Inspection on 10/03/06 for The White House

This inspection was carried out on 10th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 White House 22/01/09

The White House 15/02/08

The White House 30/08/07

The White House 28/02/07

The White House 13/10/05

The White House 29/03/05

The White House 06/01/05

The White House 29/01/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE The White House 11 Coggeshall Road Braintree Essex CM7 9DB Lead Inspector Gaynor Elvin Final Unannounced Inspection 10th March 2006 11:45 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 The White House DS0000017980.V285972.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. The White House DS0000017980.V285972.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The White House Address 11 Coggeshall Road Braintree Essex CM7 9DB 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) 01376 326847 01376 345966 micky._-@tiscali.co.uk Avidcrave Limited Mrs Kathleen Teahon Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places The White House DS0000017980.V285972.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th October 2005 Brief Description of the Service: The White House is a care home registered to provide accommodation, personal care and support to fourteen people over the age of 65 years, not falling into any other category. The home is not registered to meet the needs of people with dementia. The White House is a detached two-storey property, accommodation is provided on the ground and first floor in eight single rooms and three double rooms. Access to the first floor is by the stairs or a passenger lift. However, due to the size of the rooms and corridors the home is not suitable for wheelchair users. The site is shared with a nursing home and both units share the gardens at the rear of the building, which comprises of a patio and grassed area with seating. There is a car parking area at the front of the building. The White House DS0000017980.V285972.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place one day in March 2006, over three and a half hours. All of the key standards and the intended outcomes have been assessed in relation to this service during at least two inspections for the current inspection year (April to March). To view the assessment of standards and outcomes not included within this report, please refer to the previous published report dated 13th October 2005. This inspection focused on the key National Minimum Standards and intended outcomes not assessed in the previous inspection, looking at working practices, supporting documentation and records, as well as progress made in addressing the statutory requirements and good practice recommendations made in the previous inspection report. The White House is a care home providing personal care to 14 older people. The home is not registered to admit service users with Dementia. However, since admission, some service users have developed varying levels of mental health needs, which presented in varying degrees of cognitive impairment and short-term memory loss related to early signs of dementia. Normally, the home would not be permitted to accommodate persons who require care by way of mental frailty. As highlighted in this and two previous inspection reports, an application to the CSCI is required to request a variation to the current condition of registration, to enable those service users to remain at the home for as long as the home is able to meet their assessed needs. The names of the service users to which this applies must be submitted to the CSCI, with the application. Currently the home is in breach of the conditions of their registration. What the service does well: What has improved since the last inspection? It was recognised that care plans were clearly moving in the right direction, however, they continue to require further development particularly in relation to a person centred approach. The White House DS0000017980.V285972.R01.S.doc Version 5.1 Page 6 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. The White House DS0000017980.V285972.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 The White House DS0000017980.V285972.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): Standards 1-5 and their intended outcomes were not assessed on this occasion. Standard 6 is not applicable to this home, as it is not registered to provide intermediate care. EVIDENCE: Key standard 3 was assessed during the previous inspection 13th October 2005 and complied with NMS. The White House DS0000017980.V285972.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): 9. Based upon the sample inspected the administration and security of residents medication was found to meet National Minimum Standards. EVIDENCE: Care plans were not fully examined on this occasion. However, it was pleasing to note that shortfalls were being addressed and a new care plan examined reflected a clear direction to staff on care delivery. Discussion took place with the manager on areas requiring further improvement and that the care planning process will be fully assessed within the next inspection. Medication was received from the pharmacy in Monitored Dosage Systems and individually named containers and was appropriately stored in locked facilities. A sample of Medication Administration Records (MARs) was examined. The records were accurately completed, signed and dated. Further training for staff with regard to the safe administration of medication was planned for within the training and development plan for this year. The White House DS0000017980.V285972.R01.S.doc Version 5.1 Page 10 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): Standards 12 – 15 and their intended outcomes were not assessed on this occasion; please refer to previous report dated 13th October 2005. EVIDENCE: The White House DS0000017980.V285972.R01.S.doc Version 5.1 Page 11 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 home has a transparent approach and operates a clear and open complaints procedure. The management of the service has responded to matters associated with the protection of vulnerable adults in a comprehensive and professional manner. EVIDENCE: The home has a clear and accessible complaints procedure. No complaints regarding the service have been received by the home or the CSCI. Feedback from resident questionnaires and resident meetings expressed general satisfaction with the home Since the last inspection an allegation of abuse was received by the CSCI from an ex-member of staff. The allegation was referred back to the home for appropriate management. The correct procedure was followed and an agreed management strategy carried out with appropriate multi professionals leading to a satisfactory outcome. The Local authority and the CSCI agreed with the outcome and the allegation was not upheld. The Local authority praised the Registered Manager for robust and responsible investigative practice including maintenance of detailed records. The White House DS0000017980.V285972.R01.S.doc Version 5.1 Page 12 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, 20, 21, 22, 23, 24, 25 & 26. Although The White House presented a homely warm environment, some accommodation and bathing facilities were failing to meet a safe standard for those individuals with increasing physical and cognitive needs. The home did not provide appropriate laundry, washing machine and sluicing facilities to meet disinfection standards and control risk of infection to protect the health, safety and welfare of service users and staff. Refurbishment and/or replacement of sanitary facilities such as vanity units and en-suite toilets in some bedrooms are urgently required. The White House DS0000017980.V285972.R01.S.doc Version 5.1 Page 13 EVIDENCE: A tour of the premises was not carried out on this occasion. The Manager informed the Inspector that no further action had been taken to address previous requirements. Please see previous inspection report dated 13th October 2006 for detail. Requirements have been repeated. The White House DS0000017980.V285972.R01.S.doc Version 5.1 Page 14 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 & 30 Current staffing levels were appropriate to meet the needs of the existing service users. The home has almost achieved the required target of 50 of care staff having appropriate qualifications of NVQ level 2 in Care. Robust recruitment procedures were followed to support and protect the service users. Although a good level of staff training was planned to promote good care practice and enable staff to develop their skills, further consideration should be taken to ensure the basic level of training is complimented by further initiatives. EVIDENCE: The previous report highlighted that care staff also undertook meal preparation (breakfast and supper) and cleaning duties in addition to providing personal care, which at that time detracted from the adequacy of the staff ratio to service users needs. A cook is employed to prepare the main meal of the day. Since the last inspection the home had three resident vacancies, one vacancy only very recently filled and therefore the Manager indicated that staffing numbers had not been reviewed and the appointment of domestic staff not considered. The White House DS0000017980.V285972.R01.S.doc Version 5.1 Page 15 The manager was advised of the need to review and revise staffing levels according to the assessed needs of the residents and in accordance with the Residential Forum guidance recommended by the Department of Health, to provide an appropriate indication of the numbers of care staff required. A review should be considered when new service users are admitted and when the needs of the existing service users change. Of the fifteen care staff currently employed at The White House, the Manager confirmed that seven have successfully achieved NVQ level 2 in Care and one was currently working towards achieving it. The home had recently appointed a new member of the care staff team to replace one person who had left. The recruitment documentation was examined and found to contain all the information required by regulation to help to ensure the protection of the service users. New staff were required to commence the homes induction programme. The programme indicated that the required Skills for Care Occupational Induction and Foundation Standards were incorporated within it. An annual training and development programme for the current year included mandatory health and safety subjects such as First Aid, Fire Safety Awareness, Care of Substances Hazardous to Health (COSHH) and Boots medication update. Topics pertinent to residents assessed need such as Continence care and Dementia Awareness were also included. Whilst this level of training is satisfactory as an introductory level in conjunction with NVQ level 2 to support staff in provision of care, further development is required in the programme to ensure that the basic level of training is complimented by further initiatives. Particularly in areas such as nutrition, activity assessment and need, mobility, person centred planning, listening and communicating skills and behaviour management to enhance understanding in the needs of the older person particularly in relation to dementia care. The White House DS0000017980.V285972.R01.S.doc Version 5.1 Page 16 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, 35, 36 & 38 The home is operated by a manager who is fit and competent to do so. The home had not progressed in addressing quality assurance and quality monitoring systems and continuous self-monitoring to look at service provision; care practice and outcomes to inform future service development. The home does not manage service users financial interests but appropriate arrangements were in place to safeguard service users personal allowances within the home. A stronger emphasis on regular formal recorded supervisions is required to enable staff to reflect and develop own practice. The health safety and welfare of service users is promoted The White House DS0000017980.V285972.R01.S.doc Version 5.1 Page 17 EVIDENCE: The managers’ position remains unchanged and in addition to many years experience in caring for older people at The White House, Mrs Teahon has successfully achieved The Registered Managers Award NVQ Level 4. Various certificates provided evidence that Mrs Teahon has undertaken periodic training to update her knowledge, skills and competence in care practice, whilst managing the home. However this and previous inspections indicate there may be a training need to develop knowledge in the area of quality assurance. Although the views of service users and their representatives were sought through questionnaires and residents meetings, no further action had been taken to progress and develop systems of quality assurance, monitoring and self assessment to inform future practice, improving outcomes for residents and the services’ aims and objectives. The Manager indicated that the home did not manage service users financial interests. Arrangements for supporting service users to access their personal allowances were found to be satisfactory. They were able to request and sign for money as required and an audit of income and expenditure, with corresponding receipts, was dated and signed by the service user and person in charge. A sample was checked and correct. A sample of staff supervision files was examined. The documents were well laid out and contained most elements required for an effective supervisory process including reflection on care practice and the aims and objectives of the service. However, the formal supervisory process was infrequent and did not meet with requirements. The benefits of regular formal and documented supervisions to support staff in developing and sustaining their working practice was discussed with and acknowledged by the manager. The Manager indicated that arrangements had been made for the Infection Control Nurse from the PCT to visit the home in July to provide professional guidance and explore more effective ways within the homes current environment to meet infection control and safety guidelines. The home had recently received The Gold Food Hygiene Award by Braintree District Council for their excellent standard of food hygiene, cleanliness and structure at the food hygiene inspection in November 2005. The home had previously achieved the Silver Award. A satisfactory Environmental Health & Safety at work inspection had been carried out in December 2005. The White House DS0000017980.V285972.R01.S.doc Version 5.1 Page 18 The local Fire Officer had carried out a satisfactory inspection of Fire Safety and Evacuation policy and fire safety risk assessments in February 2006. Certificates regarding satisfactory inspection of Gas Safety Installation, Electrical Wiring Installation, Personal Electrical Appliance testing, Wheelchair service, fire alarm and fire fighting equipment were evident and current. The log of weekly fire safety checks and drills was signed and dated. The White House DS0000017980.V285972.R01.S.doc Version 5.1 Page 19 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 4 2 X 2 2 2 2 2 1 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 3 2 The White House DS0000017980.V285972.R01.S.doc Version 5.1 Page 20 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 15 Requirement The Registered Manager must improve the care planning system for service users and set out in detail the action which needs to be taken by care staff to ensure that all aspects of the health, psychological and social needs of the service user are met. This is a repeat requirement not addressed within the timescale of 1st August 2005. Not assessed on this occasion and carried over. Timescale for action 10/03/06 2. OP14 15 The Registered Manager must 10/03/06 improve the care planning system for service users and set out in detail the action which needs to be taken by care staff to ensure that all aspects of the health, psychological and social needs of the service user are met. This is a repeat requirement not addressed within the timescale of 1st August 2005. Not assessed on this occasion and carried over. DS0000017980.V285972.R01.S.doc Version 5.1 Page 21 The White House 3. OP8 12,13,16 The Registered Manager must 10/03/06 give consideration to how the service users can receive a more individualised service tailored to meet identified needs and promote optimal independence with regard to health and social needs. This is a repeat requirement not addressed within the given timescale of 1st August 2005. Not assessed on this occasion and carried over. 4. OP12 12,14,15, 16, 23. 5. OP14 12,14,15, 16, 23. 6. OP21 23 The Registered Manager must 10/03/06 ensure that service users have the opportunity to exercise their choice in relation to leisure and social activities and routines of daily living, and given opportunities for stimulation through activities which suit needs, preferences and capacities, with particular consideration given to people with dementia. Not assessed on this occasion and carried over. 10/03/06 The Registered Manager must ensure that service users have the opportunity to exercise their choice in relation to leisure and social activities and routines of daily living, and given opportunities for stimulation through activities which suit needs, preferences and capacities, with particular consideration given to people with dementia. Not assessed on this occasion and carried over. The Responsible Person must 01/09/06 ensure sufficient number of functional baths to the number and assessed needs of the service users. DS0000017980.V285972.R01.S.doc Version 5.1 Page 22 The White House 7. OP19 23, 16 This is a repeat requirement not met within timescale of 31/01/06. The Responsible Person must provide suitable equipment and facilities as may be required for service users who are old, infirm or physically impaired and ensure appropriate assisted baths are installed which are capable of meeting the assessed needs of the service users. This is a repeat requirement not met within timescale of 31/01/06. The Responsible Person must provide suitable equipment and facilities as may be required for service users who are old, infirm or physically impaired and ensure appropriate assisted baths are installed which are capable of meeting the assessed needs of the service users. This is a repeat requirement not met within timescale of 31/01/06. 01/09/06 8. OP22 23, 16 01/09/06 9. OP19 12, 23. 10. OP23 12, 23. 01/09/06 The Responsible Person must ensure room dimensions and layout options ensure that there is room on either side of the bed, to enable access for carers and any equipment needed, particularly in shared accommodation and rooms accommodating service users with high mobility needs. This is a repeat requirement not met within timescale 31/01/06 The Responsible Person must 01/09/06 ensure room dimensions and layout options ensure that there is room on either side of the bed, to enable access for carers and any equipment needed, DS0000017980.V285972.R01.S.doc Version 5.1 Page 23 The White House 11. OP19 13, 16, 23. particularly in shared accommodation and rooms accommodating service users with high mobility needs. This is a repeat requirement not met within timescale 31/01/06 The Responsible Person must 01/09/06 ensure private accommodation is equipped with furnishings to assure comfort and privacy and maintain or replace sanitary facilities, as needed paying particular attention to vanity sink units and en suite toilets. This is a repeat requirement not met within timescale 31/01/06. 01/09/06 The Responsible Person must ensure private accommodation is equipped with furnishings to assure comfort and privacy and maintain or replace sanitary facilities, as needed paying particular attention to vanity sink units and en suite toilets. This is a repeat requirement not met within timescale 31/01/06. 01/09/06 The Responsible Person must ensure private accommodation is equipped with furnishings to assure comfort and privacy and maintain or replace sanitary facilities, as needed paying particular attention to vanity sink units and en suite toilets. This is a repeat requirement not met within timescale 31/01/06. The Responsible Person must provide details as to how and when appropriate laundry facilities will be provided to meet National Minimum Standards. DS0000017980.V285972.R01.S.doc 12. OP24 13, 16, 23. 13. OP26 13, 16, 23. 14. OP26 13, 16. 01/09/06 The White House Version 5.1 Page 24 This is a SEVENTH repeat requirement not met within the given timescales of DEC 2005, Mar 2005, Jan 2005, Jan 2004, July 2003, Sept 17/18 2002. 15. OP38 13, 16. The Responsible Person must provide details as to how and when appropriate laundry facilities will be provided to meet National Minimum Standards. This is a SEVENTH repeat requirement not met within the given timescales of DEC 2005, Mar 2005, Jan 2005, Jan 2004, July 2003, Sept 17/18 2002. 01/09/06 16. OP26 17. OP38 18. OP26 The Responsible Person must ensure washing machines have the specified programming ability to meet disinfectant standards and foul laundry is washed at appropriate temperatures to thoroughly clean linen and control the risk of infection. This is a repeat requirement not met within timescale 31/01/06. 12, 13, The Responsible Person must 16. ensure washing machines have the specified programming ability to meet disinfectant standards and foul laundry is washed at appropriate temperatures to thoroughly clean linen and control the risk of infection. This is a repeat requirement not met within timescale 31/01/06. 13, 16, 23 The Responsible Person must ensure having regard to the number and needs of the service user, appropriate sluicing facilities are provided separate DS0000017980.V285972.R01.S.doc 12, 13, 16. 01/09/06 01/09/06 01/09/06 The White House Version 5.1 Page 25 from service users’ toilets and bathing facilities. This is a repeat requirement not met within timescale 31/01/06 19. OP38 13, 16, 23 The Responsible Person must ensure having regard to the number and needs of the service user, appropriate sluicing facilities are provided separate from service users’ toilets and bathing facilities. This is a repeat requirement not met within timescale 31/01/06 24 The Registered Persons must progress in the development of effective quality assurance and monitoring systems to inform future planning and ensure quality outcomes. The Responsible Persons must ensure that action is progressed within agreed timescales to implement requirements identified in CSCI inspection reports, this relates particularly to the environment. Repeat requirements not met within timescale. The Registered Manager must ensure regular and formal supervisory arrangements are carried out for all staff. 01/09/06 20. OP33 01/09/06 21. OP33 10, 12. 01/09/06 22. OP36 18 01/09/06 The White House DS0000017980.V285972.R01.S.doc Version 5.1 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP23 Good Practice Recommendations The Responsible Person should consider ways to provide personal accommodation, which are fit for purpose in respect of, appropriate of useable floor space. The Registered Manager should ensure that training and development plans are linked to the homes’ service aims and to individual plans particularly with regard to existing service users assessed needs. The Registered Manager should ensure risk assessments are carried out for all safe working practice topics and that significant findings are recorded and arrangements are in place to minimise risk. Carried over from previous inspection. 2. OP30 3. OP38 The White House DS0000017980.V285972.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 White House DS0000017980.V285972.R01.S.doc Version 5.1 Page 28 - 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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