Care Home: Ash Cottage

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What the care home does well Ash Cottage provides the people who use the service with a well-maintained, safe, homely environment to live in. The staff team work hard to meet the residents` needs in a manner that treats them with respect and dignity. Residents are fully supported by the staff team to identify and pursue their goals and to make decisions about their own lives. There is a strong commitment to helping residents maintain their social contacts and independence and relatives were seen visiting at different times throughout the day. Residents are always consulted individually and in groups about areas that affect their lives like the menu, activities, and equipment to promote their independence. Staff practices and care plans examined promoted individual human rights and choice with fairness, equality, dignity and respect, and these are central to the care provided. Residents seen were comfortable, well dressed, clean and nourished. When asked about the standard of care at the home the inspector was told, "I feel safe and happy, I`m contented and the care staff are lovely. There is nothing they wouldn`t do for you. Even if they are busy, they ask you to wait a couple of minutes and always come back to you. Please, please believe me when I say that the standard of care here isVery good, I want you to know that I`m being sincere". Comments made by other residents were; "We are well looked after" "I have no complaints, I`m happy living here". "Staff are very caring". "The staff are delightful". What has improved since the last inspection? The manager of Ash Cottage was able to discuss and demonstrate her understanding of the key principles and focus of the service. The manager and her team have carried out some much-needed work around these systems and procedures so that there are better overall outcomes for the people who use the service. It is apparent that the residents quality of life is paramount to the staff team and the newly reviewed care plans support this by focusing on equality and diversity issues which promotes their human rights. Residents` care plans and records have been fully reviewed and focus on their individual needs and ensure the care delivered is responsive and person centred. This has given each resident an opportunity to shape their service and the way they want to live and they know their care needs will be met. Existing service policies and procedures have also been reviewed and updated to meet the National Minimum Standards, current thinking and practice and underpin good practice. The passenger lift has been repaired and is in full working order promoting residents` independence and safe working practices. The manager ensures that residents are involved in risk assessments and these are taken into account in planning the care and routines of the home. Record keeping and management systems at the home have improved to ensure safe working practices and the efficient running of the service. Residents` monies are now stored securely and appropriate records are now kept to verify any transaction. This means that appropriate recording systems are in place to safeguard and protect the financial interests of the people who use the service. The manager said that she is on target to improve the existing quality monitoring systems and has planned to meet with Investors In People (IIP) in September to update these systems so that there are the best possible outcomes for the people who use the service. CARE HOMES FOR OLDER PEOPLE Ash Cottage Crow Woods Edenfield Ramsbottom Lancashire BL0 0HY Lead Inspector Mrs Christine Mulcahy Unannounced Inspection 28th July 2008 10:00 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 Ash Cottage DS0000009498.V365114.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. Ash Cottage DS0000009498.V365114.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ash Cottage Address Crow Woods Edenfield Ramsbottom Lancashire BL0 0HY 01706 826926 01706 826926 ash.cottage@hotmail.co.uk 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) Mrs Margaret Mary Holt Ms Ann Josephine Zieme Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Ash Cottage DS0000009498.V365114.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service should employ a suitably qualified and experienced person who is registered with the Commission for Social Care Inspection as manager of Ash Cottage only. 16th JULY 2007 Date of last inspection Brief Description of the Service: Ash Cottage is registered with the Commission for Social Care Inspection to provide care and accommodation to 20 older people. Ash Cottage is a detached building in its own grounds, located in a semi-rural area in the village of Edenfield, on the outskirts of Rawtenstall. The home has a large purpose built extension, and opened in 1989. There are views of open countryside on one side of the home. Public bus routes to Rawtenstall, Ramsbottom and Bury are within easy reach. In the nearby village are a number of small shops, and a public house. Banks, larger stores and other amenities can be found in Rawtenstall approximately 2 miles away. There are three separate lounge and dining areas giving the people who use the service a choice of where to sit and who to sit with. Toilets and baths are conveniently located to communal rooms and bedrooms, and have various aids and adaptations to assist and promote mobility and independence. Accommodation is offered in 12 single rooms, 5 of these have en-suite facilities, and four double bedrooms 1 with en-suite facilities. The first and second floor is accessible by a passenger lift and stair lift. People who are new to the service receive a guide about the service and a Statement of Purpose. Fees range from £360 - £410 per week and residents are billed separately for hairdressing, newspapers, magazines and chiropody. Ash Cottage DS0000009498.V365114.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection included a visit to the home and took place on 28th July 2008. Information was obtained from residents care plans, staff records, policies and procedures, management systems and inspector observations. The inspector also spoke to 9 of the people who live at the home, 2 care workers and the registered. Resident and relative surveys were not sent to the home. There have been no complaints received about the service since the last inspection. The quality rating for this service is 2 Star. This means the people who use this service experience good quality outcomes. What the service does well: Ash Cottage provides the people who use the service with a well-maintained, safe, homely environment to live in. The staff team work hard to meet the residents’ needs in a manner that treats them with respect and dignity. Residents are fully supported by the staff team to identify and pursue their goals and to make decisions about their own lives. There is a strong commitment to helping residents maintain their social contacts and independence and relatives were seen visiting at different times throughout the day. Residents are always consulted individually and in groups about areas that affect their lives like the menu, activities, and equipment to promote their independence. Staff practices and care plans examined promoted individual human rights and choice with fairness, equality, dignity and respect, and these are central to the care provided. Residents seen were comfortable, well dressed, clean and nourished. When asked about the standard of care at the home the inspector was told, “I feel safe and happy, I’m contented and the care staff are lovely. There is nothing they wouldn’t do for you. Even if they are busy, they ask you to wait a couple of minutes and always come back to you. Please, please believe me when I say that the standard of care here is Ash Cottage DS0000009498.V365114.R01.S.doc Version 5.2 Page 6 Very good, I want you to know that I’m being sincere”. Comments made by other residents were; “We are well looked after” “I have no complaints, I’m happy living here”. “Staff are very caring”. “The staff are delightful”. What has improved since the last inspection? The manager of Ash Cottage was able to discuss and demonstrate her understanding of the key principles and focus of the service. The manager and her team have carried out some much-needed work around these systems and procedures so that there are better overall outcomes for the people who use the service. It is apparent that the residents quality of life is paramount to the staff team and the newly reviewed care plans support this by focusing on equality and diversity issues which promotes their human rights. Residents’ care plans and records have been fully reviewed and focus on their individual needs and ensure the care delivered is responsive and person centred. This has given each resident an opportunity to shape their service and the way they want to live and they know their care needs will be met. Existing service policies and procedures have also been reviewed and updated to meet the National Minimum Standards, current thinking and practice and underpin good practice. The passenger lift has been repaired and is in full working order promoting residents’ independence and safe working practices. The manager ensures that residents are involved in risk assessments and these are taken into account in planning the care and routines of the home. Record keeping and management systems at the home have improved to ensure safe working practices and the efficient running of the service. Residents’ monies are now stored securely and appropriate records are now kept to verify any transaction. This means that appropriate recording systems are in place to safeguard and protect the financial interests of the people who use the service. The manager said that she is on target to improve the existing quality monitoring systems and has planned to meet with Investors In People (IIP) in Ash Cottage DS0000009498.V365114.R01.S.doc Version 5.2 Page 7 September to update these systems so that there are the best possible outcomes for the people who use the service. 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. Ash Cottage DS0000009498.V365114.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 Ash Cottage DS0000009498.V365114.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): OP 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service were given enough information about the home and a comprehensive needs assessment before they moved in so they knew their individual needs would be met. EVIDENCE: There is clearly written service guide for the people who use the service and statement of purpose to help people understand what services the home can provide. Both documents clearly set out the objectives and philosophy of the service. The manager said that admission to the home only takes place if they are confident they have the skills, ability and qualifications to meet the prospective residents assessed needs. Ash Cottage DS0000009498.V365114.R01.S.doc Version 5.2 Page 10 The care plan of one resident was examined and showed that a comprehensive needs assessment was carried out before admission into the home. The resident had been provided with clear and easy to read contract. The resident confirmed that she and her relatives knew what service to expect. The assessment documentation was always available to staff which helped familiarise them with the residents needs. Intermediate care is not provided. Ash Cottage DS0000009498.V365114.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): OP 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and social care needs of the people who use the service were clearly set out in a plan of care. Residents were protected by the homes medicine policies and procedures. The care practices observed showed residents privacy and dignity was fully respected. EVIDENCE: Case tracking of 3 people who uses the service and discussion with the manager confirmed that all resident’s had a plan of care that included sufficient details for staff to meet the identified needs. It was noted that each plan had been reviewed regularly and included initial information like name and address emergency contact. The care plan also included details about communication, mobility personal safety, medical history and medication, mental, physical state also daily routines and likes and dislikes were included. The plans detailed other areas such as dental, eye and foot care, the resident’s religion, sexuality, social activity and personal appearance. Ash Cottage DS0000009498.V365114.R01.S.doc Version 5.2 Page 12 The 3 care plans examined contained information about the resident’s daily living pattern including written information about their personal care and physical wellbeing. Where necessary moving and handling assessments and risk assessments clearly described the action to be taken and the risk associated with the activity. Care plans had been reviewed regularly and changes in the resident’s needs were identified and acted on immediately. All of the residents’ care plans and associated records have been fully reviewed and those seen focused on individual needs and maintaining a level of care that was responsive and person centred. Further records examined indicated that appropriate health care appointments were made available to the resident and other people who use the service as required or necessary. The home has an efficient medication policy supported by procedures that staff understand and follow. The manager and the supplying pharmacist make regular checks to ensure compliance with the policy. Examination of the medication administration records (MAR) showed they contained the required entries and were signed by appropriate staff at the correct times. All areas of medicines handling, recording and storage were well managed. Only the managers and senior day care staff were responsible for the administration of medication because they had completed accredited training in this area. The manager said that she would consider acreddited medication training for senior night care staff which would allow some flexibility to residents who wanted to take their medication later at night. A number of residents were observed using their bedrooms, and each of the 3 shared lounge/diners at different times during the day. It was apparent that residents could access any area of the home at any time of the day to maintain their privacy and were not discouraged from doing this. When asked about services at the home a resident confirmed that clothing worn that day was her own and clothing seen in her wardrobe was named accordingly. Another resident said, “I have no complaints, I’m happy living here”. Ash Cottage DS0000009498.V365114.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): OP 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Leisure and recreational activities available met many of the residents needs and interests. Visiting from relatives and friends was flexible. Meals and snacks ensured choice, variety and nutrition. EVIDENCE: The person in charge said that wherever possible people who use the service were able to make choices about aspects of their lives including waking and going to bed times and handling their own finances. Case tracking, examination of records and discussion with some of the resident’s confirmed that this was the case. The religious and cultural needs of the people who use the service had been assessed and identified when they moved into the home as part of the admission process and details were included in the care plan. This means that managers and staff were aware of the diversities amongst the residents and how these could be met. Activities at the home were planned and varied to suit residents preferences and capabilities. Some of the resident’s enjoy watching TV, conversation, Ash Cottage DS0000009498.V365114.R01.S.doc Version 5.2 Page 14 newspapers and magazines. One resident said about the activities` at the home, “I know the staff arrange things but most of us like to be left alone. I can always join in when I’m ready”. Another resident said, “You don’t have to do anything if you don’t want to. The staff are so kind”. Records of resident’s individual activities were noted in the daily report book and included brief details of the visits from relatives, outings, religious observance, hairdresser, art, music, games and TV. Relatives were observed visiting the home throughout the morning and afternoon and were made welcome by the staff team. The lunch served was lamb chops, mashed potato and seasonal vegetables. The meal was well presented and looked wholesome and nutritious and portions looked generous. It was apparent from the resident’s positive comments and actions that they enjoyed their meal and a number of residents managed to eat chocolate pudding afterwards. Hot and cold drinks were seen being served at regular intervals throughout the day. Ash Cottage DS0000009498.V365114.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): OP 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home follows a robust complaints procedure, so residents could be confident that any concerns were taken seriously and acted upon. The homes safeguarding procedure and staff training ensured that people living in the home were properly protected from risk of harm. EVIDENCE: There is a complaints procedure that specifies how complaints can be made and who will deal with them. There is an assurance that complaints will be responded to within a maximum of 28 working days. Although there have been no complaints to the CSCI since the last inspection the manager confirmed that complaints made would include details of the investigation and any action taken. When asked, the people who use the service said that they knew who was in charge and who to complain to if they were dissatisfied with their care at the home. A resident said, “I have no complaints, I’m happy living here”. There were procedures for staff to follow if they suspected an incident of abuse had taken place. Discussion with the manager confirmed that three care staff were not yet trained in safeguarding adults. This means that some of the care staff will not be fully aware of abusive practices. When asked, one of the untrained staff said that she would always tell the manager if she suspected Ash Cottage DS0000009498.V365114.R01.S.doc Version 5.2 Page 16 any form of abuse to residents. The registered person said there were plans to train these care staff care staff in the very near future. Ash Cottage DS0000009498.V365114.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): OP 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was maintained in good order, providing a clean, safe, warm and comfortable environment, which met residents’ needs. EVIDENCE: A tour of the home showed it was suitable for it’s stated purpose. Shared facilities, communal areas, bedrooms, bathrooms and the kitchen were decorated and furnished to a good standard. The home was light, bright and homely. Aids and adaptations like wheelchairs, stair lifts, handrails, passenger lift and other equipment to promote mobility and independence were seen being used around the home. The people who use the service were encouraged to personalise their bedrooms with their own furnishings and ornaments. Ash Cottage DS0000009498.V365114.R01.S.doc Version 5.2 Page 18 The home was well lit, clean and tidy and smelled fresh. When asked about their views on the homes environment one resident said, “It’s lovely and cosy here, very homely, I feel very lucky to be here”. Ash Cottage DS0000009498.V365114.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): OP 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care staff were competent to meet the needs of the people who use the service however the lack of staff supervision and up to date training means that some staff would not know how to fully meet the residents’ needs and the aims and philosophy of the service. EVIDENCE: The staff rota showed there were care staff vacancies however the home was staffed sufficiently. Particular attention was given to busy times of the day and specific needs of the people who use the service like medical appointments, leisure interests and at peak times of activity. The inspector observed staff involved in a number of daily activities with resident’s during the inspection demonstrating there were enough staff available to meet their needs. There was no up to date staff-training matrix and the manager said that she was in the process of changing the training provider. She said she recognised the need for continual staff training and said she was able to identify staff training needs through the review of the matrix. All of the care staff are trained to NVQ level 2 or 3 and 60 of the care staff team have received safeguarding vulnerable adults training. There is a good recruitment procedure that clearly defines the process to be followed and ensures the protection of the people who use the service. Two Ash Cottage DS0000009498.V365114.R01.S.doc Version 5.2 Page 20 staff members spoken to confirmed pre employment checks required to ensure the protection of the residents were done before they were recruited. And records in staff personnel files were examined to confirm this. The manager recognised there was a lack of male carers and said she would welcome male applicants along with others to fill the current vacancies. Ash Cottage DS0000009498.V365114.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): OP 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run in the best interest of the people who use the service. Systems are in place so that residents and staff can express their views and opinions. EVIDENCE: The registered manager has the required skills and experience to run the home and she has a clear understanding of the key principles and focus of the service. The management team regularly review the homes policies, procedures, records and practices to ensure staff awareness and ensure the wellbeing of the people who use the service. Ash Cottage DS0000009498.V365114.R01.S.doc Version 5.2 Page 22 Regular informal resident’s meetings showed that resident’ views were not always recorded. This means that their views might not always be known and acted on. The person in charge said that there is an open door policy and staff could talk to the manager at any time, however these talks were not recorded. An annual internal audit to measure relatives and resident’s satisfaction shows that the homes objectives are being met. There is a clear health and safety policy that ensures safe working practices. Records and documents examined showed fire drills, equipment and appliance safety checks were done regularly. The home has the necessary insurance cover in place to fulfil any loss or legal liabilities. There were details and records kept of resident’s fees charged and paid. A record of resident’s cash held at the home was examined. Resident and staff signatures verified the transaction. There are sound policies and procedures that are reviewed by the management team to ensure these are in line with current practice. Risk assessments were completed and taken into account when planning resident’s care and routines within the home. Ash Cottage DS0000009498.V365114.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 3 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Ash Cottage DS0000009498.V365114.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 OP32 Regulation Reg 26 Requirement The registered provider must visit the care home and interview the people who use the service and their representatives and staff working in the care home to form an opinion of the standard of care provided in the care home. Timescales of 31/01/07 and 28/09/07 not met. To ensure the homes philosophy of care, and staff career development are fully met the registered manager must ensure that persons working in the care home are appropriately supervised. Timescale for action 01/09/08 2. OP36 Reg 18 (2) 01/09/08 Ash Cottage DS0000009498.V365114.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 OP28 Good Practice Recommendations Night care staff would benefit from training on the principles behind all aspects of the homes policy on medicines handling and recording. This would ensure that all care staff knew how medicines are used and how to recognise problems in use. All care staff would benefit from regular training and refresher training so that they can fulfil the aims of the home and fully meet the changing needs of the people who use the service. 2. OP28 Ash Cottage DS0000009498.V365114.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Ash Cottage DS0000009498.V365114.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. 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