Inspection on 15/06/07 for Well House

This inspection was carried out on 15th June 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

Well House 06/06/06

Well House 14/12/05

Well House 19/01/05

Well House 10/08/04

Well House 24/02/04

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 Well House Chestnut Way Brightlingsea Essex CO7 0UH Lead Inspector Ray Burwood. Key Unannounced Inspection 15th June 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Well House DS0000017993.V343768.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. Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Well House Address Chestnut Way Brightlingsea Essex CO7 0UH 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) 01206 303311 01206 306130 Southend Care Limited Ms Kerry Jane Williams Care Home 36 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (36) of places Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 36 persons) Three persons, aged 65 years and over, who require care by reason of dementia, whose names were supplied to the Commission in October 2002 The total number of service users accommodated in the home must not exceed 36 persons 6th June 2006 Date of last inspection Brief Description of the Service: Well House is a purpose built home for older people, situated in a residential area of Brightlingsea close to the town centre. Accommodation is all on one level and the home is divided into four units, each unit consisting of seven single bedrooms and one double bedroom. Each unit has its own lounge and dining area; there is an additional large communal lounge with a small sun lounge attached, and the home has secluded garden/courtyard areas outside. The home is registered to provide personal care for 36 Older People (over the age of 65), provides 24-hour personal care and support, and has appropriate equipment (e.g. mobile hoist, hand rails, etc.) to assist residents with limited mobility. There are currently some existing service users who have diagnosed dementia living at Well House. Southend Care owns the home and the registered manager is Kerry Williams. The current scale of charges, as notified to the CSCI at the inspection of the 15th June 2007 is between £355:81 and £393:19 per week, with additional charges for personal items (toiletries, hairdresser, newspapers, chiropody, etc.). A copy of the most recent inspection report was displayed in the home, and a ‘Service Users’ Guide’ was available to prospective residents to inform them about the home. Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on the 15th June 2007 with the assistance of the Registered Manager, people who live at the home, staff, and visitors, my thanks to them all. The site visit was conducted between the hours of 10:00am and 3:00pm. The inspection involved a tour of the premises, looking at records, documents, and talking to staff, including the cook, and people who use the Day Care facilities that do not live at the home. Feedback and interviews with residents, relatives and staff were positive about the standard of care, support, and the commitment of the management team. A total of 23 standards were inspected with twenty-one of the standards being met. Some good practice recommendations have been carried forward from the last inspection visit. At the end of the site visit, the findings were discussed with the Registered Manager, and advice and guidance given. Since the home’s last inspection, plans have been drawn up for a proposed change in their registration to include care for a number of people with dementia. At present, the building work related to this is not due to be completed until July 2007. What the service does well: Well House offer people who live there a good standard of care and support but at the same time allowing them to remain as independent as possible. The home is well managed by someone who is committed to providing residents and relatives with advice and support. Residents’ personal health care needs are well supported by a team of experienced and trained care staff. The management and support for staff is good. Training and development opportunities for staff are provided, and ensure that residents’ needs are professionally met. Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: All parts of the home must be kept in a good state of repair in order to provide residents with a comfortable and well-maintained environment in which to live in. In particular, walls and carpets in hallways and bedrooms. CRB checks on new staff must be obtained before new staff commences work at the home to ensure the protection and safety of people living there. Requests should be made to GP’s to update prescription details to ensure that administration instructions to people dispensing as required medicines are correct and the home has a protocol in place for staff guidance. Social and recreational needs of residents should clearly show the action required by staff to help service users occupy their time and engage in activities or social interaction The home’s recording procedures should ensure that they demonstrate that each new carer has completed an induction process that meets the specification and guidance recommended by “Skills for Care”. The home’s annual development plans should include the promotion of dementia care and further training for staff who will be caring for people with dementia, contain objectives that reflect aims and outcomes for residents and are specific, measurable and time limited. Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 7 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. Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 and 6. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. People moving into the home have their needs fully assessed so that they and the home can be sure the placement is appropriate. EVIDENCE: The home’s Statement of Purpose and Service User Guide have been updated to include the needs the home aims to meet and the facilities it provides to meet those needs. Both documents meet the requirement of the relevant regulation, are user friendly and clearly written. Large print documents are available to those who may be visually impaired. From discussions with the Placement Co-ordinator and Manager, it was noted that more informative assessment documents had been introduced since the home’s last inspection visit. Documents viewed and relating specifically to the admissions process included the aims and objectives, long term goal planning Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 10 and reports submitted by healthcare professionals regarding follow up appointments with health professionals after people have been admitted to the home. Instruction to staff for the admission of new residents has been introduced with measures in place that a care plan is generated within three days of admission. The Placement Co-ordinator had also introduced a tool for assessing the cognitive functioning of people who have dementia in readiness for the completion of the new dementia unit. Care files examined and people spoken to who live at the home, provided the evidence that they were properly assessed and needs planned for. One person in particular discussed how they moved into the home and how the transition from hospital to the home was good. Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8.9 and 10. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. The home ensures that the health care needs of residents are identified and met. Medication systems are well managed, promoting the good health and well being of residents. EVIDENCE: Since the home’s last inspection, new care plans have been introduced and old care plans are in the process of being replaced. Residents care plans examined contained a family history, health, social and recreational needs and interests. The registered manager explained that there was some more work to do to ensure that all care plans are completed with the above information. Care plans sampled and examined were seen to be up to date, detailed and contained sufficient information to support staff in meeting the health, personal and social care needs of the individuals they were caring for. Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 12 Staff have been given guidance on filling in care plans and have access to examples of suitable content, to ensure records are of a professional nature and informative. Team Leaders have been given set care plans that they are in the process of reviewing on a monthly basis. The registered manager said the new care planning documentation would be reviewed by her and signed off following completion of all reviews. Care plans seen reflect pressure area intervention, with staff receiving instructions in relation to pressure area care and the importance of reporting any concerns to enable the appropriate action to be taken. A separate record is maintained by the home for visits made by healthcare professionals. Staff have undertaken training in the following areas: • • • Diabetes. Tissue Viability. Falls Prevention. An examination of the home’s medication room and records was undertaken with the ordering, storage, administration, including controlled drugs and their disposal found to be correct. Team Leaders are responsible for the ordering and disposal of medicines and sign off disposals in the absence of the manager. The registered manager was advised to liaise with General Practitioners regarding information being included on prescriptions to ensure that instructions to people dispensing as required medicines are correct and the home has a protocol in place for staff guidance. The registered manager explained that senior staff were aware of the requirement and importance of signing and dating any hand written details and changes they make to medication administration records. Staff were observed interacting with residents, and showed an understanding of the needs of older people and those with dementia. Staff were observed to be patient and kind, residents spoken with felt their privacy was respected and that staff are sensitive when they needed help with personal care. Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. People living at the home experience a varied life at the home with visitors encouraged, various informal activities made available, and good meals. EVIDENCE: From observations and discussions with people living at the home, it was evident the option of being involved in a range of activities taking place in the home. One person spoken with was looking forward to the local carnival-taking place at the weekend. The home offers a day care area but on the day of the visit the places were taken by people who did not live in the home, however, the inspector was able to discuss the day care facilities with the people who were present. They said the facilities were good, the food was good and it was a pleasant break from being at home. The registered manager said team leaders were responsible for liaising with staff about daily activity programmes and how they can contribute through Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 14 their expertise to the interests of residents during their shift. Residents spoken with said they were not under any pressure to attend activities and staff respected their choices about daily routines. The weekly activities information board was prominently displayed in all hallways and showed a range of activities should residents wish to join in. Some care plans that had been updated included action required by staff to help residents occupy their time and engage in social activities. The registered manager said key-workers were in the process of completing all care plans with this information. Contact with relatives and friends is encouraged by the home and visitors made welcome. One relative spoken with said she was always made welcome when they visited and was kept up to date with any relevant information. The registered manager informed the inspector that they made a point of spending time at the home at weekends specifically to meet relatives and friends who don’t visit during the week. People living at the home were spoken with during their lunch break in each unit and some who preferred to eat lunch in their rooms. All residents said they enjoyed the food presented, had a choice of meals available and were supported by staff if they needed it. The registered manager pointed out that regular meal surveys take place and menus are monitored. Discussions with the cook indicated that she would speak to people living at the home about menu planning. Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. The home has an open culture where individuals feel safe and supported to share any concerns in relation to their protection and safety. Arrangements for the protection of vulnerable adults and staff training are good and help protect residents from abuse. EVIDENCE: The home had a clear complaints policy and procedures that had been updated to include the timescales for the registered manager or others to respond to any complaints raised. The registered manager indicated that no complaints had been received since the last inspection visit. Complaints records examined verified this. One resident spoken with said if they had any concerns or problems they would talk to the registered manager or their key-worker. Policies and procedures relating to the protection of vulnerable adults were in place with appropriate guidelines for staff to follow should a complaint of abuse be made or they observe an incident of abuse taking place. Staff who had not previously trained in the Protection of Vulnerable Adults had now undertaken the appropriate training. Records of attendance were seen to this effect in staff development, training profiles and programmes. One Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 16 member of staff spoken with confirmed that they had undertaken the appropriate training in house delivered by the registered manager. Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. The home provides a safe and a generally satisfactory environment that could be improved through further decoration and refurbishment. EVIDENCE: The home’s layout and location is good, suits its purpose and generally meets the needs of most people living there. During a tour of the home some areas were observed to require attention, particularly corridor walls where protective wooden fittings were badly scoured and scratched. The registered manager said decoration to bedrooms was undertaken as and when they become vacant. Floor coverings were observed to be worn and marked although one member of staff said a carpet cleaner was now available to keep carpets clean and some replacement has taken place. Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 18 One area highlighted during the last inspection relating to an offensive odour had been addressed. The home is currently in the process of having an extension built to provide additional rooms and facilities on the first floor. The registered manager said the work has not been completed and was looking at the end of July 2007 before the buildings work would be completed. A range of communal areas was available to residents in each unit and a main lounge for all residents to share. Day care facilities and outside areas were accessible to residents and seating provided. One resident spoken to said he enjoyed the garden and patio areas particularly after lunch when they can go outside to relax. The home’s laundry was found to be clean and tidy, located away from areas where food was prepared, transported or served and was well equipped with three washing machines and three driers. Housekeepers were employed to carry out cleaning duties and provide laundry duties. Since the last inspection, staff had undertaken infection control training and instruction. Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support and meet the needs of the people who use the service. The home’s recruitment process is not robust and does not ensure the safety and protection of people who live there. EVIDENCE: Rotas examined on the day of the inspection showed that there was sufficient staff on duty during the day and night to meet the needs of people living at the home. Four new members of staff had been employed since the last inspection visit. The registered manager said some staff had been working additional hours but the situation had been risk assessed to ensure the health and safety of staff and residents were not compromised. Overtime working is monitored and regulated by the registered manager. Staff on long days have staggered breaks on the premises to ensure continuity of care and maintain staffing levels. Some agency staff has been used to cover night shifts. At the time of the inspection visit a total of twenty eight carers were employed by the home of which five had achieved the NVQ Level 3 qualification, a further Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 20 five staff had achieved the NVQ Level 2 qualification. Two members of staff were hoping to start their NVQ training soon. Seven staff employed by the home from abroad, had qualifications equivalent to the NVQ Level 3. Their qualifications were verified by the National Recognition Information Centre for the United Kingdom (UK NARK). Records and correspondence relating to the qualification checks were seen during the inspection. Files of the most recent members of staff to be employed were examined and one staff file was found not to contain the information and documents required before they are able to start work. The person was allowed to commence working on the evidence of a POVA First check being received. The member of staff concerned did however have a CRB check in place at the time of this inspection. The registered manager was advised that staff must have a CRB check in place before they start working at the home. The home’s induction training had been progressed with guidance from “Skills for Care” being used and supplemented by the organisations induction programme. Staff spoken with confirmed that they had undertaken induction training, but not the up to date version from “Skills for Care”. The registered manager said all new staff would be inducted using the new material. During the inspection visit the registered manager submitted an overview of training completed since the last visit. Evidence was provided to confirm that POVA, medication, infection control training and bereavement counselling had been completed by most staff. As previously reported, staff had received training in pressure ulcer identification and prevention, basic awareness diabetes and falls prevention. Seven members of staff and the registered manager are currently studying Dementia Awareness through distance learning. Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 and 37. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. There is leadership; guidance and direction to staff to ensure service users receive a good quality of care. Residents’ personal wellbeing and safety is promoted through staff training, comprehensive policies, procedures, and regular health and safety checks. EVIDENCE: The registered manager has enrolled onto the Registered Managers Award (RMA) and NVQ Level 4 in Care. The registered manager has also undertaken periodic training to update their knowledge, skills and competences whilst Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 22 managing the home. Feedback from residents and staff about the registered manager was positive with comments received about her being approachable, supportive and always on hand for advice. The registered manager said the home had documents and processes in place, including audit forms, residents’ surveys and business plans that supported the quality assurance and monitoring of the service. Ongoing quality monitoring and audit processes within the home continue to be used and include Management Reports that cover a wide range of practices in the home, in particular records relating to medication practices. The registered manager confirmed that regular monthly monitoring visits are carried out. The registered manager was advised that a working copy should be held in the home following these visits. The home’s annual development plan was not viewed during the inspection. The manager was advised that information should include the specific development and running of the dementia unit, together with timescales for further management training and staff training in dementia. Staff files inspected contained up to date supervision sessions with action notes and recommendations in place. Staff spoken with said they received supervision on a regular basis. Records relating to sessions were seen in staff files inspected. Residents’ finances were examined and records found to be in order. The home continues to operate a non-interest bank account for residents. Each resident had a clear account record with records showing in going and out going monies. The manager is currently appointee for two residents. Records relating to the health and safety of individuals living and working in the home were generally well maintained with appropriate training undertaken by staff in safe working practices. The testing of equipment and servicing records seen were all up to date. Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 24 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 OP19 Regulation 23 (2)(d) Requirement Timescale for action 31/10/07 2. OP29 19 All parts of the home must be kept in a good state of repair in order to provide residents with a comfortable and well-maintained environment in which to live. In particular, walls and carpets in hallways and bedrooms. CRB checks on new staff must be 31/08/07 obtained before new staff commences work at the home to ensure the protection and safety of people living there. In exceptional circumstances where a person needs to start work prior to a full CRB check being obtained, the Commission must be informed and there must be evidence that a POVA First check has been obtained and documented evidence of the supervision arrangements in place pending receipt of the CRB. (Previous timescale of 30/06/06 not met). Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 25 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 OP9 Good Practice Recommendations It is recommended that the registered person requests that GP update prescription details, to ensure that administration instructions are accurate and staff are aware of the reason why ‘as required’ medicines are to be given. It is recommended that care plans for social and recreational needs clearly show the action required by staff to help all service users occupy their time and engage in activities or social interaction. The home’s recording procedures should ensure that they can demonstrate that each new carer has completed an induction process that meets the specification of the National Training Organisation (i.e. Skills for Care). It is recommended that annual development plans including dementia care and staff training, contain objectives that reflect aims and outcomes for residents, and are specific, measurable and time limited (i.e. SMART). 2. OP12 3. OP30 4. OP33 Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Well House DS0000017993.V343768.R01.S.doc Version 5.2 Page 27 - 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!