual residents are also provided with suitable equipment when required and following a specialist assessment. Residents were also very satisfied with the standard of hygiene and cleanliness that is maintained. A dedicated house keeping staff is employed who clearly work to high standards and maintain a positive environment that promotes residents health. St Marys Haven DS0000008905.V309895.R01.S.doc Version 5.2 Page 19 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. The outcome group is adequate. This judgement is reached on information received prior to and at the time of the inspection. Sufficient number of staff is on duty each day and night to meet the needs of residents. The recruitment, selection and vetting arrangements are not satisfactory and do not safeguard residents. Staff is provided with regular opportunities to participate in training to make sure their skills and knowledge are up to date. EVIDENCE: Sufficient staff is on duty each day and night to meet the needs of residents and to maintain a safe and hygienic environment. Additional staff is employed when this is required. Two waking night staff is on duty overnight and reliable on call arrangements are in place if assistance is required. Residents commented that staff promptly responds to any requests and there is no unreasonable delay when residents require assistance. Residents said they were very satisfied with the care and support they receive and found the staff to be reliable, flexible and responsive to any requests they made. St Marys Haven DS0000008905.V309895.R01.S.doc Version 5.2 Page 20 Resident are therefore very complimentary about the care and support provided by staff and it is evident that positive and trusting relationship have been established between staff and residents. Residents also described the home as relaxed and cheerful and attribute these qualities principally to the staff and the manner in which they undertake their duties and responsibilities. The staff members therefore have a wide range of skills and abilities to meet the needs of residents. Staff said the home was an enjoyable place to work and a good spirit of cooperation and teamwork was in place. Staff also stated that the current temporary management arrangements had not resulted in any fundamental changes in the standards of care and support provided. The recruitment, selection and vetting arrangements require improvement to make sure that residents are protected. The current shortfalls centre on POVA and CRB checks and the providers ensuring that two written references are in place. However each new staff member undertakes an induction programme and it is recommended the providers adopt the recently introduced Skills for Care induction package. Staff is provided with regular training opportunities to make sure their skills and knowledge are up to date. In addition a good percentage of the staff group hold NVQ 2 and some staff have obtained NVQ 3. Good support and supervision arrangements are also in place and staff said that assistance, guidance and support were available when required. St Marys Haven DS0000008905.V309895.R01.S.doc Version 5.2 Page 21 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 and 38. The outcome group is adequate. This judgement is reached on information received prior to and at the time of the inspection. The Registered manager post is vacant and the interim manager and recently appointed responsible individual have not provided the Commission with evidence of fitness. Satisfactory arrangements are in place to provide a safe environment for residents and staff. The arrangements require more regular review to make sure every reasonable step is taken to safeguard residents and staff. EVIDENCE: The registered mangers post is currently vacant but a manager has been appointed in the interim while the providers recruit to the vacant post. A Responsible Individual has recently been appointed who is also a Trustee and regularly reports to the Registered Persons. The providers have not provided
St Marys Haven DS0000008905.V309895.R01.S.doc Version 5.2 Page 22 the Commission with documentary evidence of the responsible individuals or interim managers fitness as required by regulation. An external person has been appointed by the providers to undertake the duties prescribed in regulation 26 of the Care Homes Regulations 2001. The post holder makes unannounced visits to the home on a monthly basis and provides a detailed written report of their findings and any action that is required to promote good practise and comply with the regulations. Historically the services and facilitates have been well managed and residents and staff said that the standards had not been compromised during the interim arrangements. During each year the providers consult with residents, staff, relatives or representatives and professionals about the services and facilities provided. This makes sure that positive quality assurance measures are in place and provides valuable information about the consumers’ view of the care and support provided. A range of policies and procedures are in place to promote safe working practices and the providers have taken suitable steps to safeguard residents and staff. Where any situations arise that could compromise health or safety a risk assessment is in place. However the frequency that risk assessments are reviewed is variable and requires improvement. This will make sure that residents and staff are safeguarded. The equipment and services at the home are regularly serviced and maintained and satisfactory arrangements are in place regarding fire prevention. St Marys Haven DS0000008905.V309895.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 3 X X X X 2 St Marys Haven DS0000008905.V309895.R01.S.doc Version 5.2 Page 24 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(1) Requirement A written care plan must be in place that details how the services users needs in respect of their health and welfare are to be met. Satisfactory Criminal Records Bureau and POVA checks must be completed as required by regulation. Previous timescale of 30 March 2006 not met). The registered person shall not employ a person to work at the care home unless they are fit to do so and the provider has obtained the information and document required by regulation. The providers must appoint a suitably qualified and experienced Registered Manager to run the home. The registered manager at the home must hold the registered managers award.
DS0000008905.V309895.R01.S.doc Timescale for action 30/01/07 2. OP29 19 and sch 2 30/12/06 3. OP29 19(1) (a-c) 30/12/06 4. OP31 8(1)(a) 9(1-2) Sch 2 9(2)(b)(i) 30/12/06 5. OP31 30/12/06 St Marys Haven Version 5.2 Page 25 6. OP31 9(1-2) Sch 2 13(4) (a-c) 7. OP38 The providers must provide 30/11/06 documentary evidence of fitness for the interim manager and responsible individual. Individual service users risk 30/11/06 assessments must be regularly reviewed to make sure that every reasonable step is taken to safeguard the service user and staff. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP3 OP30 Good Practice Recommendations Assessments should be more detailed in order that residents’ needs, preferences and choices are fully taken into account. The Registered providers should adopt the Skills for Care Induction package and arrangements. St Marys Haven DS0000008905.V309895.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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