Inspection on 15/01/07 for Trepassey

This inspection was carried out on 15th January 2007.

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

Trepassey 13/03/06

Trepassey 11/01/06

Trepassey 18/03/05

Trepassey 05/07/04

Trepassey 21/12/03

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Trepassey Hillside Road Heswall Wirral CH60 OBW Lead Inspector Mrs Julie Garrity Key Unannounced Inspection 15th January 2007 10:15 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 Trepassey DS0000018949.V295291.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. Trepassey DS0000018949.V295291.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Trepassey Address Hillside Road Heswall Wirral CH60 OBW 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) 0151 342 2889 0151 342 7031 Cheshire Residential Homes Trust Mrs P Lucas Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Trepassey DS0000018949.V295291.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13/03/06 Brief Description of the Service: Trepassey is a residential care home that provides personal care and accommodation for up to 24 older people. The home is owned by a registered charity, the Cheshire Residential Homes Trust and was opened in 1958. Trepassey is located in a quiet residential area of Heswall and benefits from views across the River Dee estuary across to Wales. The town centre is less than a mile away and a bus service passes the end of the road. The home is a three-storey detached house set in well-kept sloping gardens with access to a level patio area at the front of the building. All bedrooms are single and have an en-suite toilet or shower/toilet facilities. Bedrooms are located on each floor. Communal accommodation within the home consists of 2 lounges, dining room, reception hall and a sunroom. There is a passenger lift that serves all floors and bathing aids are available. Parking is available within the grounds of the home. Trepassey DS0000018949.V295291.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over a period of one day. The inspector arrived at the home at 10:15 and left at 16:15. The inspector spoke with 7 residents, 1 visitor, 5 staff, the deputy manager and the manager. The inspectors completed the inspection by a site visit to Trepassey, a review of records available in the home and CSCI offices, discussions with residents, visitors, staff and management. Copies of records were submitted to CSCI for review in this inspection. The inspector followed an inspection plan written before the start of the inspection to ensure that all areas identified in need of review were covered. All of the Key standards were covered in this inspection, these are detailed in the report. Feedback was given to the manager during and at the end of the inspection. The arrangements for equality and diversity were discussed throughout the visit and are detailed throughout this report. Particular emphasis was placed on the methods that the home used to determine individual needs and the practices that they put into place into meeting those needs. What the service does well: What has improved since the last inspection? The manager has up dated the risk assessments in the home to maintain the residents safety and made adjustments accordingly. The level of training for Trepassey DS0000018949.V295291.R01.S.doc Version 5.2 Page 6 staff in qualifications for care have increased and` staff who are undertaking this training say that they “enjoy” the course. 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 summary of this inspection report can be made available in other formats on request. Trepassey DS0000018949.V295291.R01.S.doc Version 5.2 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 Trepassey DS0000018949.V295291.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 were reviewed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All new residents are assessed before they move in. This allows staff to determine if they can meet the resident’s needs. EVIDENCE: A review of care records showed that all potential new residents had assessments carried out before they move to the home. The assessments are done by a staff member who has received training or has qualifications to do so. These were clearly written, signed and dated when done and were used to determine the physical and medical needs of the residents. Some areas such as social needs, spiritual needs and community needs were also part of the assessment. Trepassey DS0000018949.V295291.R01.S.doc Version 5.2 Page 9 The manager is aware of equality and diversity needs of the residents and makes sure that the individual needs of the potential residents are identified. Staff spoken with had a clear understanding of the range of different needs of the residents that they cared for and were able to speak with knowledge on what these were. The majority of service users pay for their own stay in the home. If the local authority pays for the individuals care a social worker carries out a needs assessment and the home receives a copy of this and the care plan. Residents are invited to make visits to the home to view the facilities, meet other residents and staff. The residents spoken with were confident and chatty. They were very independent and spoke warmly of the way that staff understood their needs. One resident said, “I choose this place not just for the nice location but for the warmth of the staff and the fact that they spent time making sure that they understood what I want and why I felt the need to move here”. The home is a no smoking home throughout and all residents are informed of this before they move in. One resident said, “when they said I couldn’t smoke anywhere in the home I had second thoughts, but then I figured it’s a nice home its nice people it might be useful not to smoke too often. If I want a cigarette I just nip outside. It can be a bit cold in winter, but is lovely in the summer”. Trepassey DS0000018949.V295291.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 were reviewed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Medications are managed in a manner that supported the residents and helps the staff give out medications safely. There is a reliance on verbal communication. Written instructions and records regarding planning of care are insufficient to make sure that staff will always be able to provide the correct support. Staff are aware of the privacy and dignity needs of residents and residents feel that they are treated with respect at all times. EVIDENCE: Four care plans were viewed. The current arrangements for care planning are large and cumbersome. They indicate the actions that staff need to meet the needs of the residents but do not provide clear instructions for staff to follow. The plans seen are not care plans but constant records of care provided and Trepassey DS0000018949.V295291.R01.S.doc Version 5.2 Page 11 significant incidences, such as a GP visit. The format they are in does not allow residents to access and agree to the actions that staff are to take in order to support their needs. The staff have worked in the home for a long time and are keeping each other up to date regarding the residents needs on a daily basis in verbal conversation. However the manager says that the home may have to consider the usage of agency “temporary” in the home in the near future. Without clear instructions temporary staff will not be able to deliver the correct care or support to the residents. The residents spoken with had not seen a care plan. Two residents said, “what’s a care plan”. Another one said, “I didn’t know they kept records, it would be nice to see them”. As the records have become very long over time, it is very difficult to check when a GP had visited, what medical care is in place or what the instructions for care were without knowing exactly when the note was made in the record. This becomes more difficult the longer a resident a resident remains in the home has the records get longer and longer. Residents spoken with said that they are aware of any regular appointments and are supported to attended. Comments such as this were made, “if I’m ill a doctor comes straight away” and “the staff help me get to appointments I never miss them”. An audit of the medications showed that they were being given in accordance with prescription and given to the residents in a safe manner. Staff have all received training in medications and all have been assessed that they are competent to do so. On going audits for medications are done by the manager and this helps identify issues. There were some minor documentation areas that would increase the safe practice management of medications and these were discussed with the manager at the inspection. Discussions with the staff detailed that they had a good understanding of how to maintain the dignity of residents. They were aware of the diversity needs of the residents and respected that they had individual choices to be supported. This understanding makes sure that staff are aware of how to maintain the dignity of the residents they support. Residents spoken with said that staff were always “kind, courteous and happy to help”. All the residents spoken with were enthusiastic about the care they receive, the support that staff give them and the respectful manner that they are dealt with. Trepassey DS0000018949.V295291.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 were reviewed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The current residents are able to express their opinions and choices. The staff listen to these and they support the residents to exercise their choices. The food available suits the needs and choices of most of the residents. However consideration will need to be made for those potential and current residents with special diets and different choice to what is provided. EVIDENCE: Visitors are welcome at the home. The residents are very independent and said that their visitors are made to feel welcome at the home and that they can choose whether to see their visitors. The majority of service users go out with their families and friends. Representatives from local churches visit the home. A mobile shop also visits the home. There are very few records that detail resident’s personal choices. Without these written records staff rely on the residents who being able to detail what their personal choices are. Residents spoken with were clear that they are able Trepassey DS0000018949.V295291.R01.S.doc Version 5.2 Page 13 to make individual choices. Many have family locally that regularly take them out. A mealtime was observed, this was very relaxed, and residents spoken with said that they “enjoyed” the food. Although this opinion was not shared by all with one resident saying that they found the food “ a little boring at times”. There are menus available but these were not on view for the residents. The menus did not detail a choice of meal at lunchtime but there was one for the evening meal. As the residents are able to discuss their choices this lack of written information is given to them daily by the staff. At meal times the dinning tables are each given separate dishes of accompanying food such as vegetables and potatoes. They are encouraged to serve themselves and this supports their own personal choices and promotes their independence. The menus available did not detail the inclusion of special diets such as diabetes as an example. The menus were formed by the chef but are altered as it becomes obvious that the residents choices have changed. The residents spoken with were clear that their daily routines were pretty much of their choosing they were aware of when meal times are and what they could do to influence their own days. It is fortunate that the current residents are able to clearly express their opinions, however consideration will need to be made in the future should the needs of the residents change and to incorporate those residents less able or reluctant to keep charge of their daily activities. Trepassey DS0000018949.V295291.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 were reviewed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are confidant that they are able to raise any concerns and that these will be dealt with to their satisfaction. Staff have received the training and have the understanding to make sure that they can protect the residents from any potential abuse. EVIDENCE: Residents spoken with were confident that they were able to detail any concerns and that these would be addressed. One resident said, “there is no need to complain, but if I have a problem it gets fixed, no need to make a fuss. The staff are just so nice and happy to help”. A complaints procedure is available in the home that residents can ask for. The manager records any concerns raised, in the resident’s records. However these records as detailed above can become difficult to look through. All staff have received training in the protection the residents from abuse. This is part of their induction and also a separate training course. Staff spoken with had a clear understanding of this process and the ways in which an allegation of this nature would be dealt with. Trepassey DS0000018949.V295291.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, and 26 were reviewed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Trepassey is well maintained, clean and tidy. The residents like living in the home and enjoy the different facilities available. The home supports the residents to bring in personal items to make their bedrooms feel more like their own space. EVIDENCE: A tour of the home was undertaken and a sample of bedrooms seen. The residents spoken with said, “its such a lovely spot, a beautiful house with beautiful views, peaceful and happy what more could I ask”. Another said, “it’s always very clean, the girls here work very hard to keep it nice. Its always lovely and tidy”. The home is decorated in a style similar to a persons own home and attempts have been made to keep it homely with pictures etc. There was evidence of on-going decoration to maintain standards at the home. Trepassey DS0000018949.V295291.R01.S.doc Version 5.2 Page 16 There is one main dinning room and residents can eat in the dinning room or in their own bedrooms. There are several smaller lounges and a “sun room”. Residents enjoy the aspect that they can choose to sit in different places in the home. There home does not have smoking facilities residents cannot smoke anywhere in the home. Residents bedrooms were viewed. They all had items that the residents had brought in from their own homes such as pictures and odd items of furniture. One resident spoken with said, “ its nice to have my things around me. It wasn’t an easy decision to come here but they bring me comfort and help me feel settled here”. The Kitchen is located on the ground floor near the dinning room. A full cleaning schedule was available for the staff and the kitchen was clean and well maintained at the site visit. The freezers and fridge were checked, the chef detailed that there was sufficient equipment available in the kitchen and any breakdowns are dealt with very quickly. The items in the freezer what not always clearly detailed as to when they needed to be used by. The chef said that he was always in attendance and knew when things would be out of date. However it can not be guaranteed that he will always be there and as such the food should be dated to make sure that other staff are aware of the expiry date as well. The laundry is situated on the first floor of the home. A washing machine and tumble dryer are contained within a very small room. Although a system has been put in place to suit the facilities available, which includes using an outside cleaning service for the cleaning of bedding and towels, it would benefit staff if a larger area were made available for washing and drying clothes. At present it would be difficult to manage clothing that can only be hand washed. Plans to extend the home to provide a larger laundry area and further storage facilities are currently being looked at. Trepassey DS0000018949.V295291.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30 were reviewed. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents feel that there is sufficient staff available in the home to meet their needs. There is a policy that covers staff recruitment that is in place to safeguard. EVIDENCE: Staff and residents said that they felt that there was “enough staff”. The majority of the residents in the home are very independent and the staff support this independence. Staff spoken with had a good understanding of the basic needs of the residents and the comments from the residents included “great staff”, “very supportive” and “they are there when we need them and check with us if we want their help”. The manager is trying to recruit new staff and on the day of the site visit had interviews scheduled for new staff. The manager detailed that if they were unable to recruit new staff to replace those that had left they would need to use agency staff (casual staff) in order to maintain good staffing levels. The home has not used agency staff in the past and this would need to be carefully managed in order to maintain the quality of staff available in the home. Trepassey DS0000018949.V295291.R01.S.doc Version 5.2 Page 18 Staff are supported to take formal qualifications in care with the senior staff doing a higher level. All mandatory training for care staff such as health and safety and moving and handling is done on a yearly basis. Staff spoken with are aware of the need for them to have this training regularly. The manager has a training plan that shows what training they are doing and what training each staff member needs, This helps her make sure that staff always stay up to date in their general training. The home does have service users who have diabetes as an example of a specific condition. However staff have not received training in this area. In particular the chef would benefit from training in this area and other specialised diets in order that the home can readily meet the diverse needs of residents who need a specialised diet. Records showed that an induction is provided for all new staff. The induction covers all policies and procedures, care practices and the operation of the home. The health and safety training that each member of staff needs is identified and courses are arranged. Discussions with staff detailed that they were aware of having undertaken induction training. Staff files were viewed. Generally all staff had received appropriate checks such as references, police checks and fitness to work with elderly people in order to make sure that they had the right experience and skills. However one member of staff had been recruited without to references. The manager detailed that this was an “oversight” and would make sure that all staff had been recruited in accordance with the homes own policies in the future. Trepassey DS0000018949.V295291.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 36, 37 and 38 were reviewed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health and safety aspects within the home are correctly managed. The management of the home makes sure that the home can safeguard the residents and support the staff to undertake their job roles. EVIDENCE: Trepassey DS0000018949.V295291.R01.S.doc Version 5.2 Page 20 The registered manager has many years experience within the care sector and has been at the home for over 20 years. She is a Registered General Nurse (RGN) and has an NVQ level 4 in management. The manager does not have a copy of the standards that includes the Care Homes Regulation 2001. This means that the management team will find it difficult to meet these regulations without knowing what they are. There are arrangements for obtaining the views of residents and their relatives such as residents meetings and questionnaires that are regularly sent out. The information from these does influence the running of the home such as activities and menus as examples. However there is no plan developed that would assist the home in increasing the quality such as identifying training needs as an example. Staff do have supervision but this is not regular as yet but is being progressed by the manager. Staff spoken with found that the senior staff and the manager were very supportive of their points of view. Regular staff meetings are held and the staff spoken with said that they found this useful as they were kept up to date and informed of changes. There are policies and procedures in the home that also include aspects of equality and diversity such as harassment, equality of opportunity. The policies and procedures are in need of updating as some areas of best practice have changed and as yet have not been fully included in the policies available. Although readily available and discussed at induction, staff spoken with said that they don’t often have time to read them. Some personal allowances are held on behalf of residents. However the home does not have a legal responsibility for any of the funds of the residents. Receipts are kept for residents spending or holding money given them by the staff. The training records showed that staff are provided with training around safe working practices. Records demonstrated forthcoming training courses that staff are attending to update their health and safety training if needed. Maintenance certificates for gas, electricity and equipment in the home are all up to date. The fire systems are regularly checked and any issues are identified and fixed. The home has fire risk assessments and general environment risk assessments. These have been recently reviewed and the manager tries to keep them up to date. Trepassey DS0000018949.V295291.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 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 3 X 2 X 3 3 3 3 Trepassey DS0000018949.V295291.R01.S.doc Version 5.2 Page 22 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 person must ensure that the residents care plans provide sufficient information on the actions staff are to take to support residents and ensure their safety. Outstanding from 13/03/06. Timescale for action 15/05/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard RCN OP7 Good Practice Recommendations The manager should have a copy of the standards available in the home at all times. Residents and their families should be included in the writing of care plans. The plans should be written in a format that makes them accessible to residents and easy to read. They should include all aspects of personal support such as daily routine, likes, dislikes and personal preferences. The home should find away to clearly record professional DS0000018949.V295291.R01.S.doc Version 5.2 Page 23 3. Trepassey OP7 4. 5. 6. 7. OP9 OP15 OP26 OP29 interventions that allows this information to be found easily and is built into the care plans in the home. All residents who manage any aspects of their own medication should have a risk assessment in place. The manager should consider reviewing the menus available so that they clearly details a choice of lunchtime meal and any special diets. The plans to extend the home to include a laundry area should be progressed. The manager should check that all staff files are up to date and contain evidence that each member of staff has been appropriately recruited to the home. Consideration should be made to making provision for training to meet residents assessed and planned needs such as diabetes etc. The manager should review all polices and procedures in the home and make sure that they are up to date. Staff should be supported to regularly access all policies and procedures available. 8. OP30 9. OP33 Trepassey DS0000018949.V295291.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Trepassey DS0000018949.V295291.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!