Inspection on 11/07/07 for The Old Hall

This inspection was carried out on 11th July 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Old Hall 28/05/08

The Old Hall 21/08/06

The Old Hall 02/02/06

The Old Hall 17/08/05

The Old Hall 20/01/05

The Old Hall 09/09/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE The Old Hall The Old Hall Malpas Nr Chester Cheshire SY14 8NE Lead Inspector Maureen Brown Unannounced Inspection 11 July 2007 09:40 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 Old Hall DS0000054820.V333800.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 Old Hall DS0000054820.V333800.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Hall Address The Old Hall Malpas Nr Chester Cheshire SY14 8NE 01948 860414 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) Mrs Mary Kathleen Friend Mr Thomas Friend Mrs Mary Kathleen Friend Care Home 18 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (18) of places The Old Hall DS0000054820.V333800.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 18 service users to include:* Up to 18 service users in the category of OP (Old age, not falling within any other category) * No more than 4 agreed named service users in the category of DE(E) (Dementia aged over 65 years) 21st August 2006 Date of last inspection Brief Description of the Service: The Old Hall is a care home providing care and accommodation for up to eighteen older people. However, the home currently has fourteen residents who each have their own bedroom. It is a privately owned family run business. The home is in a rural setting in the Cheshire village of Malpas, situated close to a small range of local shops and other village facilities and amenities. The Old Hall is a two-storey adapted building and residents are accommodated on both floors. Access between floors is via a stair lift or the stairs. Residents’ accommodation consists of ten single and four double bedrooms, all but one have en-suite toilet and bathroom facilities. There are separate lounge and dining areas and a conservatory that overlooks the garden. The Old Hall has gardens to the rear with steps leading down to the lower levels. Handrails are provided and the top level is fully accessible to service users. Car park spaces are available to the front of the property. The home has fourteen staff that comprises of the Registered Manager, senior care assistants and care assistants. The cook and cleaner support them in their roles. The fees at The Old Hall are between £353.00 and £465.00 per week. Optional extras include hairdressing, chiropody and newspapers. The Old Hall DS0000054820.V333800.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on 11 July 2007 and lasted five hours. This visit was just one part of the inspection. Before the visit the home was also asked to complete a questionnaire to provide up to date information about services at the home. Questionnaires were also made available for residents, relatives and other professionals to find out their views. Other information since the last key inspection was also reviewed. During the visit various records and the premises were looked at. A number of residents and staff were also spoken with and they gave their views about the service. Twenty-three out of thirty-eight standards were assessed and some were met. All the key standards were assessed. Feedback was given to the registered manager at the end of the visit. What the service does well: The home had an established staff team who were keen for high standards to be maintained. Residents’ plans of care and individual case notes were well documented and reflected each resident’s needs. Day to day supervision of staff was good. The manager worked alongside the staff team on a regular basis. Meals were varied and reflected each person’s preference. They offered choice, when requested by the service user, and variety. A good standard of hygiene was seen throughout the home and the standard of décor was good. Service users commented “I usually like the meals”, “the home is usually clean”, “the care provided by the staff is good” and “sometimes there are activities arranged at the home”. Relatives commented “the staff are excellent”, “my relative could not be in a better place” and “the home has a very “homely” feel”. The Old Hall DS0000054820.V333800.R01.S.doc Version 5.2 Page 6 GPs and other professionals commented “the home gives good support to individuals”, “my contact with the staff has always been most rewarding” and “the service does care for the individual well”. What has improved since the last inspection? What they could do better: To ensure that service users and prospective service users and their families have up to date information the statement of purpose and service users guide should be reviewed annually. Also consideration should be given to producing alternative formats for these documents. A formal review must be undertaken on an annual basis for all service users, to ensure their needs are being met. To ensure service users health and safety is promoted “when required” medication that has not been used for aver six months should be returned to the pharmacist. Also creams and eye drops that have been opened should have that date written on the pharmacist label. To ensure that residents are cared for, by staff that are trained and competent to do their jobs, mandatory training must be undertaken by all staff and specialist training should be undertaken in line with the service users cared for. Also 50 of care staff must obtain NVQ level II in Care and the staff who have not received POVA training must do so. To ensure that staff are properly supervised in their role each staff members formal supervision must be completed and annual appraisals should be undertaken. Staff meetings should also be undertaken on a regular basis. To ensure that the home is run in the best interests of the residents and their views and opinions must be obtained and the information analysed. Also other interested parties and relative’s opinions must be obtained. Resident meetings should be held on a regular basis. The Old Hall DS0000054820.V333800.R01.S.doc Version 5.2 Page 7 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 Old Hall DS0000054820.V333800.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 The Old Hall DS0000054820.V333800.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): 1 & 3. Standard 6 was not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient information is provided for residents to make a decision about moving into the home. EVIDENCE: The statement of purpose and service users guide was presented in a bound folder and included all the information necessary to make an informed choice about the home. This included aims and objectives, information about the home’s manager and owners and complaints. A copy of the most recent inspection report was available in the office. Copies of the service users guide were available in the hallway and in each resident’s bedroom. It was produced in an A to Z format, in plain English and standard print format, which was easy to use, understand and read. A discussion was held with the manager regarding producing this document in other formats for ease of understanding to all prospective service users and a recommendation was made regarding this. The Old Hall DS0000054820.V333800.R01.S.doc Version 5.2 Page 10 It was recommended at the last visit that both the statement of purpose and service users guide are reviewed annually with confirmation of this kept with each copy. This recommendation was reiterated at this visit. Three care plans were examined and showed that assessments had been carried out with each person before moving into the home. Some service users confirmed that they were involved in the care planning process. During discussions with staff it was evident they were aware of service users needs. The manager confirmed that intermediate care was not provided at The Old Hall. The Old Hall DS0000054820.V333800.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ health, personal and social care needs are met by the staff team who enable them to maintain their privacy and dignity. Residents and relatives were satisfied with the support they received from the manager and staff. EVIDENCE: Out of fourteen residents, three care records were examined. These were comprehensive and well presented in individual folders. Each contained basic information covering all areas of personal care, risk assessments, visiting professionals sheet and a copy of the daily report sheets. They were reviewed on a monthly basis, in conjunction with the residents. It was noted that clients who were funded by the local authority had up to date annual reviews. However, privately funded clients did not have an annual review. It was recommended at the previous visit that a formal review be held annually for all privately funded service users. This recommendation was reiterated. Daily record sheets seen showed day-to-day activities of each resident. They were written clearly, easy to follow and were signed by carers. The Old Hall DS0000054820.V333800.R01.S.doc Version 5.2 Page 12 Professional visits were recorded and it was seen that the GP’s, district nurses, optician, audiologist and the chiropodist visited on a regular basis. All files examined had up to date service user plan reviews. Many of the service users within the home were not able to confirm that they had been involved in the care planning or review process. However they were able to confirm that staff helped them when they needed it, such as with personal care tasks and that staff were “diligent in their care”. One service user confirmed, “I usually like the meals and the home is usually fresh and clean.” Medication records examined showed that this was recorded and administered appropriately. Medication was kept secure and appropriate storage for controlled drugs was available if required. No controlled drugs were stored on the premises at this time. The home used a monitored dosage system and had a medication policy. They also had the Royal Pharmaceutical Society’s guide to control and administration of medicines for care homes and children’s services and also other books in relation to medication administration, which the manager said were used for reference purposes. It was recommended that “when required” medication, which hadn’t been used for over six months be returned to the pharmacist. Also that when creams and eye drops are opened that this date be recorded on the pharmacist label to ensure they are still effective. During discussions with the residents they commented, “staff are lovely” and “I would like more fresh vegetables” also “the staff are excellent”. Relatives spoken to said “the staff look after the welfare of people who are unable to look after themselves properly and safely”, “relationships with staff and residents is good” and “I feel my relative is well cared for and staff respond well to her needs”. Areas where relatives felt improvements could be made included “we are notified of important matters but not always straight away”, “the gardens could be maintained to a higher standard and some areas of the building need attention” and “I visit the home each week and I never see any activities going on for the residents”. Observations made during the site visit included seeing staff interaction with service users during lunch. The staff were attentive to service users needs and helped them when required. The general atmosphere within the home was warm and friendly. The Old Hall DS0000054820.V333800.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 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ were able to take part in a range of activities. Personal and family relationships were encouraged by the home and the staff team supported people with this. EVIDENCE: A range of activities were undertaken which included playing cards, scrabble, manicures, painting, armchair exercises, reading and ball games. Staff chat and go for walks with residents and assist them with choosing library books. Activity sessions are daily from 11.30 to 12.15 and 3.30 to 4.30. Outings include drives out in the countryside, afternoon tea in a local hotel, visits to the ice cream farm, garden centre, pantomime and Christmas lights. Staff shop for residents on a Monday and Friday each week and purchase items on their behalf from local shops. The manager and staff encourage visits from family and friends. Residents shared with the inspector the contact they had with family members and said they could choose to see visitors within their own room or in the shared areas. Relatives said that they were always made very welcome by the staff and were offered refreshments. The Old Hall DS0000054820.V333800.R01.S.doc Version 5.2 Page 14 Many of the residents had their own private phones, which helped them to keep in touch with family and friends. The kitchen was clean and tidy and fridge, freezer and hot food temperatures were recorded. It was noted at the previous visit that one of the fridges were showing a consistently high temperature record and the recommendation made at the time to replace the fridge had been met. Samples of menus were seen prior to the site visit. These showed that a varied diet was provided to the service users. At the site visit lunch was seen served. The meal consisted of braised steak, mashed potato, carrots, swede and green beans. Apple pie and custard was the desert. After the meal service users confirmed they had enjoyed the meal. Service users commented, “The meals are good here”. Breakfast is served in the bedrooms on service users waking, main meal is at lunchtime 12.30 and evening meal is 6.00. Drinks are available in between and supper at bedtime. The Old Hall DS0000054820.V333800.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 & 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents and relatives were satisfied with the support they received from the manager and staff. Policies were in place to ensure that residents were protected from abuse, neglect and self-harm, however not all staff had received training. EVIDENCE: The policy on complaints was seen and no complaints had been received at the home or by the Commission since the previous visit. All relevant paperwork was available in the event of a complaint being received. Residents and relatives confirmed that they were aware of the complaints procedure and to whom they would direct their complaint. Residents also confirmed that they had received a copy of the complaints procedure within the service users guide. The home had signed up to the Cheshire County Councils’ policy and procedure in line with the “No Secrets” guidance from the Department of Health. A copy of Cheshire’s Social Services policy on Adult Protection was available within the home and was accessible to staff. The manager and most of the staff had attended training on POVA following a previous requirement. The staff that had not received POVA training must do so and a recommendation was made. The home had policies on abuse, violence and aggression, guidelines on use of restraint and whistle blowing. The Old Hall DS0000054820.V333800.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a clean and comfortable environment for the people to live in. EVIDENCE: The Old Hall is furnished in a domestic style with additional equipment provided as necessary to meet the residents’ needs. The standard of décor was good. The heating and lighting was sufficient throughout the home. The garden was presented in a formal manner in a tiered style. Access to this area was through the lounge and residents said they enjoyed using the garden in the good weather. The home was clean, tidy and free from any unpleasant smells. Service users confirmed that they liked their bedrooms and that the “home was very nice”. Other comments included “I like living here” and a GP commented, “The home provides a safe and pleasant environment.” The Old Hall DS0000054820.V333800.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. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are protected by the homes recruitment policy and practices. Service users are supported by staff that do not receive adequate mandatory or specialist training. EVIDENCE: Agreed staffing levels were being maintained and the duty rota showed that senior care assistants support the manager and ancillary staff supports the care team. Six out of thirteen staff had obtained NVQ level II in care. A recommendation was made regarding achieving 50 of staff trained to NVQ level II in Care. All new staff completes a two day induction course which includes manual handling and fire safety awareness. The new staff member works alongside a member of staff for two weeks to get to know the residents and the home’s procedures. An induction book had been introduced since the last visit and each member of staff had received a copy. However, none of these books had been completed and a recommendation was made for them to be completed. Most staff had undertaken moving and handling, fire safety awareness, POVA and first aid training. Other courses that had been completed by some staff included food hygiene, oral health, continence promotion and dementia The Old Hall DS0000054820.V333800.R01.S.doc Version 5.2 Page 18 awareness training. A requirement for all mandatory training to be completed was made and a recommendation for specialist training to be undertaken was also made. The homes recruitment procedure ensures that the staff are suitable to work with vulnerable people. Three staff files showed that all pre-employment checks were carried out. Amongst the documentation available were application forms, Criminal Record Bureau checks, two references and health declarations. Staff meetings are usually held every three months. Minutes are kept and the issues that are usually discussed include residents, staffing and care plans. The last meeting was held in February 2007 and the previous meeting was in August 2006. Staff stated that the “manager gave good support”, “relationships between staff and service users were good” and “it’s a good home to work for”. Service users commented, “The care provided by the staff is good” and “the staff are lovely.” GP commented, “My contact with the staff at all levels has always been most rewarding.” Relatives confirmed, “The staff look after the welfare of people who are unable to look after themselves properly and safely” and “Relationships between staff and residents is good.” The Old Hall DS0000054820.V333800.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, 36 & 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The health, safety and welfare of the service users are protected. The views of service users are not fully obtained to influence the running of the home and service users are supported by staff that are not adequately supervised. EVIDENCE: The manager has completed her Registered Managers Award. She is the coowner of the home with her husband and is a Registered General Nurse. She had worked for fourteen years in the care of the elderly. Residents and relatives said that they felt the home was well run and that the manager and staff were very welcoming and friendly. This was confirmed during the site visit. Relatives said that the staff worked in a very professional manner. The Old Hall DS0000054820.V333800.R01.S.doc Version 5.2 Page 20 A quality assurance process was in place. Since the previous visit a system has been created to provide annual surveys to service users. These are currently being completed. A survey has also been developed for relatives and friends but this has not been circulated as yet. Surveys must be analysed and relative surveys completed and analysed on an annual basis. A requirement was made. The manager said that one to one staff supervision was given on a regular basis as she regularly worked alongside the staff team. However, formal recorded supervision was not available and a requirement was made. Appraisals were not undertaken on an annual basis and a recommendation was made. The homes policy on race, sex, age and disability was seen and primarily related to recruitment and selection of staff. Although there were no specific policies on equal opportunities it was noted through observations that service users had choices on rising and retiring, for example, when the inspector arrived at the home at 9.40 most of the service users were still in their rooms either having a lie in or their breakfast in their rooms. Also service users were able to decide on types of meals taken, joining in activities or not, where to sit and going to their own bedroom. The manager stated that she keeps no money on behalf of the service users on site. Service users have their own money or families are invoiced on a monthly basis. Safe working practices were in place. Up to date fire safety checks on extinguishes and fire system were in place. Up to date gas safety and electrical wiring safety, annual tests of hoist and stair lift. The home had policies relating to safe working practices including a range of risk assessments, COSHH, moving and handling and first aid. The smoking policy was not in line with recent changes in legislation and a recommendation was made. The Old Hall DS0000054820.V333800.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 Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 3 The Old Hall DS0000054820.V333800.R01.S.doc Version 5.2 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement The registered person must ensure that all privately funded residents have an annual review undertaken. The registered person must ensure that all staff completes mandatory training. The registered person must ensure that service user and relative surveys are completed and analysed. The registered person must ensure that all staff receive formal supervision six times a year with records kept. Timescale for action 30/09/07 2 3 OP30 OP33 18 (1)(c) 24 30/09/07 30/09/07 4 OP36 18 (2) 30/09/07 The Old Hall DS0000054820.V333800.R01.S.doc Version 5.2 Page 23 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 6 7 8 9 10 Refer to Standard OP1 OP1 OP9 OP9 OP18 OP27 OP28 OP30 OP33 OP36 Good Practice Recommendations The registered person should ensure that the statement of purpose and service users guide is reviewed annually. The registered person should consider producing the service users guide in alternative formats. The registered person should ensure that “when required” medication has not been used for over six months that it is returned to the pharmacy. The registered person should ensure that creams and eye drops are dated once opened. The registered person should ensure that staff that have not received POVA training do so. The registered person should ensure that staff meetings are held on a regular basis with records kept. The registered person should ensure that 50 of the staff team obtain NVQ level II in care. The registered person should ensure that all staff undertake specialist training. The registered person should ensure that resident meetings are undertaken with records kept. The registered person should ensure that all staff receive an annual appraisal with records kept. The Old Hall DS0000054820.V333800.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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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