Inspection on 22/02/07 for Straven House

This inspection was carried out on 22nd February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Straven House 28/11/07

Straven House 08/02/06

Straven House 22/04/05

Straven House 02/12/04

Straven House 11/05/04

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

CARE HOMES FOR OLDER PEOPLE Straven House Queens Road Ilkley West Yorkshire LS29 9QL Lead Inspector Nadia Jejna Unannounced Inspection 22nd February 2007 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 Straven House DS0000001170.V324407.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. Straven House DS0000001170.V324407.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Straven House Address Queens Road Ilkley West Yorkshire LS29 9QL 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) 01943 607063 01943 600708 www.bupa.co.uk BUPA Care Homes (GL) Ltd Care Home 24 Category(ies) of Dementia - over 65 years of age (2), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (1), Old age, not falling within any other category (21), Physical disability over 65 years of age (1) Straven House DS0000001170.V324407.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The place for MD(E) is only for the use of the service user named in connection with the variation application of 13.1.05 8th February 2006 Date of last inspection Brief Description of the Service: The home is an adapted detached property set in its own grounds on the outskirts of Ilkley. Accommodation is provided on the ground and first floors. There is a passenger lift, which can be used by residents to access the first floor and the lower ground floor where the dining room, kitchen and laundry are located. There are large attractive gardens but not all areas are accessible to residents; three patio areas have been provided, one of which has raised flower beds and another which can be accessed via the dining room has views across the valley. Ramps are available in the gardens and provide level access for wheelchair users into the building. A local bus route is near by and Ilkley town centre is within walking distance although this is a steep road. The home is registered to provide care to twenty-four residents of either sex over the age of 65, care can be provided for up to two people with dementia and one person with a physical disability. Nursing care is not provided. Two shared rooms are used as singles therefore occupancy is limited operationally to twenty-two. Information about services provided by the home is kept in a file in the reception area as well as in residents’ rooms. Information packs will be posted to people on request. At the time of writing this report the homes charges for residential care range from £495 per week to £600. Items not covered by the fee include newspapers, hairdressing and chiropody. Straven House DS0000001170.V324407.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One visit was made on 6th March 2007. The home did not know that this was going to happen. Feedback was given to the manager at the end of the visit. The purpose of the visit was to make sure the home was being managed for the benefit and well being of the residents and to see what progress had been made meeting requirements in place from the last inspection. Before visiting the home the inspector asked for information from the manager which included asking about what policies and procedures in place and when they were last reviewed, when maintenance and safety checks were carried out and by who, menus used, staff details and training provided. This was returned in the pre inspection questionnaire (PIQ). Comment cards were sent to the home to be given to residents, their relatives and other visitors to find out what their views of the home were. At the time of writing this report five resident responses had been returned. In order to find out how well staff knew residents care plans were looked at during the visit and residents, visitors and staff were spoken to. Other records in the home were looked at such as staff files, complaints and accidents records. What the service does well: What has improved since the last inspection? Straven House DS0000001170.V324407.R01.S.doc Version 5.2 Page 6 A new manager has been in post since December 2006. She has been looking at services provided in the home and looking at areas where changes and improvements can be made. The organisation has introduced new style of care plan documentation to use. The documents seen will provide staff with clear guidelines and are a definite move towards person centred individual care plans. Senior staff have been given some training on how to use the new system and all care plans should changed to the new system in the near future. The manager has made sure that all staff have received training about moving and handling and fire safety. All staff are doing a distance learning course for infection control and will then be doing one on food hygiene. Training about dementia has also been planned. 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. The summary of this inspection report can be made available in other formats on request. Straven House DS0000001170.V324407.R01.S.doc Version 5.2 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 Straven House DS0000001170.V324407.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 5. Standard 6 does not apply to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can make an informed choice about the home through visits and the information they are given. The home makes sure that it can meet the needs of prospective residents before they are admitted. EVIDENCE: Information for residents and visitors is available in the reception area. Files of useful information are placed in every bedroom. The Statement of Purpose has been produced on a company template. It uses technical jargon and makes references to company policies that mean nothing to people outside of the organisation. This document should be reader friendly and in plain English. The manager was advised to look at guidance available on the CSCI website. Straven House DS0000001170.V324407.R01.S.doc Version 5.2 Page 9 A resident who had come to live in the home in August 2006 said that they had looked round the home and received all the information they needed before making the choice to live there. They had settled into the home and said the staff were kind and caring. The manager said that a new pre admission assessment document is being used and either she or a senior member of staff will visit prospective residents to identify their needs before agreements are made about coming to Straven House. They take information about the home with them and leave it if the individual has not already seen it. All prospective residents are invited to come and look round the home and can stay for a meal if they wish and meet the other residents. The new pre admission assessment document is very detailed and easy to use. It will help staff to identify individuals needs and what care plans would be needed. It includes a section for the resident’s perspective and comments about moving into residential care, which will help staff to understand how they feel. One seen for a resident admitted five days earlier was detailed and informative. Information from resident’s surveys said that contracts were in place for services provided. The manager confirmed this. She said that three way contracts were in place if the local authority was funding care. If residents paid privately terms and conditions of residence were given and contracts in place between the resident and the home. Straven House DS0000001170.V324407.R01.S.doc Version 5.2 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. 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 plans providing staff with detailed guidance about individual’s needs and how to meet them were not in place for some residents, there is a risk that these needs will not be met. EVIDENCE: The organisation has introduced a new style of care plan to be used. The blank forms looked at included a pre admission assessment that could be revisited at intervals to review and reassess the resident’s needs and see if care plans needed to be changed. The manager said that a key worker system has been started and all residents have a named senior carer who will be responsible for writing the care plans and making sure the resident is involved with the process. Senior staff have been given training around using the new plans and are now working towards changing all care plans over to the new documents. Three care plans were looked at. One was for a resident who had come to live at the home five days earlier. They had a detailed pre admission assessment, which should have been used to put a care plan in place. However the only Straven House DS0000001170.V324407.R01.S.doc Version 5.2 Page 11 care plan seen in the file was about an agreement when night checks were to be made. The manager was made aware of this and said it would be rectified. Two more care plans were looked at. One had been changed to the new format and the other was still on the old style documents. Guidance was seen about how to meet most of the identified needs but the information was general and could have related to any resident in the home rather than to the individual. The manager said that the new care plans would address this issue. Examples where resident’s needs did not have appropriate care plans were given to the manager. These included: * No information about how the resident’s poor memory affected them and what staff could do to help them. * Daily records showed that from February one of the residents was having cream applied to sore areas of skin but there was no care plan in place. * Daily records for another resident showed that they often had pain but there was no care plan in place. Nutritional assessments are carried out when residents are admitted and reviewed at regular intervals. Individuals are weighed monthly and records kept. If residents are low weight or identified as at risk of losing weight advice is asked for from other healthcare professionals. Records charts of food wastage are kept if staff are monitoring residents diet. The charts seen did not provide clear information about what the resident had eaten. They said the resident had eaten half of breakfast but there was no indication of what the breakfast was or how much had been given/not eaten. The records of fluid intake were not clear either. This was discussed with the manager and advice given that the records should provide a clearer picture of what food and drink the resident had actually taken. Accident records showed that one resident had had four falls over a period of one month. This had been discussed with the relatives and plans made to move to a ground floor room and use a pressure alarm mat at the side of the bed. The pressure alarm mat has not yet been put in use and records seen did not show if the falls prevention team had been contacted for advice. Falls risk assessments are carried out and safety care plans put in place. But these would benefit from more detail and advice from the falls prevention team. The manager said that she would contact them. Medication audits are carried out at regular intervals. Senior staff are responsible for dealing with medications. They have received training through the organisation as part of the senior care workers training course. The care manager said they are using a different pharmacy to supply medication and are now using the monitored dosage blister packs. They have had guidance Straven House DS0000001170.V324407.R01.S.doc Version 5.2 Page 12 how to use this system and the pharmacist is going to provide certificated training about medication and elderly people. The medications administration records seen were up to date. Residents said that the staff were polite, respected their privacy and would always knock on doors before entering rooms. This was seen in practice. It was clear that there were good relationships between residents and staff. Straven House DS0000001170.V324407.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents’ choices are respected and contact with family and friends is encouraged. EVIDENCE: Residents said that they could choose how to spend their time, when to get up, when to go to bed and where to eat their meals. They said that the staff were kind and attentive and did what they could to meet their needs. They said that their visitors could come at any time and the staff made them welcome. The manager said that there have been some problems with arranging regular activities for residents since December 2006 as they did not have an activity organiser. This was reflected in resident surveys and comments were made about not enough to do at times. A new person was appointed in January 2007. They are in the process of getting to know the residents and writing up life and social histories for each resident. This information will then be used to plan regular activity sessions and as part of the care planning process. A poster showing what activity sessions were planned for the week was seen in the hallway. Straven House DS0000001170.V324407.R01.S.doc Version 5.2 Page 14 The activity person is working through the organisations distance-learning workbook about social activity. Residents were pleased that a programme of planned activity sessions was available again. Information from talking to residents and the surveys returned showed that they were happy with the meals served. The chef said that menu plans are in place and these are changed at regular intervals. Residents can choose what they want to eat and alternatives are always available if they do not want what is on the menu for that day. The chef speaks to residents and is aware of individual’s likes and dislikes and will accommodate these and any special diets or preferences. The kitchen was clean, tidy and well organised. Meals are prepared using fresh produce and residents enjoy home baking most days. Straven House DS0000001170.V324407.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. 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. Residents can be confident that their concerns will be listened to, taken seriously and acted on. EVIDENCE: A complaints procedure was in place. This is made available to all residents as part of the Statement of Purpose and the useful information file that is kept in every bedroom. Complaints leaflets are also readily available in the home for residents or visitors to use. Residents said that they knew what to do and who to speak to should they have cause to complain. Records showed that there have been two complaints since the last inspection. One was about cleanliness in the home and staffing. The manager met with the complainant and it was resolved to their satisfaction. The other was about poor lighting in the lounge and reading lights have been bought which have resolved the problem. The organisation has adult protection policies and information in place and the home has got copies of the local authority adult protection procedures. Most staff have received training around abuse and the manager has arranged for those who haven’t to attend a study day in June 2007. She has also got a training DVD and workbooks that will be used to provide in house training to all staff. Straven House DS0000001170.V324407.R01.S.doc Version 5.2 Page 16 Information from residents said that they knew who to speak to if they were unhappy. Staff said that they would report suspected or actual abuse to the person in charge. Straven House DS0000001170.V324407.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24, 25 and 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are living in a clean, tidy, safe and well-maintained home, which is suitable for their needs. EVIDENCE: The home was clean and tidy. Residents were happy with their rooms and said that they were kept clean and free from smells. The rooms seen were nicely decorated and furnished. It was clear that residents are able to bring their own belongings, and furniture where possible, to personalise their rooms. Some of the bedrooms en suite facilities include baths. There is adequate provision of communal toilets and assisted bathrooms. The building is well maintained. There is suitable access to the home and three patio/garden areas for residents of all abilities. One of these areas has raised flower beds and residents are encouraged to look after these. Straven House DS0000001170.V324407.R01.S.doc Version 5.2 Page 18 The communal areas have been furnished and decorated to a high standard. One of the lounges has lovely views over the town of Ilkley. Disposable gloves and aprons are available and there is adequate provision of liquid soap and disposable towels for staff use. The manager said that they are hoping to recruit additional domestic staff. At present there is a vacancy for sixteen hours. The two staff they have are looking after the general cleaning of the home and the laundry. Residents were satisfied with the laundry services. The manager said that the next fire safety officers visit is due in April 2007 and that work recommended a after the last visit has been done. A new nurse call system was being put in. Straven House DS0000001170.V324407.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Training provided to staff needs to be increased to make sure that they have the knowledge and skills to meet the needs of residents. EVIDENCE: When the PIQ was completed the home had eighteen18 residents, it stated that none had high dependency levels. On reviewing the information supplied about residents needs at least five residents had a high level of need for care and support from staff. The staff rotas showed that there were three staff on duty from eight in the morning till eight at night and two night staff. The manager said that these numbers were adequate to meet the needs of residents in the home at that time. One of the problems identified is the size and layout of the building, staff can be busy in different wings and not available to respond to residents. The manager was advised to make sure that staffing levels are kept under review, and that the changing needs and dependencies of residents are taken into account along with the layout of the home. Since the manager started in December 2006 she has been looking at information held about staff in order to know what training they have done and what they need to do. She has made sure that the whole staff team is up to date with moving and handling and fire safety training. All staff are enrolled on Straven House DS0000001170.V324407.R01.S.doc Version 5.2 Page 20 a distance learning course for infection control and will then be doing one on food hygiene. Records seen showed that there were big gaps in training given to staff. The manager said she will audit all staff files and put plans in place to make sure that they all receive training needed to maintain the health, safety and welfare of residents and themselves. She will also look at training about specialist care needs of residents such as stroke, diabetes and continence. She has already arranged dates for training about dementia. The PIQ showed that ten out of fifteen staff have achieved National Vocational Qualification (NVQ) level 2. The home will now has over 50 of staff with NVQ 2 or higher. Three staff files were looked at. These showed that: * Application forms including health check questionnaires were completed. But the forms must be amended to request a full employment history and ask for reasons for any gaps in employment. * Two satisfactory written references were in place before employment was offered. * Confirmation of satisfactory POVA (Protection of Vulnerable Adults) was in place before employment was offered and enhanced CRB (Criminal Records Bureau) checks were in place. * Proof of identity was seen. Straven House DS0000001170.V324407.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is being managed and run in the best interests of residents. EVIDENCE: The manager has been at the home since December 2006. She has previous experience of managing care homes and has made application to become registered with the CSCI. The home does not act as appointee or agent for any residents. If residents wanted the home to hold money in safekeeping for them there are systems in place to do this and appropriate records would be kept. The section of the PIQ providing information about when equipment has been maintained and serviced was not completed. The manager said that the Straven House DS0000001170.V324407.R01.S.doc Version 5.2 Page 22 organisation makes sure that all electrical and gas installations/equipment are serviced and maintained at least annually. The organisation makes sure that all required policies, procedures and guidance for staff is available and kept up to date. The most recent quality assurance survey of resident’s views was done in December 2006. The results are available and an action plan has been out in place to address areas where change or improvements are needed. The manager said that it will be talked about at the next residents and staff meetings. The last residents meeting was held in November 2006 and the manager was looking at dates for the nest one. The last meeting for all staff was in October 2006. Meetings for different grades of staff have been held since then, for example the heads of departments such as care, domestic and catering met in January 2007 and care staff in March 2007. Residents and staff said that the manager was open, approachable and supportive. The manager is in the process of making sure that all staff have received their first supervision with her and will then set up systems for making sure it is provided at least six times a year. Records showed that she had seen half of the staff. Accident records are kept. They have not been altered and the document used would benefit from prompts to write additional information about when the resident last seen before the accident and by who and details about the outcomes of the accident. Straven House DS0000001170.V324407.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 3 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 4 X X 4 4 3 STAFFING Standard No Score 27 3 28 3 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 2 X 3 Straven House DS0000001170.V324407.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 14, 15 Requirement The registered person must make sure that care plans are in place for all residents. Steps must be taken to make sure that they are more detailed and clearly show how an individual residents personal, physical, health and social care needs are to be met. (Requirements to meet this standard have been in place since April 2005) The manager must make sure that advice from appropriate healthcare professionals such as the falls prevention time is asked for. The registered person must ensure that all staff receive training that equips and helps them to maintain the health, safety and welfare of residents and themselves. Training about specialist care needs of service users must also be provided. Timescale for action 31/08/07 2. OP8 12 30/04/07 3. OP30 18 30/11/07 Straven House DS0000001170.V324407.R01.S.doc Version 5.2 Page 25 4. OP31 Care Standards Act 2000 18 The manager must application to become registered with the CSCI. The manager must make sure that staff receive formal supervision at least six times a year. 30/05/07 5. OP36 31/08/07 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 OP1 OP8 Good Practice Recommendations The Statement of Purpose should be revised in order to make sure that it is in plain English and reader friendly. The records used to monitor diet and fluid intake should provide a clearer picture of what food and drink the resident had actually taken. The application forms should be revised in order to request a full employment history and identify the reasons for any gaps in employment. The manager should make sure that the numbers of staff on duty are kept under review to make sure that they take into account the needs and numbers of residents living in the home. The size and layout of the building should also be taken into consideration when doing this. The accident records should include details as to when the accident victim was last seen and by whom. 3. OP29 4. OP27 5. OP38 Straven House DS0000001170.V324407.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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