CARE HOMES FOR OLDER PEOPLE
The Knolls Care Home Plantation Road Leighton Buzzard Bedfordshire LU7 3JE Lead Inspector
Katrina Derbyshire Unannounced Inspection 8th May 2007 08:05 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 The Knolls Care Home DS0000058804.V334432.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. The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service The Knolls Care Home Address Plantation Road Leighton Buzzard Bedfordshire LU7 3JE 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) 01525 380600 01525 851847 Integrated Nursing Homes Limited Mrs Dawn Bishopp Care Home 56 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (56), of places Physical disability over 65 years of age (10) The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. 5. 6. 7. The home can accommodate a maximum of 56 people. The home can accommodate up to 56 people in the category old age (OP). The home can accommodate up 10 people over 65 years in the category of physical disability (PD(E)). The home can accommodate up to 10 people over 65 years in the category of dementia (DE(E)). Service users in the PD(E) category must only be accommodated in the 10 rooms designated and assessed as suited for service users. A suitably qualified registered nurse must, at all times, be in post to support Mrs Bishopp in clinical areas. The home is permitted to accommodate one named service user (Application No. V000032333) under the age of 65 in the categories of PD only. 27th October 2006 and a random inspection on 19th February 2007. Date of last inspection Brief Description of the Service: The Knolls is registered to provide social care and nursing care for fifty-six people over the age of 65, ten of whom may also have dementia and ten of whom may also have physical disabilities. The building consists of a large original period house that has undergone structural alteration to extend the accommodation. The home has thirty-eight single rooms and nine shared rooms all with en suite facilities. Lounge and dining facilities are situated on both floors. Access to the first floor is via the stairs or shaft lift. The property has a semi-rural location to the north of Leighton Buzzard and neighbours the local golf club. The town provides a wide range of shops and other amenities, but transport would be needed to get there this is not available at the home. A copy of the homes statement of purpose and service user guide are available in the front reception. However their content at the time of this visit was not up to date so information available to prospective people who may wish to move into the home, was incorrect. The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 5 The manager Dawn Bishopp provided the following information on charges in April 2007. The fees for this home vary from £500.00 per week, to £750.00 per week, depending on the funding source and assessed need of the person. Additional charges are made for hairdressing, chiropody, telephone calls and newspapers. The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 6 SUMMARY
This is an overview of what the inspector found during the inspection. This visit was to undertake a key inspection. A further inspection had been undertaken since the previous key inspection on 27th October 2006, this was a random inspection on 19th February 2007. This was in response to concerns raised by two anonymous callers to the Commission for Social Care Inspection. The Commission for Social Care Inspection undertook the random inspection with, Bedfordshire police and Social Services. A copy of this report is available on request. This unannounced inspection was carried out on 8th May 2007. During the inspection several areas of the home were visited and the inspector spent time with many of the people who live at the home in the communal areas. The care of four people was examined by looking at their records and interviewing them and staff who look after them. The views of people living at the home and their relatives were also received through 19 returned comment cards and their feedback has been used alongside information from the home, through written evidence in the form of a pre inspection questionnaire to assess the outcomes within each standard. Evidence used and judgements made within the main body of the report include information from this visit and the random inspection carried out on 19th February 2007. Observations of care practice and communication between the people living at the home and staff was also made at the inspection. The focus of this inspection was to look at the key standards and to follow up on previous requirements. What the service does well:
People living at this home feel that if they are unhappy with something that they can make a complaint. They feel comfortable doing this and believe that their concerns will be listened to and acted upon. One person said, “ l would talk to Dawn the manager, she always listens to me and if something is not right, she changes it”. There continues to be systems in place that make sure areas of health and safety are managed well. Fire equipment is serviced regularly as is other equipment at the home, for example electrical items. Staff are trained in areas such as moving and handling, food hygiene and infection control. This means people live in a home that has undertaken precautions and measures to make it a safer pace to live and work in.
The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better:
The statement of purpose and service user guide are the documents that all prospective people wishing to move into the home must be supplied with and copies should be given to everyone already living at the home. They should describe all the services that the home offers, should include how much you have to pay, all about the manager and staff and accommodation. Nearly half
The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 8 of the people that sent in their comments to the Commission for Social Care Inspection said that they did not receive enough information about the home, before they moved in. The statement of purpose that was at the home was not correct and described a previous manager and previous regulator for example. This means people are not given the information that they need to help them decide if they want to move in or not, and if they do it is not accurate. Also before someone moves in to the home, an assessment must be undertaken to look at the person’s individual needs. This is the only way staff at a home will know if they have the experience and skills to provide the care that the person needs. This with other documents that are completed in the early stages of someone’s admission, especially for emergency admissions are very important and need to be completed in full. This had not been done, someone that had recently moved had several gaps in their assessment documentation. This means that staff do not have all the information that they need about someone. 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. The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 9 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 The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 10 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, 3 & 6 People who use this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Assessment systems and information on the home is not sufficient to ensure people can make an informed choice as to whether to move into the home or not. EVIDENCE: The statement of purpose examined at this visit and subsequent registration visit by another inspector on the 10/05/07, was noted to contain inaccurate information. Examples included a previous manager at the home and the National Care Standards Commission; the services provided by the home were also not clear, as were other entries. Within an improvement plan submitted by the management at the home to the Commission for Social Care Inspection, the management had identified deficits and advised that a revision of the statement of purpose would be undertaken, this had not been undertaken. 8
The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 11 out of 19 returned comment cards stated that they had not received sufficient information before moving into the home. The inspector spoke with two people at this visit that stated that they did not receive any document about the home, although one recalled a “flyer type brochure”. One person said, “no l wasn’t given anything like that, l know there is a contract somewhere but nothing else”. On examination of care records it was noted that all contained an assessment of need. One person’s assessment did not have any entries within their social needs assessment, although it is acknowledged that their admission was over two years ago. However the documents examined for one person who had moved into the home in the past few weeks, was also incomplete. One assessment named ‘ mental status questionnaire’ had been filled in incorrectly. The guidance had not been followed, the person’s score should have been 9, in accorandance with the guidance but the person had been given 79. On checking to see if this was a typing error it was confirmed that it was not, as the scoring entered in the individual boxes did not follow the guidance and showed that the person completing this did not understand the assessment tool. In addition further forms used by the home to be completed within 24 hours of admission, had not been completed in full. Intermediate care at the time of this visit was not offered. Although the owner of the home had submitted an application to the Commission for Social Care Inspection to seek registration to offer this service. The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 12 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 this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Medication systems in the home are sufficient and reduce the risk of people not receiving their prescribed medication. EVIDENCE: Documents were seen within the individual records of people that showed that management in the home had been undertaking audits on the care records. One audit undertaken in February 2007 identified several deficits, for example no social needs identified and gave timescales for action and nominated a person responsible for this. The actions identified had been carried out. In the week prior to this inspection, management at the home had taken action with a member of staff due to concerns about the standard of recording. Improvements were seen in the care planning for people, the guidance to staff had improved for example indicating when someone needed the assistance of
The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 13 two staff to wash and dress. However it was acknowledged by the manager at this visit that development was still required. 16 of the 19 returned comment cards stated that they received sufficient healthcare, the remaining 3 comment cards had ticked usually. Pre inspection questionnaire information showed that all people living at the home were registered with a General Practitioner. One person’s care record contained extensive documentation on the care of their wound. These entries demonstrated that constant guidance had been sought from the local tissue viability nurse, and staff had followed her recommendations. In addition guidance from a dietician was seen within the records examined, again the supplements that had been recommended were in stock at the home and were seen to be given to the person during this visit. The manager advised that the administration of medication had changed recently. On the first floor of the home medication is given to people by Registered Nurses and on the ground floor by senior care workers. The medication records that were examined were noted to contain initials when medication had been given; the stocks counted matched the amounts recorded. Audits had been carried out by management in the home. As reported in February 2007 people in the main through discussion felt that staff in the home respected their privacy and dignity. They confirmed that staff would knock on doors before entering and would communicate with them in a courteous manner. People spoken with indicated that no staff had treated them in an unacceptable way. Observation of people living at the home showed them to be clean and all were noted to be well presented. The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 14 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 this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The level of activities in the home have improved to meet the social and cultural needs of the people living there. EVIDENCE: At the random inspection in February 2007 staff were seen to assist people in eating their meals when necessary. No food was seen to be left in front of a person who would be dependant on staffs help to eat their meals. At this inspection the serving of breakfast in the ground floor dining area was observed. Menus were on each table and the meal was noted to be relaxed with people receiving the support that they needed. 15 of the 19 returned comment cards suggested satisfaction with the meals at the home. Daily menus were also displayed on boards on both floors, and their content was offered. Nutritional risk assessments had also been undertaken on people and contact with a dietician had taken place when a high risk had been identified.
The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 15 A regulation 26 report submitted by the home showed that a financial grant had been obtained to refurbish the tennis court area at the home. The manager confirmed that plans were in hand for this work to be undertaken. Activities available to people included, quizzes, film shows and plans were in place to hold a tasting event so people at the home could choose the tea options in the home. Several people spoken with stated that they felt the food at the home to be of a good standard. Religious services were available and dates and times of these services were advertised throughout the home. Options available to people in maintaining control, independence and choices in their lives included, choice of meals, voting, choice of clothing, access to a complaints procedure and access to community healthcare support. People living at the home and records confirmed that the choices associated with people’s daily lives were available to them whilst living there. The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 16 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 this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Improvements in the management of all referrals under the Protection of Vulnerable Adults scheme ensure that they are in accordance with local guidance and protect the people at the home. EVIDENCE: In February 2007 a random inspection was undertaken following information received by the Commission for Social Care Inspection. This multi agency visit following joint agreement between the Commission for Social Care Inspection, Bedfordshire Social services and Bedfordshire Police at a strategy meeting held in accordance with the local Protection of Vulnerable Adults policy, was carried out. The visit was undertaken to look at the specific concerns that were raised. During this time all agencies reported that the management at the home gave full co-operation and assisted the inspection process by providing information when requested. There was no evidence found by the multi agencies to substantiate the concerns that had been raised. The homes complaints procedure was clear and timescales for response was noted to be included. All people spoken with stated that they knew of their right to complain and would feel comfortable to do so. Records were seen of
The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 17 complaints received, and that management had investigated the concerns, responded and taken any action to make changes if needed. In February 2007 it was reported that in the two months prior to this visit the home had reported two incidences in accordance with the local policy on the protection of vulnerable adults. The management’s actions and conduct was swift, and they demonstrated a responsible approach to seek the best outcome for the people. This showed that the manager had acted in accordance with local protocols to safeguard the people living at the home. The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 18 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 this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The overall quality of the furnishings and fittings is good and provides a spacious and homely environment for the people at the home. EVIDENCE: Accommodation was seen to be across two floors with a passenger lift available to access these. On the ground floor was a large lounge and dining area a previous available additional sitting area was not being used by people who live in the home, as it had been identified as intermediate care living space. On the first floor were two smaller sitting rooms, dining space is limited in these areas, and so many people eat their meals from small tables at their armchairs. Assisted bathing and shower facilities are in place throughout the home. Several sitting, dinning areas and people’s individual rooms were seen,
The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 19 these were clean and the furnishings and décor within these areas were of a good standard. All people spoken to say that they found their environment very comfortable and all spoke highly of the standard of the external grounds. The home continues to be clean and free from offensive odours. Policies are in place regarding infection control and staff were seen to be using protective clothing where needed. The disposal of clinical waste is through a contractual agreement and the inspector saw that this was disposed of correctly. Hand washing facilities were sited in the areas where infected material/clinical waste was being handled. The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 20 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 this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Systems in this home for the recruitment of staff are robust and lower the risk of appointing unsuitable people to work at the home thus protecting the people living there. EVIDENCE: The homes recruitment policy and procedures as previously assessed are clear and comprehensive, documents submitted by the home to the Commission for Social Care Inspection show that no change has taken place to these policies. References are taken prior to staffs’ commencement and the relevant Criminal Records Bureau check is also carried out and evidence of this having been undertaken was seen. Certificates of qualifications are present within staff files, although files were noted not to have a systematic filing arrangement. Although the most recently employed staff had in fact been transferred from the employment of another home in the company, therefore no Criminal records Bureau check had been undertaken on them as this had been sought when they were first employed. The induction and training of staff was recorded in the individual records of all employees. Staff through interviewing confirmed that they had undertaken a
The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 21 variety of courses these included health and safety, moving and handling and national vocational qualifications in care. The rotas supplied by the home show that there are sufficient numbers of staff on duty throughout the day and night to meet the needs of the people at this time. People confirmed that staff were available to help and assist them when they need help. Training records examined that were supplied by the home show that staff had undertaken statutory training, including moving and handling, fire safety and food hygiene. In addition staff confirmed that they had attended a variety of courses including dementia awareness. People living at the home who were spoken with felt that the staff had a satisfactory level of knowledge and felt confident in their abilities to meet their needs. Changes to the deployment of staff had been taking place in the months prior to this visit. Changes in the number of Registered nurses had occurred and an increase in the responsibilities to senior support workers had been implemented. At the time of this visit a Human Resources manager was visiting the home to hold meetings with any staff that wished to raise any concerns that they may have. The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 22 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 this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The systems at this home for managing health and safety are good protecting the people through reducing risks in this area. EVIDENCE: As reported in February 2007 recent changes had taken place regarding the management arrangements at the home. A previous manager at the home had been employed again alongside a Registered Nurse to provide an overview and guidance on clinical matters in the home. In addition the company had appointed a new area manager who is responsible for monitoring care
The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 23 standards and has to date submitted one regulation 26 report to the Commission for Social Care Inspection. Staff were interviewed and stated that they found the management at the home to be approachable and supportive. Feedback form staff included that they found the management to be professional and knowledgeable. Observation of the managements conduct towards both people living at the home and staff showed that it was both courteous and proficient during that visit and this one. The home manages a small sum of money on behalf of several people. Records were examined that showed a balance sheet was maintained for each person. The cash balances of two people’s monies was counted and noted to be correct. Receipts of expenditure that had occurred were also kept with the balance sheet to assist in providing an audit trail. Health and safety systems at the home were seen to be carried out in accordance with the guidance within the homes policy. Staff wore protective clothing when serving food at lunchtime. In addition cleaning products were seen to be locked away, risk assessments had been undertaken for areas and activities in the home. Service reports were also examined that showed the equipment in the home was serviced regularly. The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 24 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 1 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 25 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 OP1 Regulation 4&5 Requirement A statement of purpose and service user guide that contains all matters listed within the standards must be available to people in the home and prospective people, so that they know the services that the home offer. This will provide them with information to assist them on making a decision on whether to move into the home and what services they can expect to receive. Assessment of peoples needs must be completed in full, accurate and comprehensive to ensure the assessed needs of a person are made clear. Care plans must be clear in their guidance to staff to ensure effective and consistent care is provided to all residents. (Previous requirement timescale of 31/03/07 partially met). Timescale for action 30/06/07 2. OP3 14(1) & (2) 15/07/07 3. OP7 15 15/07/07 The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 26 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 OP29 Good Practice Recommendations Staff files should be maintained in a systematic way to aid in identification of information included, and information that still needs to be sought. The Knolls Care Home DS0000058804.V334432.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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
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