CARE HOMES FOR OLDER PEOPLE
Tremethick House Meadowside Redruth Cornwall TR15 3AL Lead Inspector
Paul Freeman Unannounced 18 July 2005 10.00 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 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. Tremethick House D52-D04 S9095 Tremethick House V236108 180705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Tremethick House Address Meadowside Redruth Cornwall TR15 3AL Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01209 215713 01209 215713 Mrs Mary Anson & Mr John Anson Mrs Barbara Denise Ball Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Tremethick House D52-D04 S9095 Tremethick House V236108 180705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: There are no additional conditons of registration. Date of last inspection 28 February 2005 Brief Description of the Service: The home is owned and run by Mr and Mrs Anson and the providers take an active role in the services and facilites provided. A registered manager Mrs Denise Ball has been appointed to take the lead role in the day to day running of the home. Tremethick is a care home that offers care to twenty-eight older people. The majority of bedrooms are for single occupancy and communial space is provided throughout the home. The majority of the communal space is located on the ground floor and is mainitined to a high standard. There is reasonable access outside and inside the home for people who experience a disability. A passenger lift is also provided. The home is located on the edge of Redruth town with pleasant grounds and good car parking facility. The location provides easy access to the town, leisure facilities and health services. The home offers transport to appointments and for outings.The home state they provide care in a manner that meets the individual needs and preferences of residents ia a manner that promotes independence, dignity and the rights. Tremethick House D52-D04 S9095 Tremethick House V236108 180705 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. A planned unannounced inspection took place on 18 July 2005 and 19 July 2005. The purpose of the inspection was to consider the work that had been undertaken on the requirements set at the last inspection on 28 February 2005. Therefore some of the key standards that were considered including assessment and care planning, health and safety and staffing arrangements. The registered manager, residents and staff were consulted about the services and facilities provided. The Provider Mrs Anson was not available on the day of the Inspection due to other commitments. The environment, records and documents were also considered. The requirements and recommendations set at the last inspection had been worked upon and the registered manager, staff and residents fully cooperated and were very helpful throughout the inspection period. What the service does well:
Flexible arrangements are in place for prospective residents to visit the home to help them decide if it is a suitable place to live. The prospective residents relatives or representatives are also invited to visit. Residents commented they are well looked after and are confidant their health needs are well provided for. The records show that health professionals regularly visit the home and that services are efficiently accessed when required. The records of the visits by health professionals could be improved to make sure that staff have an up to date picture of the persons needs. Flexible visiting arrangements are in place and residents commented that visitors are well received and made to feel welcome by the managers and staff at the home. The residents described the food provided as “good” and “lovely” and a nutritionally balanced menu that is seasonally adjusted is offered. Special diets can be catered for and the meals provided reflect the preferences and choices of the residents. The providers or the Commission over the last year has received no formal complaints. Positive arrangements are in place to deal with any complaints or concerns that arise. Residents said they had confidence about raising any issues and were sure the matter would be dealt with promptly and resolved in a satisfactory manner. Satisfactory arrangements are also in place to protect residents against abuse. Any allegations or issues of concern are reported and a formal investigation occurs. Suitable whistle blowing arrangements are in place and staff are able to report any concerns to a third party if they are unable to approach the providers. This provides residents with further protection measures.
Tremethick House D52-D04 S9095 Tremethick House V236108 180705 Stage 4.doc Version 1.40 Page 6 Sufficient numbers of staff are on duty each day and night and additional staff are provided when this is required to meet the needs of residents. The staff are well trained and have a wide range of skills and experience. Resident’s commented they were very satisfied with the manner in which staff undertake their duties. The residents said that staff were flexible, reliable and available when they require care or assistance. The residents were also very complimentary about the relaxed atmosphere of the home and the positive attitude the staff have towards their work. The home maintains a good standard of hygiene and cleanliness and residents are very satisfied with the standard provided. The home is well run and managed and staff said they are actively supported in all areas of the work they undertake. The manager takes the lead in the day to day services and facilities provided and the providers also play an active role. Residents said the providers and manager are very approachable and there are no barriers to raising any issues or concerns. Residents were confidant that any issues raised would be dealt with positively and efficiently. What has improved since the last inspection? What they could do better:
The assessment arrangements for residents continue to be improved but the records of the assessments do not provide sufficient information to satisfactorily guide, direct and inform the care and support required by the person concerned. The manager assesses each prospective resident and the assessment takes account of the views and opinions of any professionals involved with the person concerned. The prospective resident and their relatives or representatives is also consulted about their needs, preferences and choices.
Tremethick House D52-D04 S9095 Tremethick House V236108 180705 Stage 4.doc Version 1.40 Page 7 Medicines are kept in secure facilities and residents are able to administer their own medication when t is safe to do so. The current arrangements to administer medicines need to be refined to make sure that medicines are not left unsupervised at any time. An immediate requirement was set about this matter during the inspection. In many parts of the environment a good standard of furniture and fittings are provided which create a comfortable and safe setting for residents. Certain areas are now tired and require improvement. The providers are in the process of finalising a refurbishment plan that will result in a good standard throughout the home and compliance with the Care Homes Regulations. The plan includes extending the facilities and accommodating more residents. A new kitchen and additional communal areas are included in the plan. Residents their relatives and representatives and staff are being consulted about the plans and an appropriate application has been made to the Commission. Residents commented they are satisfied with the facilities provided and a reliable programme of maintenance is in place. Satisfactory arrangements are in place to manage risks that may occur around the environment or with equipment at the home. The arrangements to manage risks individual residents may experience require further improvement. The provider had established a suitable format for recording risk assessments but the records show that risks are not always formally assessed when they occur. The risk assessment must also provide the staff with guidance and direction to make sure that every reasonable step is taken to protect residents. The provider also needs to establish a suitable policy and procedure for the management of risk. This will provide staff with the direction required and state the action that is necessary. 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. Tremethick House D52-D04 S9095 Tremethick House V236108 180705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Tremethick House D52-D04 S9095 Tremethick House V236108 180705 Stage 4.doc Version 1.40 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 standard(s) 3 and 5 The admission process is well managed but the records about the assessment of need do not provide adequate information to satisfactorily direct and inform the care and support required. EVIDENCE: The registered manager assesses each prospective resident before they move to the home. The assessment takes account of the views and opinions of any professionals that are involved with the person concerned as well as the prospective resident and their relatives or representatives. A format for recording the assessment is in place but this provides limited space to record the prospective residents views and the manager’s findings. The records of the assessment summarise the assessor’s findings but in the majority of instances are not sufficiently detailed to provide clear information about the needs, preferences and choices of the prospective resident. This requires improvement in order that the assessment can appropriately guide direct and inform the care plan and the care and support provided to the residents concerned.
Tremethick House D52-D04 S9095 Tremethick House V236108 180705 Stage 4.doc Version 1.40 Page 10 The assessment records have improved following the recommendation that was made at the last inspection on 28 February 2005. Prospective residents and their relatives’ and representatives are invited to visit the home to help them decide if it is a suitable setting to reside. The visiting arrangements are flexible and the prospective residents are able to choose the most suitable visiting pattern. Residents that recently moved to the home commented they found the arrangements to be positive and reassuring that their needs would be appropriately met. Residents were very positive about the welcome they received by the staff and other residents’ ands the manner in which they were helped to settle into their new environment. Tremethick House D52-D04 S9095 Tremethick House V236108 180705 Stage 4.doc Version 1.40 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 standard(s) 7, 8 and 9 Residents are well looked after but the care plans do not provide adequate guidance and direct for the staff to ensure that residents needs preferences and choices are met. Good arrangements are in place to meet resident’s health needs but the records of the visits are not satisfactory. This does not make sure that staff is clear about any instructions or guidance the health professionals have made. Medication is held securely and good records are maintained. The arrangements to administer prescribed medicines need to be improved to make sure this occurs in a safe manner. EVIDENCE: Each resident has a care plan that summarises the care and support they require. The residents commented they were very satisfied with the way in which their needs are met and were complimentary about the staff and the service that is provided. The residents said they felt in control of the care they receive and were confidant they could direct the care they recieve. The care plan records do not however provide adequate guidance and direct for staff about the residents needs and the best ways of meeting their needs, preferences and choices. Tremethick House D52-D04 S9095 Tremethick House V236108 180705 Stage 4.doc Version 1.40 Page 12 The care plans are regularly reviewed with each resident and a general record of the review is made. The records could be improved further if they include the areas discussed and any agreed action that needs to be taken. There are no barriers to residents accessing their records at any time. The quality of the record keeping does not therefore reflect the care that is provided which residents said was very good. The residents commented they were also very satisfied with the manner their health needs are met. The residents are confidant that health services are obtained promptly and efficiently when they are required. The records show that health professionals regularly visit residents and are called in when required. Some of the records were incomplete, as they did not include some of the visits that had occurred. Residents are able to administer their medication when it is safe to do so. Where assistance is provided by the staff a suitable policy and procedure is in place and the medicines are stored in a secure facility. The staff responsible for administering medication has been suitably trained and good records are maintained. The Pharmacist safely disposes of any medicines that are no longer required. Prescribed medicines are placed on residents tea trays in the kitchen and this is not a safe practise given the medication is not supervised at all times and is not in a secure facility. An immediate requirement was set at the inspection for safe arrangements to be established by 26 July 2005. Tremethick House D52-D04 S9095 Tremethick House V236108 180705 Stage 4.doc Version 1.40 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 standard(s) 13 and 14 Visitors are welcomed to the home and the visiting arrangements are flexible. Residents are therefore able to maintain family links and friendships. Good food and a varied menu are provided that reflects residents choices and preferences. EVIDENCE: Flexible visiting arrangements are in place and residents are able to decide where they meet with their visitors. The visiting arrangements are detailed in the statement of purpose and services users guide that is given to all prospective residents. Staff at the home will also support residents if they decide they do not wish to meet with any visitor. Residents commented that visitors were positively received at the home by the staff. The residents said they were also very pleased with the communication that reliably occurs between the management, staff and relatives or their representatives. A varied menu is provided each day that accommodates residents’ preferences and choices. The menu is seasonally adjusted and provides a nutritionally balanced diet. Residents choose where they take their meals and an attractive well maintained dinning room is provided in a conservatory at the rear of the building.
Tremethick House D52-D04 S9095 Tremethick House V236108 180705 Stage 4.doc Version 1.40 Page 14 The home is able to accommodate special diets and refreshments are readily available. Residents commented they were very satisfied with the meals provided and described the food as “good” and “lovely”. The recommendations set at the last inspection on 28 February 2005 were positively acted upon. Tremethick House D52-D04 S9095 Tremethick House V236108 180705 Stage 4.doc Version 1.40 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 standard(s) 16 and 18 Arrangements for protecting residents and responding to their concerns are satisfactory. EVIDENCE: The providers or CSCI has received no complaints over that last year. A satisfactory policy and procedure is in place to deal with any complaints or concerns. Residents commented they had confidence in the providers dealing with any complaints or concerns in a positive and efficient manner. The residents said there were no barriers to raising any issues or concerns with the providers. Satisfactory arrangements are also in place to protect residents against abuse and a suitable policy and procedure is in place. Any allegations of abuse are formally reported and the matter is formally followed up. The providers have also established satisfactory whistle blowing arrangements. The staff are therefore able to report any concerns they have about abuse to a third party if they feel unable to inform the providers. This provides the residents with further protection. Tremethick House D52-D04 S9095 Tremethick House V236108 180705 Stage 4.doc Version 1.40 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 standard(s) 19 The environment is maintained to a satisfactory standard but certain facilities need to be refurbished to meet the required standard. This will provide a quality environment throughout for the residents. EVIDENCE: The environment is maintained to satisfactory standard and three bedrooms have recently been redecorated and the carpets have been replaced. New chairs have also been provided in one lounge and smaller pieces of equipment have also been replaced. Residents commented they were very satisfied with the accommodation and facilities provided and many have personalised their bedrooms. Certain facilities at the home require improvement given they are tired and require refurbishment. The providers are in the process of finalising plans to improve these areas and plan to extend the home to accommodate more residents over the next year. The new plan also includes a new kitchen and additional communal and dinning areas. The residents, relatives or their representatives and staff continue to be consulted about the plans.
Tremethick House D52-D04 S9095 Tremethick House V236108 180705 Stage 4.doc Version 1.40 Page 17 The providers have established reliable arrangements to undertake repairs where this is required. The residents said the maintenance staff were efficient, very competent and reliable about any repairs that are required. Tremethick House D52-D04 S9095 Tremethick House V236108 180705 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 and 30 Staff morale is high resulting in an enthusiastic workforce who are well trained and work positively with residents to provide a good quality of life. The arrangements to vet and recruit staff are good and this provides protection for residents. EVIDENCE: Residents commented they are very satisfied with the manner in which staff undertake their duties. They said that staff were readily available, flexible and responsive to any needs or requests they have. The residents also commented on the positive attitude of the staff and the friendly atmosphere around the home. The records show that sufficient number of staff are on duty each day and night and were necessary additional staff are employed to make sure that residents needs are not compromised. The turnover of staff is not excessive and the staff group have a wide range of skills and experience. A senior member of staff is on duty throughout the day to coordinate the care and support and reliable on call arrangements are in place each night. Robust recruitment, selection and vetting arrangements have been established and satisfactory records are maintained. A Criminal records Bureau check is completed on all new staff. Recently appointed staff commented they were positively welcomed by the residents, management and staff of the home and had been given clear guidance about the duties and responsibilities of their post.
Tremethick House D52-D04 S9095 Tremethick House V236108 180705 Stage 4.doc Version 1.40 Page 19 A progressive programme of training is in place for staff. Seventy five percent of the staff will have achieved NVQ 2 by September 2005 and four other staff will be commencing the qualification in the new year. In addition the majority if staff have been trained in Dementia Awareness and staff also undertake a range of core skills training that include infection control, first aid and moving and handling. Staff commented they were very satisfied about the training opportunities at the home and are with provided regular opportunities to update and improve their skills. Tremethick House D52-D04 S9095 Tremethick House V236108 180705 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,37 and 38 The home is well run and managed and the staff is well supported by the providers and manager of the home who provide clear leadership. Staff have a clear understanding of their roles and responsibilities. Some of the records at the home require improvement and do not demonstrate the quality of the care or experience provided to residents. The home is clean and hygienic but the risk management arrangements for residents require improvement. This will make sure that residents live in a safe setting. EVIDENCE: Residents commented the home is well run and there are no barriers to raising any issues with the providers or registered manager. The registered manager coordinates the day to day services and facilities and the providers also play an active role in the running of the home. The providers and registered manager
Tremethick House D52-D04 S9095 Tremethick House V236108 180705 Stage 4.doc Version 1.40 Page 21 are experienced in social care and Mrs Anson is also a qualified nurse with an active pin number. The registered manager has also obtained the registered managers award. Staff commented they are well supported and advice guidance and assistance is readily available. Residents said they were consulted on an individual basis about the running of the care home and both Mrs Anson and the registered manager talked with them on frequent occasions. Mrs Anson does not regularly provide the Commission or registered manager with a monthly report about the running of the care home as required by regulation. There are some examples of good record keeping at the home and this includes medicines and the staff duty roster. Other records are satisfactory but some require improvement. The daily records that are maintained for each resident have improved following the last inspection. Some of the records were incomplete and did not record all the events or actions taken. Other records that require improvement have been addressed earlier in the report and these include assessment and care planning. The staff commented they found the records to be helpful but some staff said they could be improved by providing more detail. The environment is clean and hygienic and no offensive smells are evident. Residents commented they are very satisfied with the standards of cleanliness that are maintained. A range of satisfactory policies and procedures are in place to guide and direct the staff about good standards of hygiene and safe working practices. Risks are positively managed about the environment and equipment at the home. The arrangements to assess and manage risks that individual residents encounter need to be improved. In recent weeks the provider has established a suitable format for recording risk assessments but assessments are not always completed when required. The assessments that have been recorded do not always adequately identify the action the staff are required to undertake. A format to record mobility assessments is also in place but on occasions the information is incomplete. Resident commented they feel safe at the home and from the information provided by the registered manager action does take place to promote safe working practices that is not recorded. The home does not have a specific policy and procedure for managing risk. The registered manager is addressing the issues and additional guidance and advice is being offered by the Commission. Tremethick House D52-D04 S9095 Tremethick House V236108 180705 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 4 14 x 15 3
COMPLAINTS AND PROTECTION 2 x x x x x x x STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x x 2 2 Tremethick House D52-D04 S9095 Tremethick House V236108 180705 Stage 4.doc Version 1.40 Page 23 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 3 Regulation 14 Requirement The records of the assessments of service users needs must be more detailed about the service users needs choices and preferances. Care plans must provide sufficent information, guidance and direction for staff to meet the assessed needs of service users in a safe manner. Prescribed medicines must be safely administerted. The enviroment and facilities provided must meet the required standard. Regular monthly reports must be recived by the Commission and regsitered manager about the running of the home. The records about service users must be comprehensive and detail the events that occur, any action taken or required and the outcome of the action. A policy and procedure about the management of risk must be established. A risk assessment must be completed on each occassion a situation arises that could potentially compromise the
D52-D04 S9095 Tremethick House V236108 180705 Stage 4.doc Timescale for action 30.10.05 2. 7 15 30.12.05 3. 4. 5. 9 19 31 13 23 26 26.7.05 30.7.06 30.9.05 6. 37 37 30.11.05 7. 8. 38 38 13 13 30.9.05 30.9.05 Tremethick House Version 1.40 Page 24 health, safety or welfare of a service user. 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 3 8 Good Practice Recommendations The format for recording the managers assessments of service users should provide more space for the information to be recorded. Detailed records of any visits by a health proffessional or reviews of a service users needs should be maintianed. Tremethick House D52-D04 S9095 Tremethick House V236108 180705 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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