Inspection on 06/07/06 for The Tower House

This inspection was carried out on 6th July 2006.

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 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 Tower House 16/07/08

The Tower House 24/07/07

The Tower House 13/12/05

The Tower House 02/06/05

The Tower House 15/03/05

The Tower House 22/04/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE The Tower House Reading Road Shiplake Henley on Thames Oxon RG9 3JN Lead Inspector Jane Handscombe Unannounced Inspection 6th July 2006 09:30 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 Tower House DS0000040609.V301798.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 Tower House DS0000040609.V301798.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Tower House Address Reading Road Shiplake Henley on Thames Oxon RG9 3JN 01189 401197 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) bridgetkidd@btopenworld.com Bridget Kidd Care Home 6 Category(ies) of Old age, not falling within any other category registration, with number (5) of places The Tower House DS0000040609.V301798.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. In the case of the double room being used for any other persons than the two named individuals, privacy screening must be provided 13th December 2005 Date of last inspection Brief Description of the Service: Tower House is a privately owned care home with large attractive gardens, approximately two miles from Henley on Thames and on a bus route. Mrs Bridget Kidd is the proprietor and registered manager and provides care for up to six service users aged 65 and over who, for one reason or another, are no longer able to live in their own homes. She employs four part-time staff to assist with care work and domestic duties. Agency staff are employed to provide assistance when the need arises, all of whom are familiar with the home and the service users. Service users have access to a communal sitting room, a conservatory and a separate dining room, all situated on the ground floor. There are three bedrooms on the first floor with en-suite facilities of toilet and washbasin and a further double bedroom with an ensuite bathroom. There is also a communal bathroom on this floor. On the ground floor there is one bedroom with en-suite bath, toilet and washbasin. Fees: £2700.00 per month The Tower House DS0000040609.V301798.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place on the 6th July 2006. The purpose of the visit was to see how the home is meeting the National Minimum Standards. The visit involved speaking to residents in order to ascertain their views on the care and the services they receive at the home, staff members and the manager of the home, viewing care plans and assessments and case tracking these, whilst observing the general day-to-day operations of the home. Comment cards were received by the Commission for Social Care Inspection, giving feedback from residents, relatives/visitors and general practitioners who visit residents in the home, all of which were extremely positive. The home presented as one that was clean and tidy throughout. Residents were going about their daily activities in a calm, relaxed manner. Staff were seen to provide care and support in an unhurried manner whilst addressing needs appropriately. Comments received from residents during the inspection included: • • • • ‘I don’t think the care I get could be bettered’ ‘She couldn’t be more helpful than she is…….’ ‘They are very good, if you ask for something unusual X (named person) will get it’ ‘….I enjoy the food’ The inspector would like to thank the residents, staff and relatives/visitors for their assistance during the inspection process. What the service does well: The outcomes for people who use the service are generally good. The home offers a happy and positive atmosphere to live in, with the flexibility for residents to have visitors pop in to see them at any reasonable time. Independence is encouraged and where residents wish to maintain contacts within their local community, this is encouraged within a risk management process. The Tower House DS0000040609.V301798.R01.S.doc Version 5.2 Page 6 The proprietor is presently seeking to increase the facilities for further residents and provide provision for staff living accommodation, subject to registration with the Commission. Building work was seen to be in progress and provision had been made for safe access to the outside of the building. Residents informed the inspector that the building works had not been intrusive and that the builders begin and finish at appropriate times so as not to cause any inconvenience. The home presents as clean and hygienic, as always appears to have been the case during previous inspections. Residents are encouraged to bring small personal belongings if they require, which was evident since the rooms viewed on the day were personalised with small pieces of furniture, memorabilia and photographs that the residents had wished to bring with them. What has improved since the last inspection? What they could do better: There are a number of areas in which the home needed to improve upon so as to not compromise the safety and well being of those in their care. Since writing this report the majority of situations highlighted within this report have been addressed, removing the risks that were found during the inspection. A few remaining situations still need to be addressed. Grab rails still need to be provided in two rooms to aid in the residents’ safety when mobilising around the en-suite bathroom. Lockable facilities must be provided for any residents wishing to maintain responsibility for their own medication and the right to residents’ privacy must always be taken to into account in situations where residents are provided with alternative accommodation in times of need. Staff members mandatory training needs updating to ensure that they have the necessary skills and competency to address the residents’ needs. The Tower House DS0000040609.V301798.R01.S.doc Version 5.2 Page 7 In order to ensure that the management approach of the home creates an inclusive atmosphere, a quality assurance system needs to be put in place and maintained, where feedback can be gained from residents, staff and other stakeholders, which may be used to affect the way in which the service is delivered. 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 Tower House DS0000040609.V301798.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 Tower House DS0000040609.V301798.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1. 2, 3, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All prospective service users undergo an assessment of needs prior to being offered a place at Tower house. This ensures that the home is able to meet their needs. Prospective service users are invited to visit the home and spend a day with fellow residents to gain a ‘feel’ of the home and allow them to make an informed choice. Each resident is provided with a contract setting out the terms and conditions of residency EVIDENCE: The manager explained that all prospective service users are provided with information about the home and the services it can offer and are invited to spend a day at the home, after a needs assessment has been undertaken. The Tower House DS0000040609.V301798.R01.S.doc Version 5.2 Page 10 Once an admission date has been agreed, there is a month’s trial period to ensure that both parties are confident that these needs are being met. After the month’s trial period, a review of care is undertaken and a contract detailing the terms and conditions is provided. One resident explained how they had visited the home with a family member for a chat and a quick look around and, at a later date, were invited to meet with fellow residents and take lunch, to assess the quality, facilities and suitability of the home. All prospective service users undergo an assessment of needs to ensure that both parties are confident these needs can be met. Following the assessment they are invited to visit and spend a day at the home, to meet with fellow residents and staff members and gain a ‘feel’ of the home prior to being offered a place, to allow them to make an informed choice. The inspector considers that this service would be able to provide a service to meet the needs of various cultural, religious or racial backgrounds. The Tower House DS0000040609.V301798.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. All residents have an individualised plan of care, derived from an assessment of needs. Procedures to enable residents to take responsibility for their own medication was poor. Residents are treated with respect and generally their right to privacy is upheld. EVIDENCE: An individualised plan of care is drawn up for each resident from the assessment of needs, and is reviewed on a monthly basis. The home works closely with health professionals and is able to provide and access a full range of appropriate health care services to meet all the residents’ assessed needs. The Tower House DS0000040609.V301798.R01.S.doc Version 5.2 Page 12 Comments received from general practitioners were very positive. One GP stated, ‘Very caring home, X (named person) knows the patients well and patients are looked after both physically and mentally’. Feedback gained from residents during the inspection was one in which residents experience a sense of privacy and dignity at all times. However, one resident’s privacy was being compromised, in that service users’ care plans were stored in a locked filing cabinet inappropriately and encroaching upon this resident’s private space. Since writing this report the manager has addressed this shortfall and found alternative accommodation for the filing cabinets, giving the resident their right to privacy. Daily records containing personal information were found in the communal lounge, which could be easily accessed and therefore compromise all residents’ rights to confidentiality. This matter was discussed with the manager, who agreed that this practice would not continue and alternative arrangements would be made. The home’s procedures for dealing with residents who wish to maintain responsibility for their own medication was inadequate and could pose as a risk. One resident’s medication was being stored in an unlocked cabinet in their room. This was addressed immediately during the inspection and moved into the home’s medicine cabinet for safe keeping, until a lockable cabinet is provided. Further medications were found in a communal bathroom accessible to service users and were immediately removed when brought to the notice of the manager. The manager was reminded that all medication must be stored safely in a locked cupboard. The Tower House DS0000040609.V301798.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ dietary needs are well catered for, offering a well balanced and varied choice. Contact with family/friends/representatives of the local community is encouraged and support is given to maintain contact where required. Residents find the lifestyle at Tower House matches their expectations and needs appropriately. EVIDENCE: The home encourages residents to maintain links with family, friends and the local community and they are able to receive visitors in private and choose who they do/do not see. Group social events are provided where service users are encouraged to invite their relatives, if they so wish. The Tower House DS0000040609.V301798.R01.S.doc Version 5.2 Page 14 Residents explained that they enjoy wholesome meals, which offer variety and choice according to their wishes, all of which are prepared freshly on the premises. Breakfast is delivered to residents in their own rooms, whilst lunch can be taken in the attractive dining room or at a place of their choosing. One resident explained to the inspector that the manager makes every effort to accommodate their wishes and is quite prepared to go that extra mile to ensure that these are taken into account. They confirmed they could get up and go to bed when they wanted to, and could choose how they wished to spend their day and were not made to feel uncomfortable if they chose to stay in their own room, and not join fellow residents. A TV and radio are provided in each bedroom and a communal lounge and conservatory for service users’ use is provided on the ground floor. Special occasions, such as birthdays, are celebrated in the home to which family and friends are invited. A visiting hairdresser regularly visits the home to provide hairdressing services to those who require and a chaplain offers communion on a six-weekly basis for those who require. The Tower House DS0000040609.V301798.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides each resident with a clear complaints procedure and residents are confident that any complaints or compliments will be acted upon appropriately. Staff have received training in the protection of vulnerable adults and are aware of the procedures if any allegations were to be made. EVIDENCE: The home encourages service users to discuss any area of complaint with the manager or staff to ensure service user satisfaction, and provides all residents with details on how to make a complaint should the need arise. No complaints have been received by the home since the last inspection. Likewise, no complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. All staff are provided with training in order that they are aware of the signs of abuse and are aware of the procedure should any allegations arise. The Commission has not been alerted to any allegations since the last inspection. The Tower House DS0000040609.V301798.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 22, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Generally service users live in a safe, well maintained environment which is always kept to a high standard of cleanliness. There are sufficient washing and toileting facilities for service users. Service users are provided with comfortable bedrooms which were found to be personalised with their own belongings. The home provides any specialist equipment in order that service users are able to maximise their independence, although there were shortcomings in this area. The manager has addressed one situation and is endeavouring to address one more area. The Tower House DS0000040609.V301798.R01.S.doc Version 5.2 Page 17 EVIDENCE: The inspector toured the building and found all areas of the home to be cleaned and maintained to a very high standard. Generally the service users live in a safe, well maintained environment with the various specialist equipment they require to maximise their independence. However, whilst speaking with one resident it was apparent that they had problems when using the ensuite bathroom. A grab rail is provided beside the bath to help the service user, although no rails were available to help with mobility problems beside the toilet. Upon enquiry the inspector was informed that the client used the sink for this purpose. The inspector discussed the issue with the manager and advised that suitable rails be purchased and fitted to allow the service user safety and aid in their mobility, thereby maximising their independence. A further recommendation was made to provide window restrictors in one service user’s room, thereby ensuring their health and safety. Since the inspection, the Commission has received confirmation that window restrictors are now in place. Residents are provided with comfortable bedrooms which were found to be personalised with their own belongings. The Tower House DS0000040609.V301798.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff are trained and skilled to meet the needs of the service users, although some mandatory training needs to be updated. The home needs to pay particular attention to ensuring that it is staffed efficiently at all times EVIDENCE: The home has a team of carers which includes the registered manager, one full time carer, two part time carers and two bank staff. In times of sickness and annual leave a specialist agency is called upon who provide staff that are both experienced and familiar with the service users, allowing for continuity of care. Whilst visiting the home the inspector was concerned with the number of staff on duty during part of the afternoon period. The inspector was aware that on this ocassion the manager was the sole carer for a period of time until a further member of staff arrived later in the afternoon. Whilst there was a family member available should there be an incident which required help, the manager must ensure that the staff/resident ratio is accordance with the DoH guidance and sufficient in numbers to ensure that residents’ needs are met at all times. The Tower House DS0000040609.V301798.R01.S.doc Version 5.2 Page 19 The recruitment procedure was discussed with the manager, and staff files were examined. Where staff are employed directly by the care home, recruitment procedures are in place to ensure that suitable staff are employed to work with vulnerable adults. One personnel file failed to contain two written references and, upon enquiry as to whether references had been followed up by telephone to verify these, it was explained that an agency undertook the checks. There was some confusion around who was responsible and accountable in situations where staff are provided to the home by an agency. The inspector reminded the manager that, where staff are provided to the home via an agency, the registered manager must ensure not to allow a person to work at the home unless the person is fit to do so. That confirmation must be held on personnel files evidencing that the employer has obtained satisfactory information and documents specified under the care home regulations, undertaken thorough checks and is satisfied that the recruitment procedures meet the requirements under the Care Home’s Regulations. The inspector was informed that all new staff undergo an induction period followed by shadowing the registered manager until both parties are comfortable and confident in undertaking these duties alone. All care staff, whether employed by the home or supplied by the agency, are provided with all mandatory training and further training and updating is provided when the need may arise. Regular supervisions with staff take place both formally and informally. Staff training since the last inspection has included moving and handling, COSHH (Control of Substances Hazardous to Health) and elder abuse. It was noted that some mandatory training needed updating for which a requirement has been made. The Tower House DS0000040609.V301798.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager has many years’ experience in caring for older people and the residents and staff report that they have a good relationship with the manager and benefit from the management approach of the home. The home does not undertake any responsibilities in regard to residents’ finances - this is dealt with by their families. Generally the health, safety and welfare of service users and staff are promoted and protected. Staff are provided with regular supervision, where any concerns may be discussed. The Tower House DS0000040609.V301798.R01.S.doc Version 5.2 Page 21 EVIDENCE: Residents’, family members’ and visiting general practitioners’ feedback informed the inspector that the home is run in the best interests of the service users. Staff are provided with regular supervision and support as part of the management process, where discussions take place around all aspects of care provision and any care development needs. Supervision notes were held in carers’ personnel files. Generally the health, safety and welfare of residents and staff are promoted and protected. However, on this occasion there were some shortfalls (See sections headed Health and Personal Care and Environment). The manager addressed most of these shortfalls either on the day of the inspection or shortly afterwards to ensure that the residents’ health, safety and welfare is not compromised. The remaining issues addressed within the report have been acknowledged by the manager and are in hand to be addressed. The registered manager is a State Registered Nurse, with over 30 years’ experience in caring and supporting older people in a number of settings and is registered with the Commission for Social Care Inspection. She continues to update her skills when necessary thereby ensuring that she meets the residents’ needs, and she has undertaken periodic training. Although she has not yet undertaken the Registered Manager’s Award at NVQ Level 4, she is endeavouring to do so once she has completed the training course in dementia that she is presently undertaking. A score of 2 will be reflected in the report since the manager does not possess the Registered Managers’ Award or an equivalent. A quality assurance system needs to be put in place so as to ensure that the management approach of the home is creating an inclusive atmosphere, in that staff, service users and other stakeholders are given the opportunity to affect the way in which the service is delivered. A quality assurance system must be put in place and maintained whereby feedback on the service can be given. The Tower House DS0000040609.V301798.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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 3 2 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 3 X 3 3 X 2 The Tower House DS0000040609.V301798.R01.S.doc Version 5.2 Page 23 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 OP9 Regulation 13 Requirement The registered manager must make arrangements for the safe storage of all medications. The registered manager must ensure suitable adaptations are provided, where necessary, in service users own accommodation. The registered manager must ensure that all staffs mandatory training is kept up to date. Where agency staff are employed,the registered manager must gain confirmation that the agency has undertaken all relevant checks and obtained satisfactory information and documents and that their recruitment procedure meets with the requirements under the care home regulations Timescale for action 06/07/06 2 OP22 23 01/10/06 3 OP28 18 01/10/06 4 OP29 19 Schedule 2 31/08/06 The Tower House DS0000040609.V301798.R01.S.doc Version 5.2 Page 24 4 OP32 24 The registered manager must ensure that the management approach of the home creates an inclusive atmosphere, in that staff, service users and other stake holders are given the opportunity to affect the way in which the service is delivered. A quality assurance system must be put in place and maintained whereby feedback on the service can be given. This was made a requirement during the last inspection although no action has yet been taken 31/12/06 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 Refer to Standard OP10 OP18 Good Practice Recommendations It is recommended that arrangements are in place to ensure service users privacy is respected at all times. It is recommended that a system for calculating staff numbers be put into place to ensure the ratio of care staff to service users is appropriate. It is strongly recommended that the registered manager pursues NVQ training at Level 4 in Management after completion of the dementia course being undertaken. 3. OP32 The Tower House DS0000040609.V301798.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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 The Tower House DS0000040609.V301798.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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