Inspection on 24/07/06 for Zapuzino

This inspection was carried out on 24th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Zapuzino 27/06/07

Zapuzino 20/01/06

Zapuzino 13/07/05

Zapuzino 09/12/04

Zapuzino 22/06/04

Zapuzino 30/03/04

Zapuzino 27/01/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Zapuzino 205 Alexander Drive Cirencester Glos GL7 1UH Lead Inspector Mrs Janet Griffiths Key Unannounced Inspection 24th July 2006 10:40 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 Zapuzino DS0000016662.V302065.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. Zapuzino DS0000016662.V302065.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Zapuzino Address 205 Alexander Drive Cirencester Glos GL7 1UH 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) 01285 651057 Mrs Rosemary Teresa Kilby Mrs Rosemary Teresa Kilby Care Home 6 Category(ies) of Old age, not falling within any other category registration, with number (6) of places Zapuzino DS0000016662.V302065.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th January 2006 Brief Description of the Service: Zapuzino is a small Care Home within a large housing estate on the outskirts of Cirencester town. The Home is within a quiet cul- de- sac and surprisingly unobtrusive. Once inside the Home offers single accommodation for the elderly person who requires assistance and supervision in some of their daily activities. The communal lounge/diner on the ground floor has been enlarged following an extension of a small conservatory area, which provides the Home with separate dining facilities. Other accommodation consists of one bedroom that is located on the ground floor; this has communal bathing and toilet facilities next door. Five other bedrooms are located on the first floor, accessed by a stair lift and one of these has en-suite facilities, with the other four providing hand washbasins. The home does not have waking night staff and the Registered Provider/Manager provides emergency night cover. Information about the service to include CSCI reports is made available by the provider to prospective service users through the homes’ Statement of Purpose and Service Users Guide. At the time of inspection the fees are from £431.25 to £450. Hairdressing, toiletries, holidays, transport and newspapers are charged for extra. Zapuzino DS0000016662.V302065.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. This unannounced key inspection commenced on one day in July 2006, with the site visit that took place over 5.30 hours and was carried out by one inspector. During this time the inspector spoke to all of the residents, one relative, staff working in the home and the manager/provider of the home. Five resident’s files were looked at in detail. Surveys were left with the manager to hand out to relatives to be completed with the residents where possible. The one relative spoken with took a survey with her to complete. Once returned, the results will be collated and the information used in this or a later report. What the service does well: What has improved since the last inspection? Recruitment procedures have improved but the home must ensure that the relevant checks are made for all members of staff. Zapuzino DS0000016662.V302065.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Zapuzino DS0000016662.V302065.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 Zapuzino DS0000016662.V302065.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is judged to be adequate. This judgement has been made using available evidence including a visit to this service. Service users do not always have their needs fully assessed prior to admission to ensure that their needs can be fully met. EVIDENCE: Two people had been admitted since the last inspection, one of these only the week before and on respite care. Both were spoken with. The one gentleman seated in the lounge was quietly reading his paper and later sat in the garden. He said he had settled in and was relatively happy. The second gentleman had arrived on 7th July from out of county but he had been brought to the home prior to admission for the manager to assess him and get what details she could from his niece, as there were no medical records available. Zapuzino DS0000016662.V302065.R01.S.doc Version 5.2 Page 9 He had difficulty hearing and it was reported that tests for a hearing aid were being arranged. However, his conversation was quite confused and he appeared agitated and quite unsure about what was happening to him. As he has just been registered with a local doctor it was advised that the home makes an attempt to get more details of his past medical history, looking into whether there were records of any mental illness and to arrange for him to be seen by the doctor in case he required any further treatment or support. He had an assessment completed, which stated that he was anxious about moving but the assessment had not been fully completed. The other gentleman did not have all his paperwork completed but a copy of his assessment form was faxed to the Commission following the inspection. Intermediate care is not provided at this home. Zapuzino DS0000016662.V302065.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is judged to be adequate. This judgement has been made using available evidence including a visit to this service. The care planning systems in place, with one or two exceptions, provide the staff with the information they require to care for all the residents’ needs. Service users are protected by the homes policies and procedures for dealing with medicines. Service users health needs are fully met. Residents are treated with courtesy and respect. EVIDENCE: Five care files were looked at in detail during the inspection. The standex system of documentation is now being introduced and where completed provides a full assessment where problems are identified and then care is planned. The assessment also includes a moving and handing assessment. However, the frequency of reviews is not clear although reported as being 6monthly, and where acute problems have been identified, such as a sore area this is not reviewed more frequently in order to monitor the progress and the appropriateness of the treatment. Zapuzino DS0000016662.V302065.R01.S.doc Version 5.2 Page 11 In one instance where a service user suffers from epilepsy and has seizures there was no care plan for what to do in the event of a seizure, which was felt to be necessary. There was also no evidence that any care plans are reviewed with the service user or their relatives. The National Minimum Standards recommend that care plans are reviewed at least monthly and it is a requirement that where appropriate and unless it is impracticable to carry out such consultation, the review should be carried out with the service user or their representative who must be notified of any revision. One service user admitted on 7.7.06 did not have any care plans completed yet as his assessment was incomplete and had only had two entries made on the daily records, being reportedly told by the previous inspector that it was not necessary to report daily unless there were any changes or untoward events. However, when a problem is recorded this must be followed up with subsequent records to indicate what action has been taken. In all of the other care files seen a summary of the care required was completed to aid new staff and records of professional visitors were also in place. There was evidence in the records seen and from conversations with service users that they received professional visit from the doctor when necessary and any health issues were referred and dealt with by the district nurse. Wherever possible service users were taken out to visit the chiropodist, optician and dentist. Procedures are in place to ensure that medications are dealt with safely. The blister pack system is used and medications are administered directly from the blister pack to each service user and the medication record signed following administration. Most of the records were printed by the dispensing pharmacy and only prescriptions issued mid-month or for new residents would be handwritten. Those seen were clear and accurate but should be signed and countersigned by two staff to check for accuracy and dated. A medication is stored appropriately and there were no excess stocks held. The home needs to get a new British National Formulary as the current one is dated 2004. It was also suggested that a specimen signature list is kept to identity the initials of each member of staff. Staff were observed knocking on doors prior to entering service users rooms ensuring that they did not receive visitors unless they wished to do so. The residents and visitor spoken with confirmed that staff treated them with respect and were always polite and kind. Zapuzino DS0000016662.V302065.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is judged to be good. This judgement has been made using available evidence including a visit to this service. Residents experience some degrees of stimulation and social interaction at the home with visitors and community links encouraged, various informal activities being made available and appetising food being provided. EVIDENCE: On the day of inspection it was extremely hot following a very hot spell, so less activities than usual were taking place. Two residents were out for the day attending a local day centre and they were seen on their return in the afternoon. One gentleman and two ladies were sat in the lounge reading papers and the gentleman later visited the garden for a short time. The second gentleman stayed in his room until lunchtime and all but one retired to their rooms for a rest after lunch. All generally eat together at the communal dining table, which on this occasion was moved into the lounge where it was cooler. Zapuzino DS0000016662.V302065.R01.S.doc Version 5.2 Page 13 The manager and one of the carers confirmed that there were no planned activities but ad hoc games and exercises are organised according to the residents’ wishes and there is a good supply of books provided. As it is a small home, when trips are organised residents are taken out in cars of the staff who are insured to carry them. They have found that short local trips are much more favoured than long tiring outings to somewhere like Weston. A new garden centre was recently opened and they went to visit and have tea, which they confirmed they enjoyed. They also went to another garden centre for lunch recently and visit the local park and theatres. Sometimes individuals just enjoy going out shopping in town, as many have not been able to do that for some time. A communion service is held at the home each month and the hairdresser visits every week. Visitors are made to feel welcome as confirmed by the lady visiting who was spoken with. Her aunt has been at the home for five years now and she is settled and happy and her niece has had no cause for complaint. A record of the food provided each day is kept in the diary but in extreme temperatures such as the day of inspection menus are sometimes adapted accordingly. Lunch was jacket potatoes, tuna and salad followed by strawberry flan. All of this seemed to go down well and residents were heard commenting that they had enjoyed their lunch. Cold drinks were also readily available. One lady on her return from the day centre said she enjoys her day out to meet other faces but she gets a much better lunch at the home and enjoys all her meals there. The environmental health officer had visited last year and made a few recommendations, which have all been met. The report was seen. The kitchen seen following lunchtime preparation was found to be clean and in good order. Cleaning rotas were seen. Zapuzino DS0000016662.V302065.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is judged to be good. This judgement has been made using available evidence including a visit to this service. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users are protected from abuse EVIDENCE: From the pre inspection questionnaire received before the inspection the home has not received any complaints and none had been received by CSCI. A laminated copy of the complaints procedure was seen on the back of the door in each resident’s room and referred to CSCI. A copy is included in their Statement of Purpose/Service Users Guide. Residents and the relative spoken with confirmed that they knew what to do in the event of a complaint, one saying ‘Mrs Kilby will sort out any problems’. The home has policies in place to protect vulnerable adults and has a copy of the Department of Health ‘Protection of Vulnerable Adults Scheme’. The Registered Manager/Provider said all staff have read these policies. The manager confirmed that she now has a copy of the Alerters’ Guide and training has been arranged for six staff to attend one of three sessions on adult Protection training in early October. Zapuzino DS0000016662.V302065.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is judged to be adequate. This judgement has been made using available evidence including a visit to this service. The standard of the environment within this home is satisfactory and provides the service users with an attractive and homely place to live although there remain several issues that still need to be addressed to improve the environment for service users and to ensure they are not put at risk. EVIDENCE: A tour of the premises was undertaken as part of the site visit to include the garden. Most of the requirements made at the last inspection have been addressed but there is still a vanity unit surrounding a sink in one room that needs to be replaced because it could be an infection control risk. Zapuzino DS0000016662.V302065.R01.S.doc Version 5.2 Page 16 Most areas were clean with the exception of two stained carpets, despite regular cleaning. One of these rooms was also very odorous and it was suggested that alternative flooring could possibly be considered in order to eliminate odours embedded in carpets/flooring. The dining chair covers were also stained but it was reported that they are due to be recovered this week and the flooring in the assisted bathroom is due to be replaced also. Other than the above, the rooms seen were clean and satisfactorily furnished and most rooms had been personalised by the residents with photographs, pictures, ornaments and favourite items of furniture. Everywhere appeared to be well maintained and in good decorative order. There was a pleasant garden for residents to sit, with a garden shed, garden furniture and views across the fields. Zapuzino DS0000016662.V302065.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is judged to be adequate. This judgement has been made using available evidence including a visit to this service. The numbers of staff and skill mix generally meet the service users needs. The procedures for the recruitment of staff have improved but must be maintained to protect the people living in the home. Training opportunities have been provided for staff to improve their skills but there are inconsistencies with not all staff receiving training appropriate to the tasks they are to perform. EVIDENCE: The home was fully occupied with six residents at the time of inspection and there were two staff on-duty throughout the day. In addition to this there was an administrator working mornings to complete the homes’ paperwork. Care staff cook and prepare meals and complete laundry duties in addition to their care duties. There are no waking night staff, the manager who lives next door is on call and each room is fitted with an emergency alarm situated over their beds. One resident who suffers form seizures has an additional bell that she carries with her when she goes to the toilet or bathroom, but all bathrooms and toilets are fitted with emergency call bells. Most some residents have commodes in their rooms for night use. Obviously the condition of the residents must be under constant review and should anyone deteriorate and Zapuzino DS0000016662.V302065.R01.S.doc Version 5.2 Page 18 require more care or if someone upstairs started to become confused or wandering then either waking night staff would need to be available or the residents would have to be moved to another home. There are two senior carers appointed. One was on late shift and the other is on leave. Most of the care staff are allocated service users as key workers. Those spoken with during the inspection were fully aware of the needs of both their residents and the other residents in the home. Where possible they liaise closely with the families of these service users and give a monthly feedback to the manager of their care and condition and this is used at their supervision sessions. Although the home attempts to update training records as often as possible and to keep certificates or copies of them on file, it was apparent that these records were not up to date and the manager would be unable to see at a glance, especially during supervision sessions what training needed to be updated, especially mandatory training. The administrator will compile a list of recent staff training for this purpose. The manager is booked to attend a food hygiene update course on 14/9/06 and the Adult Protection training is booked for October. Fire training had been arranged for this month but was cancelled by the trainer and rearranged for 4/8/06; there was no evidence of recent moving and handling updates and the last first aid training according to certificates seen was in 2000. First aid training and all other mandatory training must be given as part of the induction programme and updated regularly. Two staff have NVQ 3 and a third has commenced the Foundation course leading to NVQ training. Files of the three most recently appointed staff were seen. All had an application completed with full carer history, a medical questionnaire, two references and CRB/POVA checks being carried out. Other documents noted in the files include an offer letter, the Code of Conduct, personal details, a job description and an induction checklist. It was noted that one file did not have a photograph or other identification such as a passport. The photograph has reportedly been taken and is waiting to be developed. It was reported that a young relative of the manager, who has left school does come to the home on occasions and helps out, working a few hours bed making, some cleaning and general (non-personal care) tasks. It was discussed that she will also require a CRB check and a personal file kept. All of the staff spoken with on the early and late shift enjoy their work and are fully aware of the needs of the service users. They have all received an induction and opportunities to undertake training. Zapuzino DS0000016662.V302065.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is judged to be adequate. This judgement has been made using available evidence including a visit to this service. The Registered Manager/Provider has a supportive, open approach to running the home, which benefits the service users, staff and relatives. So far as is reasonably practicable the health, safety and welfare of service users, staff and visitors are protected, however the home is not undertaking all the required safety training. There are processes in place to safeguard the financial interests of service users. Zapuzino DS0000016662.V302065.R01.S.doc Version 5.2 Page 20 EVIDENCE: There have not been any changes to the Management of the home although the manager recently appointed a relative to the post of administrator to deal with all the paperwork. The Registered Manager/Provider has completed the NVQ 4 training and has also undertaken an ASET course about Dementia. She is aware of the importance of keeping herself updated with training. Regular staff meetings are held; the last being 18/7/06 and minutes were seen. Six staff attended. Satisfaction surveys were sent out 18 months ago to both residents and relatives. This must now be repeated and the existing form is to be reviewed and updated. Once completed the results are to be collated, a report written and sent to CSCI with an action plan and a copy made available to those who participated as well as being available in the service users guide. Ways to expand the homes’ quality assurance programme were discussed and included obtaining the views of visiting professionals to the home such as district nurses and social workers. The manager does not act as appointee for any resident’s financial affairs but does hold at the residents/families requests, small amounts of personal expenditure money for two residents and records and receipts are kept for any financial transaction undertaken. There were still no records to provide evidence that staff have received fire training, but this has now been arranged (see standard 30). The home must ensure that staff receive fire training to reduce any risks to service users. Records of fire alarm and lighting testing were inspected and one member of staff spoken with confirmed that the alarms are tested every Thursday. Zapuzino DS0000016662.V302065.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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 2 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 2 X X 2 Zapuzino DS0000016662.V302065.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 OP3 Regulation 14 Requirement Timescale for action 2. OP7 15 3. OP19 23(2b) The registered person shall not provide accommodation to a 31/08/06 service user at the care home, unless , so far as it shall have been practicable to do so, the needs of the service user have been assessed by a suitably qualified/trained person; and a copy of the assessment has been obtained by the home Ensure that individual care plans reflect current needs of service 31/08/06 users. Review the care plan regularly with the service user or their representative where appropriate and unless it is impracticable to do so. The Registered Manager/Provider must address the maintenance 31/08/06 issues identified in standards 1926. This requirement has been repeated from the last two inspections. Zapuzino DS0000016662.V302065.R01.S.doc Version 5.2 Page 23 5. OP29 7, 9, 19 & Sch 2 The Registered Manager/Provider must obtain evidence that 31/08/06 appropriate checks have been undertaken on the work experience person to include a Criminal Records Bureau check. This requirement has been repeated from the last inspection. The Registered Manager/Provider 28/02/07 must ensure that training is provided for staff for the tasks they are to perform. This requirement has been repeated from the last inspection. A system must be maintained to review and improve the quality 28/02/07 of care provided in the home The Registered Manager/Provider must ensure staff receive fire 31/08/06 training as directed by the Fire Service and records must be maintained as evidence. This requirement has been repeated from the last inspection. 6 OP30 18 1 (ci) 7 8 OP33 OP38 24 23 4(d.) 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 The home should update its British National Formulary (BNF) annually and keep a specimen signature list of all the staff. Zapuzino DS0000016662.V302065.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Zapuzino DS0000016662.V302065.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!