Care Home: Franklin House

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What the care home does well People were happy with the flexible routines in the home, saying "I go to bed late because it is more peaceful to watch TV" and "Everything they do here is good". One relative said, "I looked at several homes but chose this one because I thought it was a safe environment and all on one level". We dined with people in the home who were satisfied with the food and choices available to them. One person said, "The food is always good here". Staff had access to training and a high percentage of staff have obtained NVQ`s. One person said "I am happy with the care staff they are very good". What has improved since the last inspection? Medication administration, recording and storage had improved since the last inspection. Refurbishment work had started with a number of aspects being completed, for example, corridors had been redecorated and new carpets had been fitted. A number of windows had been replaced and redecoration of bedrooms and replacement of carpets needed had begun, which was ongoing at the time of this visit. Routines in the dining room had improved providing a more congenial atmosphere for people in the home. CARE HOMES FOR OLDER PEOPLE Franklin House 4 Franklin Street Oldham OL1 2DP Lead Inspector Sandra Buckley Unannounced Inspection 11th June 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 Franklin House DS0000005507.V365479.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. Franklin House DS0000005507.V365479.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Franklin House Address 4 Franklin Street Oldham OL1 2DP 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) 0161 678 7870 0161 785 0779 Mr Harold Hilton Mrs Margaret Smith Mrs Marie Louise Powers Care Home 38 Category(ies) of Dementia - over 65 years of age (14), Old age, registration, with number not falling within any other category (23), of places Sensory Impairment over 65 years of age (1) Franklin House DS0000005507.V365479.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 23 OP up to 14 DE(E) and up to 1 SI (E) Date of last inspection 2nd July 2007 Brief Description of the Service: Franklin House is a detached, purpose built property, registered to accommodate 38 people. The home is privately owned and is situated in fairly close proximity to Oldham town centre. Accommodation for service users is situated on the ground floor. All bedrooms are single, 28 of which have en-suite toilet facilities. The home is built on a quadrangle with a central courtyard. Lift access is provided to the lower ground floor, which houses the laundry and provides access to a garden area. Car parking space is available at the front of the building. Fees charged by the home are £360. Franklin House DS0000005507.V365479.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 2 star. This means the people who use this service experience good quality outcomes This was a key inspection that included a site visit to the home. The manager was not told beforehand that we were coming to inspect, this is called an unannounced inspection. This inspection looked at all the key standards and included a review of all available information received by the Commission for Social Care (CSCI) about the service provided at the home since the last inspection. During the site visit information was taken from various sources, including observing care practices and talking to people in the home. The manager, relatives and some members of the staff team were also interviewed. A tour of the home was undertaken and a sample of care, employment and health and safety records were seen. Comments from questionnaires returned from residents and their relatives are also included in this report. The CSCI requires the home to complete an annual quality assurance assessment (AQAA) in order to demonstrate the level of care provided. The manager had completed this and comparisons were made with this document at the time of inspection. On this inspection the outcomes for people in the home did reflect that indicated by the manager in the AQAA, especially in relation to daily life, and protection. The manager had recognised what improvements could be made and was taking steps to address the issues. The Commission for Social Care Inspection had not received any complaints about the home. However, the manager had recorded eight complaints since August 2007 that had been appropriately dealt with and had been positively received. There were no adult protection issues at the time of this visit. Franklin House DS0000005507.V365479.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The manager must make sure that she obtains a full detailed assessment of people’s needs before she offers them a place at the home. This will ensure that no-one is admitted whose needs cannot be met by the staff group. More detail needs to be added to the care plans, especially in relation to accident recording and progress once an injury had occurred. The ongoing improvements to the home and garden area have created health and safety issues because of the amount of materials and tools left in the home. The manager must keep this under review to ensure people’s safety while such work is in progress. Franklin House DS0000005507.V365479.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Franklin House DS0000005507.V365479.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 Franklin House DS0000005507.V365479.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): Standard 3 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The failure to obtain an up to date assessment of people’s needs prior to them entering the home may put people at risk. EVIDENCE: Three case files were examined; one was found to have a full assessment of need from professionals. One case file looked at was for a person who had been in the home for a number of years, therefore assessment in relation to their needs at present was not applicable. However, there was evidence that reviews of care had taken place both by the home and the funding authority. In the third instance, a person recently admitted had an out of date assessment (2006), which related to domiciliary care and did not reflect the person’s needs at present. Franklin House DS0000005507.V365479.R01.S.doc Version 5.2 Page 10 The Annual Quality Assurance Assessment completed by the manager stated, that a full assessment of needs prior to admission is undertaken, together with the involvement of the social worker, so as to gather as much information about the prospective service user as possible and to ascertain if they can meet their needs effectively. This did not fully reflect the evidence we saw on this inspection. The manager acknowledged that there is room for improvement and that they are continuing to work towards meeting the national minimum standards. Franklin House DS0000005507.V365479.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): Standard 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 care plans in place are sufficient to provide staff with knowledge about how to meet people’s needs. EVIDENCE: There was evidence that improvements had been made in some aspects of care planning. People were weighed regularly and care plans gave clear instructions to staff on the capabilities of people. For residents whose communication was poor, staff were advised to give simple clear instructions. There were good observations made by staff on people’s habits that may indicate pain or a need to use the bathroom, for example, “places newspaper underarm if requires the bathroom.” Franklin House DS0000005507.V365479.R01.S.doc Version 5.2 Page 12 The Annual Quality Assurance Assessment stated that care plans are now posted to families who did not visit regularly and they are encouraged to provide input to the care plan. Professional visits were recorded and care plans had been reviewed. People’s interests, hobbies, their preferences and short social histories were also recorded. Some shortfalls were noted, for example, a care plan stated that a person with diabetes was diet controlled when it should have recorded insulin dependant and given clear instructions to staff on how to deal with any adverse reactions. Staff at interview did demonstrate an understanding of people’s needs and their levels of independence. Staff questionnaires reported that they had up-to-date information regarding service users. One respondent said “we are kept up to date with all information regarding service users, especially if there are any changes”. Questionnaires returned from people in the home reported that they receive the care and support they needed and that staff listened and acted on what they said. All respondents said they received the medical support they needed. Relative questionnaires stated that usually they receive enough information about their relative’s needs. One respondent said “Always told everything if she is ill or any problems there are”; another said I visit about three times a week and am made very welcome”. Other quotes included: “They always give her the attention and she is well cared for” and “Would call me if needed”. When asked what the home does well, relatives’ comments included: “The service and care I have encountered on my visit has been very good, staff have been caring and considerate and helpful”. We evidenced a number of recorded of accidents and noted that not all had been followed through to care planning and daily notes. We looked at three people’s accident records, which showed one graze to elbow, one skin tear and a cut to right foot and back sustained. Only in one case was there evidence that these accidents and outcomes had been recorded fully into care planning and daily notes. We did not see any evidence that the records detailed the progress people had made in recovery or treatment needed if any. Franklin House DS0000005507.V365479.R01.S.doc Version 5.2 Page 13 Three systems of communication were in use consisting of a communication book, records held on computer, and some daily notes. We felt this had the potential to be confusing and a review of how the staff communicate information, both verbally and written, should be undertaken to ensure people’s needs are met and nothing is being missed. There was sufficient independence. equipment in the home to promote people’s Improvements had been made to the storage, administration and the recording of medication. Where people had been identified has having allergies this was also recorded on medication sheets. Staff were observed doing safe working practices and dealing with people in a sensitive manner with people looking well presented. Two members of staff were interviewed both had completed NVQ level 2 or above. They stated other training had been provided in moving and handling, first aid, dementia care and protection of vulnerable adults. They had a good knowledge of people in their care and gave examples on how to maintain privacy and dignity, for example, always explain to people what you are going to do and throughout the process. People in the home discussed access to professionals; one said, “I have my own teeth and the dentist comes here or sometimes I go there”. Also “Staff do my fingernails and the chiropodist does my toenails. Franklin House DS0000005507.V365479.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Routines are flexible and people have choices in their daily lives. EVIDENCE: People interviewed felt that routines in the home were flexible. One person said “I go to bed late because it is more peaceful to watch TV then”, another said “You can please yourself when you go to bed but I prefer to go to bed at 9:30pm” and “Everything they do here is good”. The home has a cat and dog in residence which most people found comforting. One person said, “I like the cat to stay with me”. We dined with people and found that menus were displayed in large print, which offered a variety of choices at each meal with the main meal of the day being served in the evening. Franklin House DS0000005507.V365479.R01.S.doc Version 5.2 Page 15 Tables were set attractively and people who were independent are provided with individual teapots. One person said, “I enjoyed my tea tremendously” and “The food is always good here”. People were offered extra portions if they wished. The Annual Quality Assurance Assessment stated that improvements in the last 12 months have been employing an activity person two hours a day to provide additional stimulation and activities in an afternoon. Questionnaires from people in the home said usually activities were arranged and staff questionnaires stated “We are friendly and offer a good service to people who live here”. One person said, “I prefer to watch TV in my room” which demonstrates that people have the option of joining in activities, or not. The document also stated that there was no restriction on visiting, although one relative questionnaire told us that a notice had been put up requesting visitors not to call at mealtimes. People also have access to local churches and that an advocate can be obtained should any problems arise and no relatives are involved. There was evidence in the minutes of a residents’ meeting on 17th April 2008 that they are consulted on daily life in the home. For example, meals were discussed and one person commented that meals were not hot enough. Notes also identified that this had been addressed with kitchen staff. Problems with a delay at weekend of laundry being returned were also talked about. People said they were happy with the personal care and that they hoped the alterations to the garden would soon be finished. People were asked if they were satisfied with the activities, with people saying they would like a trip out and more in-house entertainment. Relative questionnaires returned said they felt that the home supported people to live the life they choose. Franklin House DS0000005507.V365479.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users are protected from abuse or exploitation by the policies and practices in place and were confident that any complaint would be dealt with appropriately. EVIDENCE: A written complaints procedure is in place which has been found to be appropriate on previous occasions and was not looked at during this visit. Respondents to the service users and relatives surveys all indicated they knew how to make a complaint if necessary. Respondents to the staff survey said they knew what to do if they received a complaint from any service user or representative. Relatives’ surveys indicated that the home respond appropriately to any concerns raised either always or usually. Comments included “I have found very few minor concerns so far and they have responded very well”. The log of complaints was looked at. This presented as being appropriately maintained and indicated that complaints were dealt with positively. Franklin House DS0000005507.V365479.R01.S.doc Version 5.2 Page 17 The information provided by the manager before this site visit indicated that staff were trained to recognise abuse and the procedures to be followed should they suspect abuse. This self-assessment also identified that further training was an issue which needed to be addressed. The manager reported that several staff had undertaken POVA training. Some documentary evidence of this was available although the training ‘matrix’ for 2007 could not be located at the time of this visit. We were not aware of any safeguarding issues relating to service users at Franklin House since our last key inspection. Franklin House DS0000005507.V365479.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home is predominantly appropriately maintained to provide a safe and homely environment for service users. EVIDENCE: During the visit to the home a tour of the building was undertaken. This included communal areas and a selection of service users’ bedrooms. There were several communal areas where service users could spend their time, or they could access their rooms when they chose. Service users’ bedrooms showed clear signs of personalisation. Staff who were asked, confirmed that service users were encouraged to bring in personal effects. Franklin House DS0000005507.V365479.R01.S.doc Version 5.2 Page 19 Most of the building presented as being safe and well maintained. Effective maintenance records were maintained including plans for future refurbishment. There was clear evidence, both visually and through documentation, that the fabric of the building was being improved, for example, the replacement of a large number of windows. One respondent to our survey questionnaires had identified improvements to the garden area as something the home could do better. Similarly, this was identified by the manager in the AQAA. It was clear that building work was underway to address this. Unfortunately, as a consequence of this, at the time of this visit, there were several hazards to health and safety in the inner courtyard and an adjoining conservatory area. These would be particularly hazardous to people who may be prone to tripping or who had a cognitive impairment. These concerns were brought to the attention of the manager at the time of the visit who undertook to restrict service user access to these areas. During this visit the home presented as being clean and tidy with no unpleasant smells. Respondents to the service user survey all said the home was clean and fresh, either always or usually. Two relatives commented, in response to being asked what the home does well, “kept very clean, keep up with decorating and furnishing” and “ … cleanliness of facilities”. Franklin House DS0000005507.V365479.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The numbers and skills mix of staff on duty promotes the independence and well being of service users. Recruitment and vetting procedures are predominantly effectively applied to minimise the risk to service users of inappropriate staff being employed. EVIDENCE: The staff rota for the week beginning 2nd June 2008 was looked at. This confirmed that staffing levels were usually provided at the level of five carers during the day (08:00 – 22:00) and three at night. Additionally, the home employs cooks, domestic staff and a handyman. The manager’s hours were in addition to those identified above. All respondents to the relatives survey felt that the care staff have the right skills and experience to look after people properly, either always or usually. All service users who responded to the survey said that staff were either always or usually available when needed. Respondents to the staff survey were less positive about staffing levels. In response to the question “are there enough staff to meet the individual needs of all people use the service?”, one replied always; three replied usually; and two replied sometimes. Franklin House DS0000005507.V365479.R01.S.doc Version 5.2 Page 21 The manager’s self-assessment reported that they had a high percentage of staff with NVQ level 2 and above. Staff respondents to the survey all reported positively on training. Staff who were asked at interview confirmed they received appropriate training and a selection of certificates were available to verify the information provided to us. A selection of files relating to the recruitment procedures for some new staff was looked at. These demonstrated an improvement in the vetting procedures from that identified at the last key inspection. Criminal Record Bureau disclosures and references were documented as having been received before the person commenced work. All respondents to the staff survey confirmed that pre-employment checks were undertaken. One person also said “I was not allowed to start working from the company until all the checks were back. This took a while but I was patient”. Scrutiny of the applicant’s employment history presented as being done less efficiently. Examples were seen where gaps in employment, according to the application form, had either not been explored, or the explanation had not been recorded. Similarly, references had been received, but it was not always clear why the particular referee had been approached. Service users who were spoken to during the visit were positive about the staff team. Comments included: “everything staff do here is good”, “staff treat me well” and “carers are very good.” Franklin House DS0000005507.V365479.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The manager does not consistently maintain systems which minimise any risks to service users. EVIDENCE: The manager is appropriately qualified and experienced. Responses from the surveys were positive about the care provided by the home. Two relatives made a point of saying they thought the home did everything well. One said they were “very happy indeed” with the home, another said “ … they are always there for me and another specifically said “[the manager] is especially helpful and friendly with all the residents and families.” Franklin House DS0000005507.V365479.R01.S.doc Version 5.2 Page 23 There was documentary evidence that the home had sent out surveys to assist in their own quality audit in 2008. The responses to these had not been collated at the time of this visit. However, documentary evidence was provided to demonstrate that this had been done in the previous year, together with an action plan. There was documentary evidence of a potentially comprehensive internal “quality control” process, which should identify areas where things are being done well, or where there may be room for improvement. However, a number of examples were seen where a failure to fully complete the process rendered it, effectively, not helpful. The fact that it was being done indicated a positive commitment to improving standards, but the failure to complete it fully was indicative of a gap in the managerial oversight. A selection of records relating to money held by Franklin House on behalf of service users was looked at. The records presented as being predominantly appropriately maintained to safeguard the interests of the service users, with an ‘audit trail’ to explain each individual expenditure. A small sample of records relating to the routine maintenance and independent checking of equipment was looked at. This included the fire detection and alarm system, the passenger lift and hoists. These records presented as being in order. The failure to adequately protect service users from access to the dangers in the courtyard posed a potential risk to their health and safety. Staff who were asked confirmed the availability and use of personal protective equipment such as disposable gloves and aprons, to minimise the risk of crossinfection. Franklin House DS0000005507.V365479.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 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Franklin House DS0000005507.V365479.R01.S.doc Version 5.2 Page 25 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 Detailed assessment of need relating to residential care must be obtained prior to people’s admission, which will ensure the service is able to meet people’s assessed needs. Timescale of 31/07/07 NOT MET. Timescale for action 31/08/08 Franklin House DS0000005507.V365479.R01.S.doc Version 5.2 Page 26 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 OP7 Good Practice Recommendations Care plans and accident recording must reflect the updated needs of people, especially when having sustained an accident to ensure that staff deliver the appropriate care. Continue to assess health and safety issues in relation to outside garden areas and building work for the protection of people in the home. Any gaps in work history identified on staff application forms once explored verbally must be recorded for future reference. Record keeping and filing systems in the home need to be reviewed in order to ensure consistency in communication and lessen duplication of records, as demonstrated in daily reports, with some being recorded on paper in files and others electontronically. 2 3 4 OP19 OP29 OP38 Franklin House DS0000005507.V365479.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Manchester Local Office Unit 1, 3rd Floor Tustin Court Port Way 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 Franklin House DS0000005507.V365479.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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