Inspection on 26/01/06 for St Mary`s Residential Home

This inspection was carried out on 26th January 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 Mary`s Residential Home 02/05/07

St Mary`s Residential Home 31/01/07

St Mary`s Residential Home 09/06/06

St Mary`s Residential Home 14/04/05

St Mary`s Residential Home 26/01/05

St Mary`s Residential Home 11/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE St Mary`s Residential Home North Walsham Road Crostwick Norwich Norfolk NR12 7BQ Lead Inspector Ruth Hannent Announced Inspection 26th January 2006 09:30 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 Mary`s Residential Home DS0000027467.V271566.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Mary`s Residential Home DS0000027467.V271566.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service St Mary`s Residential Home Address North Walsham Road Crostwick Norwich Norfolk NR12 7BQ 01603 898277 01603 891105 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) County Healthcare Ltd, a wholly owned subsidiary of Four Seasons Health Care Ltd Linda Bowker-Howe Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (44) of places St Mary`s Residential Home DS0000027467.V271566.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Forty-four (44) Older People of either sex, not falling into any other category, may be accommodated. 14th April 2005 Date of last inspection Brief Description of the Service: St. Marys is a large single storey building situated in the village of Crostwick.The accommodation consists of thirty-two single and six double bedrooms. Thirty-three bedrooms have an en suite facility. There are a variety of communal areas for the use of service users.St. Marys is situated in its own grounds with a large car park to the front of the premises St Mary`s Residential Home DS0000027467.V271566.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took place over a period of five hours. The pre-questionnaire was discussed. 7 relatives and 20 residents comment cards had been received and were also discussed. Residents and staff were spoken to. A meal was taken with the residents. A tour of the building took place. Some records were looked at that included health and safety, care plans, resident’s personal allowances and personnel records. What the service does well: What has improved since the last inspection? What they could do better: St Mary`s Residential Home DS0000027467.V271566.R01.S.doc Version 5.0 Page 6 The personnel files need to be in order and all records retained. The supervision of staff needs to be in place and to include all staff. Residents meetings need to be regular and recorded. Activities, stimulation and occupation needs to be focussed upon. More interaction with residents over the choice of meals needs to take place. Care hours need to be increased at night 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 Mary`s Residential Home DS0000027467.V271566.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Mary`s Residential Home DS0000027467.V271566.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 5 All the information is now available to help prospective residents make a choice as to whether they wish to live in St. Mary’s. Terms and conditions are now in place for all residents. Potential residents are assessed before they move into the home to be sure the home can meet the needs. Residents, relatives and friends are welcome to look around the Home to see the facilities and check the suitability of the service offered. EVIDENCE: The Four Seasons terms and conditions for St Mary’s is now in place with copies seen in the office for all new residents. Existing residents have been issued with a copy and some have been returned and signed with others to be collected shortly. All this information is now inside the full brochure that describes the Home and the service it offers. St Mary`s Residential Home DS0000027467.V271566.R01.S.doc Version 5.0 Page 9 An assessment of a person who had recently been admitted was seen on the care plan file. The basic details were written to enable the manager to make a judgement on the service being able to meet the need. This particular person was causing some concerns as to whether the Home was meeting that need and as it was only week three of admission was still within the trial period and still settling. During the inspection a family arrived to have a look around the Home. This was carried out in a professional manner by the Deputy Manager who showed the couple around the accommodation, answered questions, gave them the brochures and terms and conditions regarding the Home. They appeared happy with their visit and said they would be in touch after they had made a decision. St Mary`s Residential Home DS0000027467.V271566.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 10 There is some information in care plan folders but they need to have more detail to make them individual. The health care needs of residents are met. Residents are treated with respect and their right to privacy is upheld. EVIDENCE: Two care plans were looked at that have basic information within them but as mentioned in the previous inspection report they do need to have more detail about the whole person. They need to show how each person is to have their needs met and not just personal care and health care but include social care and support with aims and goals. (Outstanding Requirement). On the day of the inspection the community nurse and GP attended at different times. Both held conversations with staff that showed continuity of care and that the resident involved was receiving the care from both the health professionals and the care staff. Details are recorded but it may not always be St Mary`s Residential Home DS0000027467.V271566.R01.S.doc Version 5.0 Page 11 communicated with one concern shared over a comment card received that stated a staff member had escorted a doctor into a resident but did not know why the doctor had been called. (Recommendation). Throughout the inspection staff were carrying out their duties calmly and respectfully. Residents were asked choices especially at the dinner table. All staff were noted to knock on the bedroom doors before entering and on talking to three residents they all said the staff are polite and treated them with dignity. “You have nothing left when your dignity has gone and that does not happen here our dignity is still with us”. St Mary`s Residential Home DS0000027467.V271566.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 15 The Home only partly meets the expectations of residents and needs to develop the service to include social and recreational interests. The meals appear wholesome and well balanced and although some residents comments show they are not always happy with the meals this needs to be discussed more in depth within residents meetings. EVIDENCE: A long discussion was held with some residents over the lifestyle they have at St. Mary’s. Although the care they receive they are happy with, the amount of stimulation and activities is limited. On the day of the inspection when the one activity of bowls had finished residents were left sitting in a wide circle with nothing to do. The same applied after lunch when those who did want to go to the lounge were pushed in and left. An entertainer was due but actually did not arrive with residents just sitting. The same applied to the small area by the front door and the conservatory area with most people asleep. To ascertain what the residents require the manager is starting to hold residents meetings but no records of the meeting was available. (Recommendation). St Mary`s Residential Home DS0000027467.V271566.R01.S.doc Version 5.0 Page 13 The development of the care plans needs to take place to ensure some form of stimulation/occupation is available to allow residents to interact when and if they wish to. (Requirement). A meal was taken with three residents in the dining room with observation of the rest of the room. The menu was on the table for the day and according to the resident’s is always there for them to make a choice. The meal that day was turkey and ham pie with boiled potatoes, leeks and carrots and to follow jam sponge and custard or mousse. (Two flavours as one was for the diabetics). The residents all had something different. One had corn beef and potatoes one had salad and one had the menu choice. For pudding one had just custard one had the jam sponge and one had yoghurt as she did not like either puddings. (Three different flavours were shown to offer choice).The meal was enjoyed, was hot and well presented. The inspector had received some comment cards regarding the meals and the allegedly poor quality of either flavour or lack of fresh vegetables and fruit. After the meal the invoice for the vegetables and fruit was seen and included many items (All purchased from the local garden shop) and on talking to the chef she was able to show how often and what vegetables and fruit are used. Very little frozen or tinned items are on the menu. The breakfasts always included something cooked as well as cereals or grapefruit and for tea there is a choice of something on toast, soup, sausage rolls or sandwiches. One suggestion was to ensure the diabetic puddings are made separately so deserts such as crumbles are sweet enough for the non-diabetics. It was also suggested that residents always have the mealtime concerns as part of the agenda at residents meetings. (Recommendation). St Mary`s Residential Home DS0000027467.V271566.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The residents and relatives will have there concerns and complaints listened to and acted upon. Residents are protected from abuse but staff, need to have their knowledge updated. EVIDENCE: The Home has a complaints procedure that is on display within the entrance hall and is also inside the brochure with all the information about the Home. The Manager has not received any formal complaints so nothing is logged but will deal with any concerns as they happen. One resident told the inspector that she could go to the Manager if she was unhappy with anything. During the Inspection a family member wanted to talk to the Manager about some concerns and appeared relaxed and happy to discuss the issues with ease. Another resident volunteered information when talking to the inspector about a complaint her family made a long time ago and how it was resolved by the Home. A recent incident that led to an investigation was carried out in the Home and appropriate action was taken to ensure protection was in place for the vulnerable people in St Mary’s. The Home called all the staff together and the protection of vulnerable adults was discussed with each staff member being involved and asked to complete some paperwork on their understanding of St Mary`s Residential Home DS0000027467.V271566.R01.S.doc Version 5.0 Page 15 abuse. The Home now needs to ensure all staff are fully aware of the subject of POVA by attending a recognised training programme on this subject and obtaining a certificate. (Outstanding Requirement). St Mary`s Residential Home DS0000027467.V271566.R01.S.doc Version 5.0 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, 21, 24, 25 and 26 The Home is safe and well maintained. There are sufficient toilets and washing facilities but some need new floor covering. Residents have safe comfortable bedrooms with their own possessions around them. The Home does need to review the quality of the light in the corridor areas. The Home is clean but needs to change one carpet and the bathroom floorings before they can be hygienic. EVIDENCE: The Home is purpose built and is suitable for the service it offers. The maintenance staff member was able to show clear records of recording of the St Mary`s Residential Home DS0000027467.V271566.R01.S.doc Version 5.0 Page 17 fire alarm, emergency lighting and fire exit checks. (The only problem recently had been a sensor by the back door that had needed replacing and was done immediately). Fire extinguishers were all serviced in May 2005 and the Legionella water check in November 2005. Water temperatures throughout the building are checked monthly with dates seen of the recent checks on January 6 and 10th 2006. The home has adequate bathing facilities with assisted baths. It was noted the flooring in some bathroom areas were stained and beginning to lift with water seeping into the floor underneath, especially around the toilets. This makes the area difficult to clean and carry out infection control procedures correctly. (Requirement). In all, fifteen bedrooms were seen throughout the inspection. Each one was personalised, clean and housed the correct furniture. The rooms are bright and cheerful and on talking to different residents all of them stated how happy they were with the accommodation and how it was definitely their room with their own bits and pieces. The areas throughout the building that are poorly lit are the corridors where there is no natural light. On the day of the inspection when walking from a bright sunny bedroom into a poorly lit corridor it was noted how some areas are badly illuminated. (Requirement). The Home has thermostatic valves on each sink and bath (the one bathroom has just had a valve added) and all radiators are guarded. With all temperatures checked regularly. The Home has a sluice facility on the washing machine and all soiled laundry is held in appropriate containers. The laundry was clean and although very small was orderly. The Home has an infection control policy and has in place gloves and protective aprons. The one empty bedroom is in need of a replacement carpet, which has an offensive odour and should be changed before a new resident is offered the room. (Requirement) St Mary`s Residential Home DS0000027467.V271566.R01.S.doc Version 5.0 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 The number of carers on duty needs to be revised to ensure all the needs can be met in a timely fashion by staff. The number of staff undertaking the NVQ qualification needs to increase. The Homes procedures for recruitment are almost in place but records need to be orderly to monitor the process. Some training is in place but all staff need to be included in appropriate training. EVIDENCE: The Staff rota’s were discussed with the Manager. The Home has growing needs for some residents with at least seven people needing assistance from two carers for any transfers through the day and night. The staff team are a fairly experienced group with a number of years of working within the caring profession but due to the layout of the building and the growing needs of the residents the Home needs to increase the hours of staff on duty especially over night. (Immediate Requirement). The Home is working with only thirty-eight residents at present and if the admission increases to the registered number of forty-four there will not be enough staff to cover the care needs in a timely manner and the day hours will St Mary`s Residential Home DS0000027467.V271566.R01.S.doc Version 5.0 Page 19 need to be increased. (The calculations were discussed and shown to the Manager who will look at the hours as the resident numbers increase). The number of staff who hold an NVQ 2 or above qualification is only four out of a care staff number of twenty-two. This does not meet the required 50 of qualified staff and a drive to encourage the staff to commit to this qualification must be achieved. (Requirement). Two personnel files were looked at with difficulty. Although eventually the required paperwork was found it was stored in a drawer with no system to the individual files. The records were hard to find and some paperwork relating to forms of identification could not be found. (Requirement). A copy of a fast track induction programme was seen on two files. These are used for staff who have knowledge of the job when first employed through work experiences elsewhere. The staff members that they related to were not on duty, but each section, had been signed off by the staff member and the Manager or Deputy Manager on completion. Staff training was noted on the staff room notice board with moving and handling about to commence and fire training just completed. On talking to non care staff within the building these sessions are not made available for them and as they do not have one to one supervision sessions training needs for non care staff are not promoted. (Requirement). St Mary`s Residential Home DS0000027467.V271566.R01.S.doc Version 5.0 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, and 33, 35, 36 and 38 The Manager is able to discharge the responsibilities expected with the qualification of NVQ expected shortly. There is no quality assurance system in place to monitor the service is run in the residents best interests. The resident’s financial interests are safe guarded. Staff do not have appropriate and regular supervision sessions. The health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: St Mary`s Residential Home DS0000027467.V271566.R01.S.doc Version 5.0 Page 21 The Manager has been in post over two years and has experience within the caring profession. All the units for NVQ 4 have been submitted and the outcome from the Verifier is pending. The Home to date has no quality assurance system or documents to ascertain the views of residents, families, friends and professionals involved in the Home. The residents have just started holding meetings with the Manager but minutes were not available which could form part of the quality checks. To be able to develop an annual action/development plan and improve the service a quality monitoring system should be in place to aid this process. (Requirement). The Home has a good system stored on the computer of all the resident’s personal money. Transactions both in and out were seen recorded and receipts held. The Four Seasons Healthcare Ltd also have a regional administrator who will visit regularly and check the recordings and count the money to ensure all procedures are followed. In the personnel drawer some records of supervision were seen hidden amongst the recruitment paperwork. The papers were not in order and again difficult to find. Two files were looked at and showed supervision as only happening on occasions. Only two in a year, and for continuity from one session to another the information recorded did not follow on. On talking to two staff members they had never received formal supervision and although they were not care staff felt they would appreciate some one to one time with a senior staff member and use this session constructively and for their own development. (Outstanding Requirement). The staff have access to training for moving and handling which was seen advertised on the staff room notice board. (Although needs to be promoted to all staff) The Deputy Manager delivers the fire training and is her-self updated on the latest information. Six staff hold a current first aid certificate (seen on the pre inspection questionnaire) and the Home has an infection control policy within the Heath and Safety policy folder for easy access for all staff. On talking to a staff member she new where the policy folder was and that she could read it at any time. The Home has liquid soap and paper towels in all areas. All cleaning chemicals stored have COSHH sheets in place for all cleaning liquids used and all in one safety data folder. The Maintenance Officer carries out all checks on equipment and seen were the records of tests on he water for Legionella and water temperatures. The assisted bath now has a water temperature valve installed and on testing was at the correct temperature. St Mary`s Residential Home DS0000027467.V271566.R01.S.doc Version 5.0 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 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 3 X 2 X X 3 2 2 STAFFING Standard No Score 27 2 28 1 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 1 X 3 1 X 3 St Mary`s Residential Home DS0000027467.V271566.R01.S.doc Version 5.0 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 Manager must have clear documentation on a care plan that is person centred and includes personal, health and social care needs. (Outstanding Requirement) The Registered Manager must ensure that residents have a care plan that reflects their interests to aid stimulation and occupation. The Registered Manager must deliver a recognised training programme to all staff on the Protection Of Vulnerable Adults (Outstanding Requirement) The Registered Manager must ensure the bathroom floors are water tight and able to be kept clean and as free from infection as possible. The Registered Manager must ensure the lighting in the corridors is adequate and safe. The Registered Manager must replace the carpet with an odour in the bedroom as discussed. The Registered Manager must revise the staff rota to ensure DS0000027467.V271566.R01.S.doc Timescale for action 31/03/06 2 OP12 16 31/03/06 3 OP18 18 31/03/06 4 OP21 23 (2) 30/04/06 5 6 7 OP25 OP26 OP27 23 (2) 16 (2) 18 30/04/06 28/02/06 01/02/06 St Mary`s Residential Home Version 5.0 Page 24 8 OP28 18 9 OP29 17.2 10 OP30 18 11 OP33 24 12 OP36 18 enough staff are on duty to cover the needs in a timely and safe manner by care staff, especially at night. (Immediate Requirement) The Registered Manager must ensure at least 50 of the staff are aiming to achieve an NVQ qualification. The Registered Manager must ensure all records of staff who are employed in the Home are available as shown in Schedule 4 (6) The Registered Manager must ensure that all staff have access and are encouraged to participate in training that is appropriate. The Registered Manager must introduce a quality assurance system that is reviewed regularly and has aims for improving the service. The Manager must ensure appropriate supervision sessions are planned and recorded for staff one to one meetings at least 6 times a year. (Outstanding Requirement) 30/05/06 28/02/06 30/04/06 30/04/06 31/03/06 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 8 Good Practice Recommendations The Registered Manager should ensure that all staff are aware of any issues regarding residents to be able to escort professionals to the resident and give appropriate information as required. (E.g. GP visits) The Registered Manager should hold all records of DS0000027467.V271566.R01.S.doc Version 5.0 Page 25 2 12 St Mary`s Residential Home 3 15 residents meetings to use as a tool for quality assurance and to improve the service. The Registered Manager should ensure the meals provided is part of the agenda at residents meetings to ensure people who are unhappy with the food can discuss the issue and discuss ways of helping to improve the situation.. St Mary`s Residential Home DS0000027467.V271566.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Mary`s Residential Home DS0000027467.V271566.R01.S.doc Version 5.0 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. 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