Inspection on 09/03/06 for The Orchards

This inspection was carried out on 9th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Orchards 20/11/07

The Orchards 15/05/07

The Orchards 20/09/06

The Orchards 09/08/05

The Orchards 07/03/05

The Orchards 17/09/04

The Orchards 15/01/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Orchards The 164 Shard End Crescent Shard End Birmingham West Midlands B34 7BP Lead Inspector Lisa Evitts Unannounced Inspection 9th March 2006 10:45 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 Orchards The DS0000024876.V285948.R01.S.doc Version 5.1 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. Orchards The DS0000024876.V285948.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Orchards The Address 164 Shard End Crescent Shard End Birmingham West Midlands B34 7BP 0121 730 2040 0121 730 1655 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) Southern Cross Care Homes No 2 Limited Mrs Kathleen Kirby Care Home 72 Category(ies) of Dementia - over 65 years of age (72), Old age, registration, with number not falling within any other category (72) of places Orchards The DS0000024876.V285948.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 66 persons requiring nursing care and 6 persons requiring residential care The home may accommodate 5 named residents between 50 and 65 years of age. 9th August 2005 Date of last inspection Brief Description of the Service: The Orchards is a modern purpose built care home first registered in 1998 and situated in a residential area close to local shops and public transport links. The home provides 24 hour nursing, residential and respite care for a maximum of 72 older people. This includes the provision of transitional care for up to sixteen older people who are in need of short-term care arranged by two Primary Care Trusts. Accommodation is available over two floors and each bedroom is for single occupancy with an en suite facility. Provision can be made for two companion bedrooms if required, subject to availability. There are two good-sized lounges and one dining room on both floors. There is a pleasant enclosed courtyard with a variety of attractive features, which is within easy access for residents. The first floor is serviced by two passenger lifts. The home has a hair salon and the hairdresser visits once a week. Security is good at the home and CCTV is unobtrusively installed, to monitor the car park and reception area. There is limited parking space available at the front of the home however there is ample space to the rear of the building. Orchards The DS0000024876.V285948.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was undertaken by two inspectors over one day and was assisted throughout by the Registered Manager. There were 66 residents living at the home on the day of the inspection, this included three residents receiving transitional care. Information was gathered from speaking with residents and relatives, observing care staff perform their duties and examining care and health and safety records. A partial tour of the building was undertaken. There was a good atmosphere in the home and staff were interacting well with the residents. It was apparent that staff had built up a good rapport with the residents and their relatives. This is the second statutory inspection for the 2005-2006 year and it is recommended that this report is read in conjunction with the previous inspection report for the home. What the service does well: Residents are provided with a clean, homely and safe environment to live in, where staff interact well with the residents and their families. One resident said, “I couldn’t be better off, I’m very happy here” Residents are able to make decisions about how they wish to spend their day and are involved in changes they would like to see within the home. Residents and relatives meetings are regularly held and this ensures that everyone has the opportunity to discuss ideas and concerns in an open atmosphere. The home is regularly monitored for quality and the views of residents are sought and acted upon. Comments from residents included: “The girls come in and play dominoes with me” “I like the food, plenty of choices” “If I had a problem I would talk to the head one” “I’m very happy with my room” “Staff are very obliging” “You can get up what time you like” Relatives also commented: ”The staff are very approachable” “We know all the staff by name” “Staff are very good and polite” Orchards The DS0000024876.V285948.R01.S.doc Version 5.1 Page 6 “We can come at anytime” What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Orchards The DS0000024876.V285948.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Orchards The DS0000024876.V285948.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The assessment processes are comprehensive and ensure that the resident knows that their assessed needs can be met. EVIDENCE: All of the four files reviewed had pre admission assessments undertaken. The manager had devised a further assessment tool in order to help establish as much information about the resident prior to admission as possible, this assures the residents that the home can meet their needs. The manager had just received a new pre admission document, which Southern Cross had devised and this was found to be comprehensive. The implementation and effectiveness of this will be reviewed at the next inspection. Orchards The DS0000024876.V285948.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 Resident’s health and personal care needs were well met by the nursing and care staff. Short-term care needs are not always documented appropriately and therefore do not provide information and instruction for care staff to follow. EVIDENCE: All four files reviewed had comprehensive pre admission assessments in place and care plans were initiated from these assessments. Care plans had been written for the majority of identified needs and this included challenging behaviour and outbursts of anger. Some care plans required minor amendments to include more specific details of the care to be afforded to the residents. One file did not have a care plan in place for incontinence; the daily record indicated this need. Staff must ensure that care plans are written for all identified needs to ensure that care staff have the information required to assist residents to meet their assessed needs. Daily records were very detailed and included information about how the resident had spent their day, any external visitors received and any changes to condition. Orchards The DS0000024876.V285948.R01.S.doc Version 5.1 Page 10 One file reviewed contained evidence in the daily records that the resident had been seen by the GP and commenced antibiotics; however there was no shortterm care plan in place and it was not clear what the antibiotics were for. The visit had not been recorded on the professional visit chart. There was some evidence that relatives had been involved in the care planning and evaluation of identified needs and this shows that relatives can take an active part in planning how needs can be best met. One resident had not had a formal review of the care and this was brought to the manager’s attention, to ensure that the current care needs identified were still accurate. Bed rail assessments were in place and monthly observations were recorded. Pressure sores were documented on a separate chart and wound sizes and descriptions were also documented. One file reviewed had pressure area risk assessments, moving and handling, dependency rating and nutritional scores calculated two weeks after admission in January but these had not been reviewed since. Assessments should be evaluated on a monthly basis or as conditions change, to ensure appropriate actions are taken. One file showed that a falls risk assessment had been reviewed after each fall; this is viewed as being good practice. A relative said, “ I get informed each time dad has a fall, he tries to walk and has started to feed himself again” Professional visits were recorded and this included visits by the G.P and Tissue Viability Nurses. Professional visits are well documented and include rationale and outcome of visit. Letters received and hospital appointments were filed separately at the back of the folder. There was evidence that referrals had been made to physiotherapists. There are many pages of the documentation that are not used and it is recommended that these be filed separately for ease of access to current data. The management of medication was not assessed at this inspection. Orchards The DS0000024876.V285948.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14, 15 Residents are given choice and freedom to make decisions regarding their daily lives and this promotes independence and individuality. Residents receive a wholesome and varied diet, which meets any dietary needs and preferences, and offers residents good choices. EVIDENCE: Residents were observed to be engaging in a game of skittles in the upstairs lounge, residents downstairs were entertaining their visitors. Residents were seen to have remained in their rooms to listen to the football on the radio or watch TV, as they had chosen. One resident who was required to spend the majority of time on bed rest said “the girls come in and play dominoes with me”. A new activities coordinator has recently been appointed. The activity folder was seen and this contained an activity matrix for each resident, with a key for each activity at the front of the folder. There was evidence of varied activities being on offer for residents who wished to participate in this. A newsletter produced by the home was available in the reception area, and this included details of forthcoming events, news about staff and residents birthdays. Orchards The DS0000024876.V285948.R01.S.doc Version 5.1 Page 12 Relatives were visiting during the inspection and one stated, “We can come at anytime, and we know all the staff by name”. The home has an open visiting policy. In the reception area were leaflets for an advocacy service and this is commendable as such services assist residents and their families, to exercise personal autonomy and choice over their lives. The home had recently distributed resident satisfaction forms and generally the food was indicated as “excellent/good”, with some comments of meals being “fair/poor”. However only a few forms had been returned at this point and the manager will need to further evaluate this once all the forms have been returned. The manager had recently held a “food and nutrition meeting” with the staff, and a residents meeting was also held. Minutes from the meetings suggest further improvements to the menu and indicated that residents provided constructive criticism and suggestions for improvements. This indicates that the residents are able to voice their opinions about changes they would like to see in the home. The four-week rolling menu was reviewed in December 2005 and is very varied and nutritionally balanced. Breakfast, lunch and tea are all included in the menu and there is a choice of hot or cold foods for each meal. Key workers complete food intake charts covering breakfast, mid morning, lunch, mid afternoon, evening meal and supper. Charts permit specific foods to be recorded but not the amount. Quantities of food eaten must be recorded to ensure that an accurate recording of food is maintained. Comments from residents included: “The meals are quite good and choices are given” “I like the food, plenty of choices” “Food is reasonably good” “We get good food” Orchards The DS0000024876.V285948.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 The complaints procedure is comprehensive and accessible to residents and their representatives should they need to make a complaint. Staff must ensure that all complaints are documented in the complaints book. Improvements are required to the adult protection policy to ensure that staff have the correct guidelines to follow if there is an allegation of abuse. EVIDENCE: The complaints procedure was on display in the main reception area. The manager has plans for a compliments/complaints book to be available in the reception area. Since the last inspection there had been two complaints recorded at the home and both of these had been dealt with in a timely manner. Response letters and correspondence was available with the complaint so that the outcome was identified. CSCI have not received any complaints pertaining to the home. During the inspection one resident raised a complaint and consent was obtained to bring this to the attention of the manager. The manager had not been aware of the residents complaint, however contacted the inspector the morning after the inspection to state that the problem had been resolved to the satisfaction of the resident. The problem had been discussed the previous week with the Deputy Manager however; the resident had declined to take up the offers of how the problem could be resolved at that time. Staff must ensure that all complaints are recorded along with the outcome. One resident commented, “If I had a problem I would talk to the head one” Orchards The DS0000024876.V285948.R01.S.doc Version 5.1 Page 14 It was recommended that the manager keeps an audit log of complaints received in order to establish any trends or reoccurrences of complaints. The manager was very receptive to the recommendation and this was in place before the close of the inspection. There were many “thank you” letters and cards on display from residents and their families. The adult protection policy was reviewed and needs some amendments as currently it does not clearly identify that social health and care are the lead agency and implies that managers decide the level of seriousness of the allegation and actions to be taken. It is also required that any staff involved must fully document their findings and any actions taken. The home had recently had an adult protection referral, however following an investigation the allegations were not upheld. The home had followed the correct procedure for the reporting of the incident. Orchards The DS0000024876.V285948.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 25, 26 Residents are provided with a homely, clean and comfortable and safe environment in which to live. EVIDENCE: A full tour of the building was not completed, but areas seen were homely in style and were found to be clean and odour free. Furniture, fixtures and fittings seen were all of a high standard. The reception area is very pleasant and spacious, and residents were observed to be seated in the communal areas whilst others had chosen to stay in their rooms. There are two lounges on each floor, however only one lounge on each floor was in use at the time of the inspection, where residents were engaging in activities or socialising with relatives. One resident commented “I’m very happy with my room” Orchards The DS0000024876.V285948.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28, 29, 30 There are robust recruitment procedures in place to ensure that residents are protected. Improvements are required to staff training to ensure that staff have the knowledge and skills to meet the assessed needs of the residents. EVIDENCE: 17 staff currently hold the NVQ Level 2 certificate and two also have NVQ Level 3. A further 5 staff are currently working towards Level 2 and 8 are working towards Level 3. The Deputy Manager has completed NVQ Level 4. Many of the staff that are working towards Level 3 have completed Level 2 and are progressing to the next stage of their training. 7 staff have been identified to register on the training course in the near future. Recruitment procedures are robust and ensure that residents are protected. Two staff files were reviewed and were found to contain all the required information. Two references had been obtained, including one from last employer/tutor and POVA first checks had been completed prior to employment commencing. Job descriptions and contracts of terms and conditions of employment were on file. An interview checklist is also in place. Comments from residents included: “If you are in difficulty staff are pretty good and rally round” “Staff are very good” “Staff are alright and assist as required” “Staff are very obliging” “They are very good here” Orchards The DS0000024876.V285948.R01.S.doc Version 5.1 Page 17 Relatives also commented that: ”The staff are very approachable” “We know all the staff by name” “Staff are very good and polite” Training records were reviewed and each member of staff had a separate page for recording their training, however this information did not always correspond to the information on the training matrix. Only one of the 14 trained staff appeared to have received training in adult protection and gaps were identified in the refreshers for moving and handling and fire training. A bank member of staff had not received any fire training since 2004 or had any mandatory training; this was brought to the manager’s attention, as this does not afford full protection to residents and other people within the building. Training is booked for the near future. The manager must review all staff training and ensure that the training needs are identified and that staff receive refresher statutory training as required. At the previous inspection it was identified that a number of staff worked an excessive amount of hours by choice. Rotas were reviewed and this now appears to have been resolved. The home currently has no staff vacancies. Correction fluid was used on staffing rotas and this is not considered to be good practice, therefore it is recommended that this is no longer used on documentation. Orchards The DS0000024876.V285948.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 38 The Registered manager ensures that a good standard of service is provided at the home and regularly monitors the home for quality. EVIDENCE: The Registered Manager has been in post since September 2005 and has previous experience as a home manager. She is a Registered Nurse and has a Diploma in Nursing Studies, BSc Hons Degree in community nursing, NVQ Level 5 in Operational Management and is a Moving and Handling trainer. The Registered Manager also has many other certificates and qualifications of training courses achieved prior to becoming a home manager, this ensures she has the knowledge and skills to maintain the standards at the home. The manager was very receptive to suggestions made and is keen to ensure that standards are maintained and continue to improve. Orchards The DS0000024876.V285948.R01.S.doc Version 5.1 Page 19 Relatives meetings are held regularly and the manager held a meeting shortly after commencing employment at the home, in order to introduce herself and meet with the relatives. The home has recently distributed a resident satisfaction survey and the forms were in the process of being returned. The Manager undertakes weekly medication audits with a more in-depth audit completed each month. In addition to this the home manager also completes monthly audits for accidents, personal staff files, pressure sore evaluation, recruitment and vacancies, catering, premises (including exterior), complaints, social activities programme, care plans, maintenance and domestic services, statutory records and finances. The Operations Manager also completes Regulation 26 visits and these were available to review. Fire records were reviewed and the maintenance person carries out weekly checks on fire systems and fire doors. Emergency lights are checked monthly and the home had had a quarterly check of the fire system by an external company. Fire drills had taken place in December 2005 and the names of staff attending and outcomes had been recorded. A comprehensive fire risk assessment was available and had been reviewed in August 2005. The home had recently had an inspection by the West Midlands Fire Service. During the tour it was noted that the liability insurance certificate for the home had expired and this was brought to the attention of the manager, who requested that a new certificate was sent out. A copy of the new certificate has been forwarded to CSCI since the inspection was undertaken. Risk assessments had been written in respect of trailing multi socket adapters and items in the garden, which had been requirements from the last inspection. Accident records were fully detailed. The home manager signs all accident forms and forms had actions taken identified on them and it was clear what actions had been taken to minimise any further risks. Accident records were kept in a file in alphabetical order, which makes monitoring easy. Orchards The DS0000024876.V285948.R01.S.doc Version 5.1 Page 20 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 X X X X X X 3 3 STAFFING Standard No Score 27 X 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 2 Orchards The DS0000024876.V285948.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 12(2)(3) 15 Requirement Care plans and personal risk assessments must be further developed to include: The actual care to be afforded to residents (Previous timescale of 31/10/05 not met) Short-term care plans must be devised. GP visits must be recorded on the professional visit chart. Residents must have formal reviews to ensure that current care needs are accurate. Pressure sore risk assessments, nutritional risk assessments, dependency ratings and moving and handling assessments must be evaluated each month. Prescription creams must be dated on opening and a system to improve and monitor stock control of these must be implemented. Not assessed on this occasion. DS0000024876.V285948.R01.S.doc Timescale for action 30/04/06 2. OP8 12(1)(b) 15(2)(b) 31/03/06 3. OP9 13(2) 15/09/06 Orchards The Version 5.1 Page 22 4. 5. 6. OP15 OP16 OP18 12(1) 22 13(6) 7. OP30 19(5)(b) 8. OP30 18(1)(a,c) (i) 13(6) 18(1)(c) (i) 13(4) 23(4) 9. 10. OP30 OP38 An accurate record of the amount of food eaten by residents must be completed. Staff must ensure that all complaints are recorded in the complaints book. The adult protection procedure requires four amendments and must include a statement that observations and actions of any staff must be recorded. The manager must ensure that individual training records are up to date and that they correspond to the training matrix. The manager must review all training files and ensure that all staff receive mandatory and refresher training as required. All staff must receive training in the protection of vulnerable adults. In the event that bedroom and lounge doors on the first floor are to be kept open, they should be fitted with devices that are linked into the fire alarm system (A quote for the work to be completed has been obtained) A further action plan should be submitted to CSCI indicating timescales for completion of the work by 07/04/06 31/03/06 05/05/06 28/04/06 14/04/06 05/06/06 24/04/06 Orchards The DS0000024876.V285948.R01.S.doc Version 5.1 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. Refer to Standard OP7 OP15 OP27 Good Practice Recommendations Documentation pages, which are not being used, could be stored separately from the main area of the file for ease. The home manager is to review that there is sufficient fridge/freezer space available. Correction fluid should not be used on staffing rotas. Orchards The DS0000024876.V285948.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Orchards The DS0000024876.V285948.R01.S.doc Version 5.1 Page 25 - 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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