CARE HOMES FOR OLDER PEOPLE
The Stratfords Residential Home Anthony Court Russell Street Stony Stratford Milton Keynes Bucks MK11 1BT Lead Inspector
Christine Sidwell Unannounced Inspection 20th June 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Stratfords Residential Home DS0000065902.V339286.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 Stratfords Residential Home DS0000065902.V339286.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service The Stratfords Residential Home Address Anthony Court Russell Street Stony Stratford Milton Keynes Bucks MK11 1BT 01908 262621 01908 262621 vulcanresidential@hotmail.co.uk 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) Vulcan Residential Limited vacant Care Home 11 Category(ies) of Old age, not falling within any other category registration, with number (11) of places The Stratfords Residential Home DS0000065902.V339286.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 8th December 2006 Brief Description of the Service: The Stratfords is a two-storey residential care home, proving care for up to eleven older people, over the age of 65 years. The home is situated in a quiet residential area of Stony Stratford and is within a short walking of the town centre, which offers a variety of shops, restaurants, public houses and other local amenities. It is a two-storey building and has single room accommodation. Resident’s rooms are located on the ground floor and upper floor. There is lift access to the first floor. Most rooms do not have ensuite facilities. There is a communal lounge/dining room on the ground floor. A cook provides freshly cooked meals on site and special diets can be catered for. There are waking care staff on duty at all times. Public transport is accessible to service users if they wish to use this. The fees for this home range from £448.00 - £468.00 per week. The Stratfords Residential Home DS0000065902.V339286.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was conducted over the course of three days and included a six hour unannounced visit to the home. The key standards for older people’s services were covered. Information received about the home since the last inspection was taken into account in the planning of the visit. Prior to the visit, a questionnaire was sent to the manager with questionnaires for distribution to service users, relatives and visiting professionals. Nine residents or family members returned the questionnaires. Residents and families were also spoken to on the day of the unannounced visit. Discussions took place with the manager and care staff. Care practice was observed and the care of three residents followed through in detail. A tour of the premises and examination of records was also undertaken. The homes approach to equality and diversity was considered throughout. What the service does well: What has improved since the last inspection?
The statement of purpose and residents guide have been updated and have been transcribed by the Royal national Institute for the Blind onto tape format for those who cannot see. The standard of care planning has improved although further improvements could be made which are described in the report.
The Stratfords Residential Home DS0000065902.V339286.R01.S.doc Version 5.2 Page 6 Medication management has improved and accurate records of resident’s medication are now kept. The bath has been repaired although there is still a need to upgrade the facilities to fully provide for people who have disabilities. The recruitment policies and procedures have improved although there is still room for improvement to ensure that robust checks as to the person’s suitability are carried out before the person starts work. Staff are now offered more training and the proprietors state that they are committed to ensuring that staff are fully trained to undertake their role. The homes policies and procedures have been updated and are available to staff. What they could do better:
There is a need to ensure that residents and their families are involved in care planning and that care plans are updated regularly to ensure that they reflect residents current needs. There is a need to ensure that risk assessments hold sufficient detail to describe to carers the steps that they should take if a resident is found to be at risk. There is little organised activity to bring interest and diversion to the day. This aspect of the care should be developed to ensure that residents are able to enjoy activities, which are meaningful to them. There are policies and procedures in place to safeguard vulnerable adults although their application would be improved if the manager and staff were to undergo training in this area. The proprietor should take professional advice as to the best way to improve the facilities in the home to meet the needs of people with disabilities and should take professional advice as to the range and suitability of moving and handling aids, which should be available in the home. The proprietors must ensure that recruitment files contain all the information specified in Regulation 19 and Shedules2 and 4 of the Care Homes Regulations 2001. The proprietors must ensure that two references are sought for all employees and that one is from the last employer where the person has been in employment. The proprietor should ensure that residents’ risk assessments contain sufficient detail to describe the steps that carers should take if a resident is found to be at risk in any way.
The Stratfords Residential Home DS0000065902.V339286.R01.S.doc Version 5.2 Page 7 The proprietors should review the infection control policies and procedures in line with guidance given by the Department of Health in June 2006. It is recommended that a training matrix be developed and kept up to date to allow for identification of training needs and the due dates for updating of mandatory training. The quality assurance programme should be fully implemented and developed to include regular review of all aspects of the home’s operation, for instance care planning and medication administration. An accurate record of money held on behalf of residents should be kept and individual receipts given for all money received and expenditure incurred on behalf of residents. 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 Stratfords Residential Home DS0000065902.V339286.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 Stratfords Residential Home DS0000065902.V339286.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, 2, 3 and 6 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The assessment process works well and potential residents and their families have information about the home, in formats which are accessible to them, to help them decide whether their needs can be met, before they decide to move permanently. EVIDENCE: The care of three residents was followed through in detail. Their care files showed that the home manager had assessed them before they moved to the home. There was also information available from the care manager and the local primary healthcare team. The assessment documentation prompted staff to ask about specific needs relating to religious and cultural needs. All the residents and family members who returned the questionnaires said that they had received enough information about the home before they moved. All but one of the residents or their families who returned the questionnaires said that they had received a contract and evidence to verify this was found in residents’ files. The statement of purpose and resident’s guide has been updated in the
The Stratfords Residential Home DS0000065902.V339286.R01.S.doc Version 5.2 Page 10 last year and copies were available in the home. The home has had these transcribed onto a tape to meet the needs of a resident who is unable to see. The home does not offer intermediate care. The Stratfords Residential Home DS0000065902.V339286.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 and 10 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. In general residents personal, healthcare and medication needs are met. There is a need to ensure that residents and their families are involved in care planning, that care plans are updated regularly and that risk assessments contain sufficient detail for carers to know what steps they should take if a resident is at risk for any reason. EVIDENCE: The care of three people was looked at in detail and a number of other care files examined. All files held care plans. Not all had been signed by the resident or their family, although those who returned the questionnaires and who were spoken to on the day of the visit said that they had been asked about the care that they wanted. The personal hygiene needs of all those who could not manage this for themselves had been met. A daily record of care given was kept and this was signed and dated. Not all care plans had been updated monthly. The care plans had evidence that the general practitioner visits regularly and that people who live in the home have access to the optician and chiropodist. Moving and handling risk assessments had been undertaken as had residents’ risk of developing pressure damage. These plans need to be further developed
The Stratfords Residential Home DS0000065902.V339286.R01.S.doc Version 5.2 Page 12 to ensure that they have sufficient guidance for staff as to what action they should take if a resident were found to be at risk. Residents are weighed regularly and the weights of those people whose care was looked at in detail had remained stable since they moved to the home. All residents seen had drinks within reach throughout the day of the visit. The residents spoken to said that they saw the doctor regularly and the families spoken to said that they were kept informed if their family member was unwell. They were all pleased with the care that they received from the care staff in the home. There are medication policies and procedures in place. Storage facilities are satisfactory. Records are kept of medication entering and leaving the home. The medication administration records were accurately completed. The carer spoken to said that medication was not administered covertly. If a resident refused medication this would be recorded. If the medication was essential and the resident lacked the capacity to make to the decision the doctor and family would be informed and a way forward agreed. The training records showed that all staff who administer medication have had training. The staff were observed to be speaking to residents with respect and courtesy. The service users who returned the questionnaires said that staff listened and acted on what they said, although one qualified this by saying ‘according to how busy they are’. The Stratfords Residential Home DS0000065902.V339286.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is responsive to people’s wishes and respects their right to choose how they spend their day. There is little organised activity to bring interest and diversion to the day. EVIDENCE: The social history sections of the care plans were poorly completed. A list of activities was on display on the wall but there was no evidence to show that this was delivered. The staff spoken to said that most residents did not like to join in activities. One resident spoken to said that she would like more to do. Of the residents and families who returned the questionnaires most said that there were few activities arranged. Comments such as ‘apart from Easter and Christmas there are no events’ and ‘very few communal activities arranged’ were made. The proprietors said that they were considering appointing an activities coordinator to develop this aspect of the home’s service. The home stocks a number of books from the local library. Talking books and talking newspapers can also be obtained for those who need them. One resident said that she particularly enjoyed this, as ‘she could get lost in a book’ The Stratfords Residential Home DS0000065902.V339286.R01.S.doc Version 5.2 Page 14 The meals offered are of a good standard and the residents spoken to said that they enjoyed them. All the residents who returned the questionnaires said that they usually or always liked the food. Meals are served in residents’ rooms or in the dining area in the lounge. There is no formal choice of main meal although the chef was very aware of resident’s likes and dislikes and offered alternatives if the resident did not like the meal planned for the day. The chef said that she would be able to meet residents cultural dietary needs should the need arise. The residents spoken to said that they could always make suggestions for the menu and the chef had one recipe that a resident had given her, which she was going to try out at the weekend. The home is open to visitors and there are no restrictions on visiting. Residents may have a telephone in their room if they wish. The Stratfords Residential Home DS0000065902.V339286.R01.S.doc Version 5.2 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are policies and procedures in place to safeguard vulnerable adults although their application would be improved if the manager and staff were to undergo training in this area. EVIDENCE: There are complaints policies and procedures in place. A complaints log is kept. All the residents and family members who returned the questionnaires said that they knew who to speak to if they were unhappy. There have been no complaints made since the last inspection. The home has a copy of the local multi agency strategy for the Protection of Vulnerable Adults and some staff have had safeguarding training. Those spoken to said that they would have no hesitation in reporting any concerns to the manager or ringing the Commission for Social Care Inspection. The manager and staff were unclear as to the role of the Local Authority, which is the lead agency in this area. This should be addressed and the manager should seek training for himself and staff to ensure that they are fully conversant with the correct action to take should they have any concerns regarding safeguarding vulnerable adults. The Commission for Social Care Inspection has not been notified of any concerns or complaints about the home and has not been notified of any allegations made to the local authority. The Stratfords Residential Home DS0000065902.V339286.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, 22, 24 and 26 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is in need of some upgrading although the personal accommodation for residents is spacious, enabling them to personalise their rooms to maintain their own identity and memories. EVIDENCE: Residents’ rooms are large and spacious. They are generally reasonably well decorated and residents are encouraged to bring their own belongings to personalise them and most had chosen to do so. The result was that rooms were very personalised and one resident said ‘my room is like a home from home’. The corridors and communal areas are less well decorated and the bathrooms need upgrading. The lounge dining room is small and the garden /courtyard areas are in need of upgrading and making more secure. The proprietors are aware of this and have put in a bid for a grant to upgrade the bathrooms, build a conservatory and improve the gardens and are awaiting the outcome. The Stratfords Residential Home DS0000065902.V339286.R01.S.doc Version 5.2 Page 17 There are some adaptations to meet the needs of the physically frail although the provision of bathroom facilities needs upgrading. There are also difficulties in moving the hoist upstairs, which makes it difficult for carers to care for anyone who needs a hoist to help them move safely upstairs. The proprietor should take professional advice as to the best way to adapt the home to meet the needs of physically frail people and on the purchase of suitable aids. The proprietor should also ensure that suitable moving and handling equipment is available throughout the home. There are infection control policies and procedures in place and staff were observed to washing their hands. It is recommended that the proprietor review the infection control policies and procedures to ensure that they are in line with the latest guidance issued by the Department of Health in June 2006. The laundry is situated away from the main kitchen and equipped with domestic washing machines and driers. The residents spoken to said that their clothes were looked after well. The Stratfords Residential Home DS0000065902.V339286.R01.S.doc Version 5.2 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staffing levels and skills are generally sufficient to meet residents’ needs although these should be monitored carefully. There are further improvements to made to the recruitment procedures to ensure that suitable people care for residents. EVIDENCE: There are two care staff on duty at all times including during the night. In addition there is a housekeeper and chef. The care staff work hard and feel that whilst in general the staffing levels are sufficient they have difficulty if two staff members are needed to care for individual residents, if their needs are complex or they become unwell. This means that other residents may not be supervised. The manager is advised to monitor staffing levels carefully and to ensure that if residents’ needs increase that additional staff are in place to meet these. The standard of training has improved since the last inspection. Seventy-five per cent of care staff hold the National Vocational Qualification in Care at Level 2 and the remaining twenty-five per cent are working towards it. Training has been offered in the basic mandatory topics of manual handling, food hygiene and first aid. Records to confirm this were seen in individual files. The proprietor should consider developing a matrix to demonstrate that all staff have had training in mandatory topics as well as maintaining individual training records.
The Stratfords Residential Home DS0000065902.V339286.R01.S.doc Version 5.2 Page 19 The recruitment procedures have been improved since the last inspection although there are still improvements to be made. The recruitment files of five staff members were examined. They had been updated since the last inspection and a systematic approach to recruitment had been implemented. All contained an up to date photograph of the staff member. Evidence of their identity had been sought in order to apply for Criminal Records Bureau (CRB) disclosures, although this had not been retained on file. No one had started work before the ‘POVA first’ had been received and all staff had CRB disclosures. All staff had two references although in the case of one member of staff, one reference was not dated and the references did not coincide with the work history described in the application form. This should be addressed and the proprietors must ensure that they receive a validated reference from the last employer. Copies of staff passports and work permits were not on file. The proprietors must ensure that they keep records on file in line with Regulation 19 and schedules 2 and 4 of the Care Homes Regulations 2001. It is recommended that the proprietors review their recruitment policies and procedures in line with guidance given by The Commission for Social Care Inspection and available on their website www.csci.org.uk The Stratfords Residential Home DS0000065902.V339286.R01.S.doc Version 5.2 Page 20 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 and 38 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The proprietors have improved the management of the home since they bought it and are in the process of implementing sound management and quality assurance procedures to ensure that residents live in a well managed home and that residents’ views and interests are sought and protected. EVIDENCE: The home is currently registered with the Commission for Social Care Inspection (CSCI) as a company and one of the proprietors is registered as responsible individual. The proprietors are in the home regularly and one acts as the manager of the home. His attendance as manager is not recorded on the duty rota. He has sought advice as to whether he should register with CSCI as the manager of the home. The proprietors have begun to develop a
The Stratfords Residential Home DS0000065902.V339286.R01.S.doc Version 5.2 Page 21 quality assurance system and have developed policy statements and are seeking the views of residents. The quality assurance system should be developed further to include regular reviews of all aspects of the home’s operation taking into account residents’ views. Action was taken to address or begin to address all the issues, which were identified at the last inspection. All policies and procedures have been updated since the last inspection and copies are made available to staff. The residents spoken to said that they had confidence in the staff and the proprietors. The proprietors do not act as appointee for any residents and do not manage their financial affairs in any way. A small amount of money may be kept in the home on behalf of residents. Records of money kept by the home are kept although these were not found to be up to date, leading to some minor inaccuracies. These records should be updated and receipts should be given, and copies kept, for all money received and expenditure incurred on behalf of residents. There are health and safety policies and procedures in place. The chef has now had food handing training and has undertaken training in better food management offered by the local authority environmental health department. There is a need to ensure that all staff have training in basic mandatory health and safety topics as described in the staffing section of this report and to ensure that suitable moving and handling equipment is available on both floors. The proprietors report that fire safety risk assessments have been undertaken and that risk assessments for all activities and procedures in the home have been carried out and documented. The Stratfords Residential Home DS0000065902.V339286.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X 2 X 3 X 3 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 2 X X 2 The Stratfords Residential Home DS0000065902.V339286.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 (1) and (2) Requirement Care plans should contain evidence that residents and their families are involved in drawing them up. Timescale for action 30/09/07 2 OP12 16(2)m 3 4 OP18 OP22 13(6) 23(2)(m) They should be updated when necessary and at least monthly to ensure that they contain up to date information about residents needs. Residents should be given 30/09/07 opportunities for stimulation through leisure and recreational activities in and outside the home, providing for both mental and physical stimulation, which suit their needs, preferences and capacities. The manager and all staff must 31/10/07 have training in the safeguarding of vulnerable adults. The proprietor must take 30/09/07 professional advice as to the best way to adapt the home, in particular the bathrooms, to meet the needs of physically frail people. A programme to implement this advice should be agreed if necessary over a period
DS0000065902.V339286.R01.S.doc Version 5.2 Page 24 The Stratfords Residential Home 5 OP29 19 and schedules 2 and 4 of time. The proprietors must ensure that recruitment files contain all the information specified in Regulation 19 and Shedules2 and 4 of the Care Homes Regulations 2001. The proprietors must ensure that two references are sought for all employees and that one is from the last employer where the person has been in employment. The proprietor must take professional advice as to the purchase of suitable moving and handling aids to meet resident’s needs. 31/07/07 6 OP38 13(5) 30/09/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP7 OP26 OP27 OP30 Good Practice Recommendations Risk assessments should hold sufficient detail to describe the steps that carers should take if a resident is found to be at risk in any way. The proprietors should review the infection control policies and procedures in line with guidance given by the Department of Health in June 2006. Staffing levels should be monitored carefully to ensure that additional staff are provided if residents needs increase. It is recommended that a training matrix be developed and kept up to date to allow for identification of training needs and the due dates for updating of mandatory training. The quality assurance programme should be fully implemented and developed to include regular review of all aspects of the home’s operation, for instance care planning and medication administration. 5 OP33 The Stratfords Residential Home DS0000065902.V339286.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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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