Care Home: Four Seasons

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What the care home does well Discussion with residents, relatives, staff and visiting health and social care professionals revealed that residents were treated with respect and that their right to privacy was upheld. Comments made included; `the staff are attentive and very helpful`, `I like it here and the staff know how to look after me`, `I feel safe and happy here`. On the day of inspection staff were observed to interact positively with residents and show them respect, protect their dignity and assist them properly throughout the day. What has improved since the last inspection? The range of activities continues to be increased within the home, with recent purchase of multi sensory equipment which is accessible to all residents. The environment on all units has been improved. For example new carpets have been laid. The redecoration of the bedrooms continues as part of the home`s ongoing programme of refusrbishment. Residents menus have been reviewed. The way residents are cared for towards the end of life has been radically reviewed and changed through the introduction of the `Gold Standards Framework` (supported by visiting advanced nurse practitioners) that enures that end of life needs of residents can be met appropriately at the home and prevent the need for hospital/hospice admission. The requirements made at the last inspection have been complied with. What the care home could do better: Whilst there is generally a robust recruitment process in place a recent photograph of all staff employed at the home should be retained. Also it is recommended that two staff sign written entries to resident`s medicine administration records. It is also acknowledged that the home has identified through its quality assurance processes areas where they can provide a better quality service to residents and have taken action to do so. CARE HOMES FOR OLDER PEOPLE Four Seasons Breightmet Fold Lane Bolton Lancashire BL2 5NB Lead Inspector Mike Murphy Unannounced Inspection 15th May 2008 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 Four Seasons DS0000005678.V363837.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. Four Seasons DS0000005678.V363837.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Four Seasons Address Breightmet Fold Lane Bolton Lancashire BL2 5NB 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) 01204 392005 01204 393005 fourseasons@schealthcare.co.uk www.schealthcare.co.uk Southern Cross Healthcare Services Ltd ‘Post vacant’ Care Home 121 Category(ies) of Dementia (54), Old age, not falling within any registration, with number other category (67) of places Four Seasons DS0000005678.V363837.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP (maximum number of places: 67) Dementia - Code DE (maximum number of places: 54) The maximum number of service users who can be accommodated is: 121 Date of last inspection 20th November 2007 Brief Description of the Service: Four Seasons is a 121-bedded care home providing a service to mainly older people, which include general nursing, dementia and residential care. The Home is also registered to provide care for eight younger people with a physical disability. The Home is situated on a bus route about 2 miles from Bolton Town Centre. The premises are purpose built on two levels with two lifts to the first floor. All bedrooms have en-suite facilities. Fee structure at the time of this inspection - from £363.83 to £589.00 per week (figures supplied by the home). Please consult the home for further details. Four Seasons DS0000005678.V363837.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 stars. This means the people who use this service experience excellent quality outcomes. This inspection which included a site visit that the home did not know was going to take place was carried out over a ten hour period on the 15th May 2008. The process of inspection included observing what went on in the home, talking to residents, relatives, staff, visiting health and social care professionals and the home manager, looking round the home, and examining some important records. Before the inspection, we also asked the manager of the home to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This helps us to determine if the management of the home sees the service they provide the same way that we see the service. We felt this form was completed in well. What the service does well: What has improved since the last inspection? The range of activities continues to be increased within the home, with recent purchase of multi sensory equipment which is accessible to all residents. The environment on all units has been improved. For example new carpets have been laid. The redecoration of the bedrooms continues as part of the home’s ongoing programme of refusrbishment. Residents menus have been reviewed. The way residents are cared for towards the end of life has been radically reviewed and changed through the introduction of the ‘Gold Standards Framework’ (supported by visiting advanced nurse practitioners) that enures that end of life needs of residents can be met appropriately at the home and Four Seasons DS0000005678.V363837.R01.S.doc Version 5.2 Page 6 prevent the need for hospital/hospice admission. The requirements made at the last inspection have been complied with. 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. Four Seasons DS0000005678.V363837.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 Four Seasons DS0000005678.V363837.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are appropriately assessed prior to admission to ensure the home can meet their care and support needs. EVIDENCE: The pre-admission assessment records of 8 residents admitted since the last inspection were looked at. Before residents are admitted to the home an assessment of their needs is carried out in consultation with the resident, their relatives and relevant health and social care professionals such as doctors and social workers. The reason for such an assessment is to help the prospective resident (and their relatives) decide how appropriate a placement at the home would be and enable the nurse conducting the assessment to determine if the Four Seasons DS0000005678.V363837.R01.S.doc Version 5.2 Page 9 home will be able to meet the prospective resident’s needs appropriately. The initial assessment helps to form the basis of the plan of care to be followed following admission to the home. The 8 residents care records inspected contained detailed pre and post admission assessments. Respite care is offered if beds are available at the time of enquiry. The manager advises prospective residents to look at other care provision in the local area, so a comparison can be made thereby promoting choice. Residents and relatives spoken to indicated that they were involved in the preadmission process and that their views were important in the process. Four Seasons DS0000005678.V363837.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 and 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care provided for residents is suitable, well organised, and meets the expectations of residents and their relatives. EVIDENCE: The care records of twelve residents were inspected – three from each of the four units at the home. These contained care plans that were initially based on the pre-admission assessment that is referred to earlier in this report. Care plans addressed the health and personal care needs of residents in a clear, organised way and were evaluated at least monthly. Risk assessments, that seek to protect resident’s health and welfare supplement the care plans in respect of residents skin integrity (assessing the risk of pressure sores), mobility/moving and handling, nutrition, (including regular weight monitoring) and other areas of potential risk for individual residents were also assessed at Four Seasons DS0000005678.V363837.R01.S.doc Version 5.2 Page 11 least monthly (for example the need for bed rails to be used). Daily statements regarding resident’s progress are also recorded and these are dated, timed and signed by staff. All residents are registered with a local GP and it was evident that all were enabled to access the services of dieticians, opticians, chiropodists, dentists, district nurses and other specialist services as individual residents needed. Care records are audited regularly as part of the home’s quality assurance processes. Discussion with resident’s relatives on the day of inspection indicated that they are kept informed of all changes in their relation’s health. The arrangements for resident’s medicines were inspected on each unit at the home. The practices for the receipt, recording, storage, handling, administration and disposal of resident’s medicines were appropriate and safe. The nursing staff are responsible for the management of resident’s medicines on the nursing units and senior care staff (who have received appropriate training) on the ‘residential’ unit. Medicine records had been completed properly. However it is recommended that two members of staff sign handwritten transcriptions on medication administration records. Discussion with residents and staff revealed that residents were treated with respect and that privacy was upheld and dignity respected. Comments made included; ‘the staff are attentive and very helpful’, ‘I like it here and the staff know how to look after me’, ‘I feel safe and happy here’. On the day of inspection staff were observed to interact positively with residents and show them respect, protect their dignity and assist them properly throughout the day. The home has clear and robust practices for the care of residents who are dying. Plans contain clear information about the residents’ wishes. The management team provide support and training for staff and there are opportunities to express anxieties and share emotional stress in this area of work. The gold standard framework is being operated in relation to palliative care and two senior nurses at the home are ‘champions’ for this and liase with Macmillan nurses/advanced nurse parctitioners to enure that end of life needs can be met appropriately at the home and prevent the need for hospital/hospice admission. Also a relative room has been provided adjacent to the general nursing unit. Staff employed at home feel they have been provided with very good training/support to deliver this vital care. Four Seasons DS0000005678.V363837.R01.S.doc Version 5.2 Page 12 Four Seasons DS0000005678.V363837.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged and enabled to maintain family/community contacts and participate in social activities and are also encouraged to make personal choices in their daily life. There was satisfaction with food provision at the home. EVIDENCE: A wide range of leisure and social activities continues to be provided. Residents from each unit are able to participate in the varied group activities provided. A programme of activities and events was prominently displayed throughout the home – this lets residents know what is going on and choose what activities they wish to participate in. The programme of activities is supplemented by entertainers coming to the home and a variety of outings that provide opportunities for residents to enjoy life and leisure in the wider community. Residents spoken to say they found the activities they chose to participate in Four Seasons DS0000005678.V363837.R01.S.doc Version 5.2 Page 14 enjoyable and appropriate. The home has recently purchased sensory equipment for a new sensory room on one of the EMI units that is accessible to all residents within Four Seasons. There are also plans to create a sensory path in the gardens which will incorporate a seating area scented bushes and plants. Residents and their relatives said that there continues to be no unreasonable restrictions to visiting at the home. The only time restrictions would be imposed is when requested by residents. Relatives spoken to during the inspection said they were always made welcome at the home and were able to see their relatives in the privacy of their own rooms. Residents wishing to maintain their religious links are enabled to do so. Observation of care practice and information in care plans indicated residents are encouraged to make choices. For example what time they like to get up/go to bed. While some residents chose to sit in the lounge areas within the various units a number were observed to spend their time in their own rooms. Meals are cooked on site in the home’s kitchen. Meals are varied, balanced and the menu provides choice – 3 meals a day plus supper provided are provided – also snack food/drink is available at all times on all units. Meals are prepared in a central kitchen on site. Menus were prominently displayed throughout home and in foyer area for all to view. There are appropriate and comfortable dining areas on all four units. Lunch was observed on the day of inspection (on 1 unit) – this was a hot substantial meal, providing choice, good portions and residents were appropriately/sensitively supported by staff. Staff wore disposable aprons and residents clothing was suitably protected. Residents can choose to eat in their own room if preferred. Medical/religious/vegetarian diets were being catered for. The consensus view from residents is that the food is good and that an alternative to the menu can always be obtained if requested and that this is supplied with good grace. The Catering Manager provides an annual assessment and audit of the kitchen area and records, to improve the standards within the kitchen area and overall nutrition provided to our Service Users. Four Seasons DS0000005678.V363837.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives knew how to make a complaint if they felt it necessary. Written guidance and training arrangements ensure that staff members have knowledge of abuse and protection arrangements and safeguards were in place to protect the welfare of residents. EVIDENCE: The complaints procedure was prominently displayed and is also available in the ‘Service users guide’ that is provided for resident’s and their relative’s information. A complaints log is maintained that details the nature of the complaint, how it has been investigated and the outcome. The home operates safeguarding and whistle-blowing policies that seek to protect residents. In addition, a copy of Bolton’s Inter agency protection procedure is held on site. Staff spoken to confirmed that they had safeguarding training (this was reflected in training records maintained by the home) and were aware of the whistle-blowing policy. Appropriate pre-employment checks are conducted on all staff to ensure suitable people look after the resident’s. There have been complaints and safeguarding issues since the last key inspection. These have been managed appropriately within the complaints and safeguarding procedures operated at the home and by the local authority. The Four Seasons DS0000005678.V363837.R01.S.doc Version 5.2 Page 16 home manager has alerted the appropriate authority promptly of any suspected safeguarding issues. Four Seasons DS0000005678.V363837.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): 19,21,22,24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home appeared to be structurally well maintained throughout and provides a suitable and comfortable environment for the care of residents. EVIDENCE: A tour of the four units at the home was made during this inspection. All communal lounges and dining rooms were inspected and between four and six resident’s bedrooms on each unit. All areas were clean and warm and suitably ventilated. It was evident from inspection and discussion with the manager that a large number of environmental improvements have been made since the last inspection. These improvements include programmes of re-decoration and Four Seasons DS0000005678.V363837.R01.S.doc Version 5.2 Page 18 refurbishment in each unit occupied by residents. An ongoing programme of work is planned for the future in respect of each unit. Lounge and dining areas on each unit were clean adequately decorated and suitably/comfortably furnished. Bedrooms inspected on each unit were clean, suitably furnished and equipped and in a number of cases very personalised. All bedrooms are provided with en-suite WC and washbasin. Aids and adaptations have been made generally to the environment to assist and enable residents and appropriate hoisting equipment is available. Specialist beds are provided for those residents whose nursing needs require such provision. There are a number of well-maintained garden areas at the home. These are accessible to all residents and there are plans as stated earlier in this report to develop a sensory garden. The laundry area is separate from resident areas. The laundry was adequately equipped and staffed and the arrangements to provide residents with a laundry service were suitable and appropriate. Measures were in place to prevent the spread of infection such as suitable protective clothing for staff, cleaning programmes and hand washing arrangements. Malodour was being managed well specifically in areas of the home where it can be a challenge. All residents have their continence needs assessed and are provided with aids and support to appropriately deal with those needs. Also mechanical ventilation has been installed in one unit and the use of alternative floor coverings is also being considered to further combat the problem. Four Seasons DS0000005678.V363837.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The recruitment, provision and training of staff employed at the home are managed appropriately. This is important to ensure residents are cared for adequately and appropriately by staff able to deliver this support safely and competently. EVIDENCE: Staffing records showed that qualified nurses were on duty at all times on the nursing units and a team leader/senior carer on the ‘residential’ unit and that, in addition to nursing and care staff, the home employs a manager, two deputy managers, an administrator, a cook, kitchen assistants, laundry staff, maintenance and other staff to ensure that residents needs can be met appropriately. Inspection of staffing records, discussion with residents, the home manager and staff revealed the care and support needs, of the 120 residents living at the home at the time of this inspection appeared to be being met. Four Seasons DS0000005678.V363837.R01.S.doc Version 5.2 Page 20 The home continues to make progress in the provision of NVQ 2 and 3 training. At the time of inspection in excess of 25 of the care staff had received such training. 3 staff recruitment files were inspected on this occasion. They contained evidence of CRB checks (including POVA first checks), 2 written references, criminal convictions declarations, proof of identity, (but not a current photograph) and completed application forms – these included a detailed work history and a declaration relating to the prospective employees health status. Checks are made and recorded in respect of the status of registered nurses with their registered body. Training records and discussion with staff indicated that they were provided with induction training on commencing employment. There was also documentary evidence that staff had been provided training in moving and handling, safeguarding, fire safety and basic food hygiene and other topics. Four Seasons DS0000005678.V363837.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 and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is being very effectively managed by the new home manager - a qualified registered nurse with wide experience in nursing/management and the care of older people. EVIDENCE: A new home manager is currently managing the home since the departure of the person who was the registered manager earlier this year. The home manager is a very experienced qualified nurse and was previously the deputy manager at the home for many years. At the time of this Four Seasons DS0000005678.V363837.R01.S.doc Version 5.2 Page 22 inspection the manager was preparing to apply for registration with the CSCI and is shortly to commence study for the Registered Managers Award. Two deputy managers and an administrator support the manager in her role. A senior management team appointed by the company who own and operate the home also provides regular support. Discussion with residents, their relatives and staff indicate that the manager is accessible and visits all units of the home regularly. Discussion with residents, their relatives, staff and visiting professionals revealed that the manager adopts an approach that enables issues to be easily discussed with her and that emphasis is placed on operating the home in the best interests of the residents. Residents, their relatives and staff can also affect the way services are delivered at the home at the more formal regular meetings with the manager. Management policies are effectively implemented and monitored. The manager operates procedures that seek to ensure the quality of the service provided is good – and where it is identified as not being up to standard takes appropriate action to rectify the situation. The manager and her deputies regularly conduct formal audits of various aspects of systems and procedures operated by the home. For example residents care records are periodically checked to ensure they properly reflect the care and support needed by residents and also demonstrate care and support is delivered. The manager’s area manager also visits the home periodically and conducts her own audit of the home. Measures were in place to ensure that residents’ financial interests are safeguarded. Residents are encouraged to control their own money. However where they are unable (or choose not to) personal allowances are managed by the home. The arrangements for this were secure, appropriately documented and are regularly audited by the financial auditors of the organisation who own the home. The health, safety and welfare of residents and others are promoted and protected. For example staff are provided with regular training and appropriate equipment to ensure resident’s moving and handling needs are met – an example of this would be for a resident who needs to be safely moved with the aid of a hoist. Fire safety training is regularly provided. Documentary evidence was seen of gas and electrical safety inspections/servicing. The premises were secure at the time of this unannounced inspection. Hot water temperatures were being monitored regularly and the inspector was informed all immersion baths/showers are fitted with devices that are intended to prevent burns. The passenger lifts that enable residents and others to access all areas of the home have been serviced as has all hoisting equipment used in the home. Four Seasons DS0000005678.V363837.R01.S.doc Version 5.2 Page 23 All significant events in the home – including accidents and illness and monitoring visits by the home’s owners – are recorded and reported (as required legally) to the CSCI. Four Seasons DS0000005678.V363837.R01.S.doc Version 5.2 Page 24 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 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 X 3 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 4 X 4 X 4 X X 3 Four Seasons DS0000005678.V363837.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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 OP29 Regulation 19 Schedule 2 Paragraph 1 Timescale for action That in respect of people working 30/06/08 at the home; The CSCI is informed in writing that a recent photograph is kept of all staff working at Four Seasons Care home Requirement 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 That all handwritten transcriptions made to residents medicine administration records are signed by 2 staff Four Seasons DS0000005678.V363837.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Four Seasons DS0000005678.V363837.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. 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