Inspection on 22/01/08 for The Cottage

This inspection was carried out on 22nd January 2008.

CSCI found this care home to be providing an Adequate service.

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

The Cottage 18/01/07

The Cottage 13/12/05

The Cottage 12/08/05

The Cottage 09/11/04

The Cottage 15/07/04

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Snydale Care Home

Hawkhills

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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 The Cottage 2050-2052 Hessle Road Hessle Hull East Yorkshire HU13 9NW Lead Inspector Sarah Rodmell Unannounced Inspection 22nd January 2008 09:00 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 DS0000000841.V358523.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. DS0000000841.V358523.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Cottage Address 2050-2052 Hessle Road Hessle Hull East Yorkshire HU13 9NW 01482 645098 01482 633395 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) Mr Ian Crowther Mrs Karen Serena Harrison Care Home 30 Category(ies) of Dementia (30), Old age, not falling within any registration, with number other category (30) of places DS0000000841.V358523.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th January 2007 Brief Description of the Service: The Cottage is situated on the outskirts of Hull, adjacent to the town of Hessle. The home is registered to provide care and accommodation for up to 30 older people. Accommodation is provided on two floors, with a passenger lift allowing access to the first floor. Access to two rooms on the first floor still requires the negotiation of a short flight of stairs. Local shops, health services and large retail shops are within close proximity to the home, with local bus services available adjacent to the home. The registered manager told us at the time of the visit that the fees for living in the home are £350 per week with additional charges for extras, which include toiletries and the hairdresser. DS0000000841.V358523.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is one star. This means the people who use this service experience adequate quality outcomes. This inspection report is based on information received by the Commission for Social Care Inspection (CSCI) since the last inspection of the home, including information gathered during a visit to the home. Since last inspection the CSCI has not received any new information about the home from the registered provider and there have been no letters or complaints to us from other people. As part of the inspection we send out an Annual Quality Assurance Assessment (AQAA), which is a self-assessment document that the registered person must complete and return to the Commission. It should show how well the home is meeting regulations and National Minimum Standards, what has been done to improve the service since the last inspection or since registration and what still needs to be done. The provider returned the AQAA to us so we had the necessary information to help us check what relatives of people living in the home and professionals working with them think of the service. We sent surveys out but none were returned to us. The site visit took place on 22 January 2008, beginning at 9.30 am and ending at 4.30 pm. The provider was not told in advance of the date or time we planned to visit. The manager was available for this visit and we spoke to the manager, people living in the home, visitors and staff during the visit. We looked around the home including people’s rooms and the shared areas of the home, and we inspected records of people’s care, staff files, health and safety documents and other records. One relative told us ‘ this is a good home’. A person living in the home said that they like the home and that they are happy to stay there. They also said that they ‘cant find any fault’. What the service does well: People’s needs are assessed before they move into the home to make sure that their needs can be met by the home. DS0000000841.V358523.R01.S.doc Version 5.2 Page 6 There are plans of care in place that includes the details of people’s needs and how these are to be met. This provides information to the staff team to enable them to support people. People are supported to maintain contact with their family and friends and their life choices are respected. There are systems in place to support people should an allegation of harm occur within the home. What has improved since the last inspection? What they could do better: In order for people’s medication needs to continue to be met, medication that is required to be kept cool must be stored securely. This would help prevent medication becoming missing and as a result people’s medication needs not being fully met. The activities on offer within the home could be increased and a wider choice given. This would help to meet the leisure needs of the people living in the home and to give them more choice. The correct references and checks must be undertaken on people to make sure that they are suitable to work in the home, and that they have the right qualifications and experience. These also confirm that they do not hold a criminal conviction which may make them unsuitable to work with vulnerable people. Some repairs and refurbishment is now required in the home as the furnishings make the home less comfortable for the people living there. The exterior has required attention for some time and has been reported on in a previous inspection report. Some of the carpets in the home are becoming threadbare and pose a risk to the safety of both the people living in the home and those visiting or working in the home and must be replaced. The staff induction needs to be completed to a Nationally recognised standard, this would help to make sure that staff are as competent as possible when they start to work in the home. DS0000000841.V358523.R01.S.doc Version 5.2 Page 7 A quality assurance system needs to be operated in the home, including visits by the registered person. This would help to develop a picture of how well the home is meeting the needs of the people living there, including the points of view of the people living in the home. In turn this information could be used to improve the service provided by the home. Although the registered manager confirmed that the majority of the required maintenance work has been undertaken there is not always evidence to prove this. There is therefore not sufficient evidence that the environment is safe, and no record of when this work is next to be undertaken. 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. DS0000000841.V358523.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 DS0000000841.V358523.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 People who use the service experience good outcomes in this area. We have made this judgment using available evidence including a visit to this service. People are assessed before moving into the home to make sure that the home can meet their identified needs. EVIDENCE: Assessing people’s needs prior to them moving into the home helps to make sure that only people whose needs can be met by the home are admitted. Of the three people’s files we looked at all included an assessment of their needs. This included one that had been completed by the Local Authority. A relative also told us that they had received information about the home before moving into it. The registered manager told us that the home does not provide intermediate care. DS0000000841.V358523.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 & 10 People who use the service experience adequate outcomes in this area. We have made this judgment using available evidence including a visit to this service. People’s privacy is respected and their health and medication needs are met through individual care planning. EVIDENCE: Three peoples’ files were looked at and all three contained a copy of their assessment of their needs and a plan for their care. The areas covered by the care plans included details of people’s level of mobility and vision, and risk assessments including those for people’s nutritional needs, the use of bed rails and for promoting people’s skin care. Care plans also held long and short term goals on how people’s needs were to be met. People’s diary notes contained information regarding their health needs and how these are being met and when we talked to people they told us that they felt their health needs were being met. DS0000000841.V358523.R01.S.doc Version 5.2 Page 11 The information contained in the AQAA included that there were a number of people who had suffered with pressure sores. This was discussed with the registered manager who told us that there is good support from the district nurses in the area for people who suffer with pressure sores. A relative told us that the district nurse and a physiotherapist come in and support their relative with their health needs. However staff have not undertaken training on how to care for people with pressure sores; this would assist staff both in their understanding of this and in the meeting of the needs of the people living in the home. Medication is stored in lockable containers in the main lounge of the home. The registered manager told us that this was for safety reasons. Records are kept for the receipt of medicines. However prior to these being completed medication is kept within the office of the home and at the time of the visit these were not secure as the door was unlocked. There is a photograph of each person on their medication records that helps to identify them and reduce the risk of medication errors. Records for the administration of medicines were found to be up to date and correct, as were the records of medicines returned to the pharmacy. There is a refrigerator for the storage of medicines that are required to be kept cold, However this fridge is not lockable and the safety of these medicines is compromised. Staff were observed to be respectful in their interactions with the people who live in the home. Staff told us how they encourage people and offer them choices including offering them support to be in their room if they wish to have privacy. One person has their own telephone in their room so they can make and receive personal calls. DS0000000841.V358523.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 People who use the service experience adequate outcomes in this area. We have made this judgment using available evidence including a visit to this service. People are offered choices in their lives, they are supported to maintain relationships, have some leisure opportunities and have their dietary needs met. EVIDENCE: People’s daily notes included details of the person’s choices, for example what food they like and what time they like to get up and go to bed. There are records of activities within the home. However these are limited and the registered manager is aware of the need to improve these. Staff told us how people make choices and that these choices are respected, for example, people can decide when to get up, what to wear, whether to have a drink and if they want to have their cup of tea in their room. Staff also described how they knock on people’s doors before going in to respect people’s privacy. DS0000000841.V358523.R01.S.doc Version 5.2 Page 13 A relative told us that they can visit at anytime and do visit regularly, also that other family members can visit as they wish. They said that their relative has had a telephone installed in their room so that they can keep in touch with them. There are menus available that are designed over a 4 week basis. They offer a varied diet and also cater for people who may have specific dietary needs for example, people who require a gluten free diet. Lunch was observed to be relaxed with people receiving support to assist them with their lunches. There were two choices of main course and people spoken to said that they liked the food. We were told that people sometimes receive large portions of food, and that the quality could be improved: two other people told us that they liked the food provided. Food that was prepared for people who required their food to be softer was not well presented as this was mixed together and did not appear appetising. This was discussed with the registered manager who agreed that this was something that could be changed. Individual support offered to people to help them eat their meal was appropriate and staff sat with the people living in the home to eat their lunch. DS0000000841.V358523.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use the service experience good outcomes in this area. We have made this judgment using available evidence including a visit to this service. People are supported to raise concerns and systems are in place to help them to be protected from harm. EVIDENCE: There is a complaints policy held within the home. There have been four complaints over the last year and these were discussed with the registered manager. Although one complaint had been signed by the individual to confirm that they were happy with how it had been dealt with, this was not always the case and the registered manager is aware of the need for this. When we spoke to staff about complaints they were confident in their replies on how to handle a complaint and that this would be dealt with by the registered manager. People living in the home felt that they could approach the manager should they wish to raise a concern about the home. There is a copy of the Local Authorities policy ‘ The Protection of Vulnerable People’ available within the home and when spoken to staff reflected a good understanding of protecting vulnerable people and also on how to handle confidential information. DS0000000841.V358523.R01.S.doc Version 5.2 Page 15 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 & 26 People who use the service experience adequate outcomes in this area. We have made this judgment using available evidence including a visit to this service. People live in a clean home that is comfortable but that requires some maintenance work in areas: this detracts from its homeliness and may pose a risk to people’s health and safety. EVIDENCE: During the visit people appeared comfortable in the lounges and dining areas of the home. A staff member told us that the carpets have been replaced in the communal areas. The exterior of the property continues to be in need of maintenance/painting, this has been previously required of the home, with an initial requirement date of February 2006. DS0000000841.V358523.R01.S.doc Version 5.2 Page 16 Several areas of the home are in need of refurbishment. At least two of the bedrooms were found to have a carpet that was in need of replacement, being almost threadbare in places; this could pose a risk of injury to the people in the home. Some mattresses were nearing the time for replacement and wallpaper was hanging from the wall of one bedroom whilst others were in need of redecoration. Some windows did not have restrictors in place and also required re-painting. The laundry area has had a new boiler. However the walls have not been finished from this work and the seals on the flooring require attention to make sure that they are watertight. If the floors and walls are not impermeable the control of infection procedures within the home may be compromised. The home was clean throughout and a relative told us ‘ they are always cleaning’. The majority of areas of the home did not have any unpleasant smells, although two bedrooms did and this requires attention. DS0000000841.V358523.R01.S.doc Version 5.2 Page 17 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 & 30 People who use the service experience poor outcomes in this area. We have made this judgment using available evidence including a visit to this service. People are supported by a staff team, who are not always correctly recruited and who have not been fully trained. EVIDENCE: The duty rotas showed that there are normally 4 staff on duty each day between 7 am and 2.30 pm, with the registered manager confirming to us that if necessary, staffing levels can be reduced to 3 between 2.30 pm and 10 pm. A relative told us that they ‘get on well with all the staff’. The AQAA recorded that there had been high turnover of staff in the home over the last year. The registered manager told us that this was primarily due to people leaving for other jobs that had higher salaries, with one person leaving on personal grounds. The registered manager told us that all the vacancies had been filled. The AQAA also recorded that there were no male staff working in the home. Employing male carers would allow men living in the home the opportunity to receive personal care from someone of the same sex, helping maintain their dignity. The registered manager told us that there had been no applications for employment by men and consequently this was an ongoing problem. DS0000000841.V358523.R01.S.doc Version 5.2 Page 18 We looked at three staff files. All three of the files included an application form from the staff member and one contained evidence that two written references had been received, which helps confirm that the person is suitable for the role they have applied for. The other two staff members had only one reference in place and one of these had been written ‘To whom it may concern’. This means that the reference was not written directly to the care home and that the person writing the reference could not comment on the person’s ability to work in a care setting. Without two written references in place is not easy for the employer to make sure that the person is suitable to work in the care home. Two of the three staff had a Criminal Records Bureau (CRB) check in place, this check helps to make sure that the person does not hold a criminal conviction, which may make them unsuitable to work with vulnerable people. Staff told us that they had completed this check as part of their application for working in the home. All of the three staff had an induction package in place in their files, although only one of these had been completed. Staff spoken with recalled their induction and the courses that they had undertaken. Completing an induction would help staff to understand their role from when they are first employed within the home. There was no evidence to show that the induction met with the requirements of Skills for Care, which would mean that it met National training requirements. Of the three files, one contained evidence that the staff member had completed training. Their training included Medication, First Aid, Understanding Dementia and Health and Safety. One other person had documents that showed that they had applied to undertake training. Making sure that the staff team are correctly trained is essential in the ongoing meeting of peoples’ needs. A staff member told us how they had completed a moving and handling course and that their certificates were up to date, as they had completed a variety of courses before they came to work in the home. Another person told us how they had training booked for the near future. DS0000000841.V358523.R01.S.doc Version 5.2 Page 19 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, 33, 35 & 38 People who use the service experience adequate outcomes in this area. We have made this judgment using available evidence including a visit to this service. People are supported by management systems that do not always make sure that people’s health and safety needs are fully met. EVIDENCE: The registered manager told us that they hold the Registered Managers Award and a City and Guilds Management for Care certificate. They have completed year 1 of a social care course, updated their POVA (Protection of Vulnerable Adults) training and undertaken Mental Capacity Act training. None of these certificates were available as the registered manager holds these and it is recommended that copies be kept within the home. DS0000000841.V358523.R01.S.doc Version 5.2 Page 20 There was no evidence available within the home to show that visits from the registered person takes place on a monthly basis as per Regulation 26 of the Care homes Regulations 2001. These visits help the senior management gain an insight into how well the home is meeting the needs of the people living in the home and without this information this they would not be able to assess this. The registered manager talked to us about the quality assurance system and we looked at the file. Although there is a system in place audits have only been completed in October 2007 and a full picture of the home has not been completed. Using the full quality assurance system would provide the management of the home with information showing how well the home is meeting its aims and objectives and the needs of the people living there. Two of the people living in the home receive support with their personal monies. Both of these have receipts kept for some but not all of their purchases and it was recommended to the registered manager that receipts should be kept of all expenditure including the hairdresser. Maintenance certificates were available for some of the checks completed within the home. These included the emergency lighting, nurse call system and portable fire fighting equipment. The registered manager told us that the maintenance of the home was up to date including the electrical wiring checks. However no certificate was available to confirm this and the registered manager agreed to forward this to the CSCI; this has not been received. The registered manager also told us that the lift had been services, although no evidence was available for this. DS0000000841.V358523.R01.S.doc Version 5.2 Page 21 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 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 Score X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 1 X X X X X X 2 STAFFING Standard No Score 27 2 28 2 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 2 X x 1 DS0000000841.V358523.R01.S.doc Version 5.2 Page 22 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 OP8 OP30 Regulation 18 Requirement The registered person must make sure that staff are trained to meet the needs of the people living in the home. The registered person must make sure that medication is stored securely and safely. The registered person must make sure that there are adequate opportunities for people to participate in leisure activities of their choice. The registered person must ensure that the complaints record holds evidence that complainants are satisfied with the outcome. This is an ongoing requirement with a previous timescale of 31/03/07 not met. The exterior paintwork, namely window frames and other fascias, must be maintained to an acceptable standard TIMESCALE OF 28/02/06 AND 30/04/07 NOT MET. The registered person must DS0000000841.V358523.R01.S.doc Timescale for action 15/06/08 2 OP9 3 OP12 13 16 15/04/08 15/04/08 4 OP16 22 15/04/08 5. OP19 17,23 30/04/08 6. OP19 13 30/03/08 Version 5.2 Page 23 7. OP19 23 8 OP19 23, 13 9 OP26 13 10 OP29 19 11 OP29 19 12 OP28 18 13 OP31 26 14 OP38 13 15 OP38 13 make sure, through a risk assessment basis, that windows do not pose a risk to the safety of the people living in the home. The registered person must make sure that the furnishings within the home are maintained to an acceptable standard. The registered person must make sure that the carpets within the home do not pose a risk to the health and safety of people. The registered person must make sure that the walls and ceilings of the laundry room are maintained to a standard so that the control of infection is not compromised. The registered person must make sure that the correct references are gained on potential staff members prior to their employment. The registered person must make sure that satisfactory POVA and CRB checks are undertaken on potential staff prior to employment. The registered person must make sure that staff undertake an induction which meets with the requirements of Skills for Care. The registered person must make sure that visits to the home are undertaken as per the requirements of Regulation 26 of the Care Homes Regulations 2001. The registered person must provide evidence that the electrical wiring in the home has been tested as safe. The registered person must provide evidence to the CSCI that the lift has been tested as safe. DS0000000841.V358523.R01.S.doc 30/05/08 30/03/08 30/05/08 30/03/08 30/03/08 30/05/08 30/04/08 30/03/08 30/03/08 Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 Refer to Standard OP15 OP27 OP31 OP33 OP35 Good Practice Recommendations The registered person should make sure that all foods are well presented. The registered person should offer people the opportunity for personal care to be completed by people of the same gender of that is the individual’s choice. The registered manager should make available evidence of their qualifications. The registered person should make sure that the quality assurance system is fully implemented within the home. The registered person should make sure that individual receipts are obtained for all purchases. DS0000000841.V358523.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle upon Tyne NE1 1NB 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. Extracts may not be used or reproduced without the express permission of CSCI DS0000000841.V358523.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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