Care Home: Manorfield House

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What the care home does well What has improved since the last inspection? Since the last inspection the manager and other managers in the organisation have developed a new format to record people`s care plan, so that staff have all the assessed needs and action for them to follow when giving the care. The medication trolley, which was stored in the dining room, is now kept in a locked room. The staffing levels at night are risk assessed and the manager and her line manager will continually monitor staffing for nights, and will adjust staffing levels if there was an identified need. The manager has started to carry out moving and handling training so that all staff have up to date training. A coded lock has now been fitted to the door of the room care planning room. 90% of the staff have an NVQ National Vocational Qualification at level 2 or 3. All staff that administer medication, have done a distance learning course on safe handling of medication and Dementia awareness. The manager told us that the home is now working with "CHESS" (Care Home End of life Support Services) looking at End of Life training for staff. What the care home could do better: The manager must make sure that clear and detailed care plans are in place for all the residents to provide clear instructions for staff and evidence that care needs are met. A requirement was made at the last inspection. However some work has started to address this matter. Three people at the home said that they were bored and needed more occupy and stimulation them. All staff must have up to date First aid training. The manager and her staff should continue to work at developing the care plans to make sure that the individual records consistently provide detail and evidence of care. CARE HOMES FOR OLDER PEOPLE Manorfield House Manor Road Horsforth Leeds LS18 4DX Lead Inspector Valerie Francis Key Unannounced Inspection 30th January 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 DS0000033211.V359008.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. DS0000033211.V359008.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Manorfield House Address Manor Road Horsforth Leeds LS18 4DX 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) 0113 2583561 0113 2583561 Zena.Naheedyb@leeds.gov.uk Leeds City Council Department of Social Services Jacqueline Ross Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places DS0000033211.V359008.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th March 2007 Brief Description of the Service: Manorfield House is a purpose built residential home offering personal care to twenty-seven older people. It is owned and operated by Leeds City Council. The home has undergone a major refurbishment and the rooms are now all single and apart from two have en suite facilities. Accommodation is provided over two floors, the first being accessed by a passenger lift or staircase. All bathrooms have been fitted with specialist baths and equipment allowing residents to retain independence, privacy and dignity. Personal laundry is done on the premises and an outside contractor has responsibility for laundering towels and bed linen. All food is freshly prepared on the premises. The home is situated off the main road and parking is available for visitors. The fees range from £73.95 to £473.60 per week. There are additional charges for hairdressing and newspapers. This information was provided by the Home. DS0000033211.V359008.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. The Commission for Social Care Inspection (CSCI) inspects services at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. There is an evaluation of the quality of a service and any risk it might present at key inspection, the outcome focuses on the outcomes for people using the service. During this visit the key National Minimum Standards are assessed and this provides the evidence for the outcomes experienced by people. At times it may be necessary to carry out additional visits, which might focus on specific areas like personal care or dealing with medication and are known as random inspections. More information about the inspection process can be found on our website www.csci.org.uk The home was not told that an inspection would be taking place. One inspector carried out the inspection, which was started on the 22nd and completed on the 28th January 2008 feedback on the finding of inspection was given to the registered manager and the Principal unit Manager. The evidence used in this report has included: • • A review of the information kept by the CSCI (Commission for Social Care Inspection) on the agency since registration. An Annual Quality Assurance Assessment (AQAA) had been completed by the home before the visit to provide additional information. This is a self-assessment of the service provided. These documents seen at the home were also used as evidence in his report: • • • Policies and procedures Health and safety Care assessments DS0000033211.V359008.R01.S.doc Version 5.2 Page 6 • • • Training records Recruitment records Supervision records What the service does well: The home works closely with other homes in the organisation in the locality to carry out shared training to improve staff training in the homes. People were complementary about the care staff give them, people and their visitors told us: • • • • • • Staff are very kind and always willing to help. We are always made to feel welcome. If I have any concern about my mother I can see her key worker or the manager. If I have any concern it will be looked into and dealt with. We are very happy with the care we get. Staff are friendly and take an interest in the people they care for. People live in a home that is well maintained and kept clean to a high standard. Staff said they work well together to care and support the people living in the home. People who use the service, their visitors and staff said that the manager is approachable and always make time to discuss any issues they may have. What has improved since the last inspection? Since the last inspection the manager and other managers in the organisation have developed a new format to record people’s care plan, so that staff have all the assessed needs and action for them to follow when giving the care. The medication trolley, which was stored in the dining room, is now kept in a locked room. The staffing levels at night are risk assessed and the manager and her line manager will continually monitor staffing for nights, and will adjust staffing levels if there was an identified need. The manager has started to carry out moving and handling training so that all staff have up to date training. A coded lock has now been fitted to the door of the room care planning room. 90 of the staff have an NVQ National Vocational Qualification at level 2 or 3. DS0000033211.V359008.R01.S.doc Version 5.2 Page 7 All staff that administer medication, have done a distance learning course on safe handling of medication and Dementia awareness. The manager told us that the home is now working with “CHESS” (Care Home End of life Support Services) looking at End of Life training for staff. 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. DS0000033211.V359008.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 DS0000033211.V359008.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 & 3. Quality in this outcome area is good. There is enough information available to people to make sure they have an informed choice about moving into the home. The admission and introduction procedure is good. An introductory visit is part of the process if possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s Statement of Purpose gives people who wish to use the service, their relatives, carers and professional good information about the home and the service it provides. The Resident Guide gives people who live in the home additional information about the service provided. Both documents are looked at regularly and updated if necessary. DS0000033211.V359008.R01.S.doc Version 5.2 Page 10 We saw that up to date pre- admission information is gathered for all people who are admitted to the home. When people are admitted in an emergency situation, as much information as possible is gathered before they come to the home. We were also told that the home assessment process continues when they move into the home, to make sure staff have good information about the person, so that a care plan can be written to show how all their identified needs will be met by the staff. The Easy Care assessment document in most cases is received for all admissions, this is a record giving staff information about care needs from an assessment carried out by health or social care professionals. We saw a copy in the file of one of the last people admitted to the home at this time. It is part of the admission process to encourage people to visit and spend time at the home before they make the decision to move in. DS0000033211.V359008.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is good. The home is good at meeting the care needs of the people in their care but records do not consistently provide evidence of this. Medication practices are safe and healthcare needs are met This judgement has been made using available evidence including a visit to this service. EVIDENCE: From discussion we had with the manager and staff it was evident that the manager and the care staff team were knowledgeable about the people who they provide care and support to. During discussion with people they said that: • “I am well looked after.” • We are very happy with all that is done by staff. • When I ask for something it is always done for me. • I can always ask any of the staff for help and I will get it. DS0000033211.V359008.R01.S.doc Version 5.2 Page 12 We talked to people and their visitors about their involvement in the care planning process. They were not quite sure if there was a care plan in place, but they knew that they had discussed what they like and did not like and how they wanted to be treated with the manager and their key worker, who was a named designated staff who looked after them. The manager said she would have further discussion with people and their relatives about the care plan and their right to see the plans. Although the present Life Style Plans in place had good information there were no clear plans of action for staff to follow to meet people’s assessed needs. As part of addressing the shortfalls the manager is developing a more ‘user friendly’ care plan format with the intention of improving the written evidence of care. The new format to record care plans were seen, this the manager said she will be used to record care plans. Although she had written several people’s plan on assistance with bathing and this showed clear action for staff to follow. More work is still needed so that all identify needs have a plan of care with action for staff to follow. The case records of three people who live at the home were looked at in detail. All had a Lifestyle plan. There was useful and specific personal detail in the plans clearly indicating personal preferences about care needs. The standard of recording information about people who use the service in the Life Style plan was good but action needs to be taken and evaluation of records needs to be in place so that people’s needs are not overlooked and there is regular over view of the plan. All life style plans looked at contained information such as: • People’s name and their next of kin. • The name of the key worker. • Likes and dislikes. • Needs identified using activities of daily living. • Monthly weight recording. • Nutritional screening and risk assessments. • Falls risk assessments and management. • Moving and handling assessments. During the visit we talked about the home making the new care plans more individualised, for example, by including social histories. This will mean that staff can be sure that they provide care they way people want. People files had information of any visits by their G P, opticians, dentists, district nurses and any specialist healthcare agency. DS0000033211.V359008.R01.S.doc Version 5.2 Page 13 Although risk assessments were seen for risk of falling, mobility, moving and handling fall and fall management these for some people had not been reviewed for some time. • • • Were told by people that there were no restriction and they can if the wanted go to their rooms if they wanted. People said they were supported by their key worker, who in most cases they knew who they were. Staff were said to be “helpful and always willing to help. The drug trolley is safely stored. All the staff involved in the administration of medication have had training and receive regular updates. The local pharmacist also provides good support to the home. One senior member of staff oversees the ordering of drugs and all staff involved in administration share the responsibility of making sure the medication administration record (MAR) sheets are clear and up to date. We saw that staff and the people who live at the home are friendly without being overly friendly and people are treated with respect. The manager and her staff are committed to developing the records to make sure that they reflect people’s needs and the care given. Overall people living at the home are confident and happy with their care and feel well looked after. DS0000033211.V359008.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): 12, 13, 14 & 15. Quality in this outcome area is good. People who live at the home are able to exercise choice in their daily routines and their social expectations are met. People living at the home are provided with a varied and nutritious diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From observation and discussion with some of the people living at the home they made it clear that they were able to exercise choice and control over their daily lives as far as possible. The manager said since the last inspection an in house quality audit was carried out and the main concern people had was the lack of social stimulation. We were told that people’s comments were taken on board and there were plans for more activities. DS0000033211.V359008.R01.S.doc Version 5.2 Page 15 At the time of the inspection we saw people sitting talking to each other or their visitors, some were sleeping, watching TV or reading. Some people had chosen to spend time in their room. A copy of the home’s newsletter that was seen informed people of the outcome of the survey carried out by the home. The daily activities displayed on the board, for the day of the inspection was a sing along. Written copies of recent and present activities were available for inspection. Although people were happy with the care given and staff support, some people felt that there still not enough to do in the day. Young people on placements at the home from the local school carried out activities with people in the main sitting area. Not all people had life history, which would give staff some information about people and what they did in their past life, such as their job and about their families. This could assist them when caring for people. People’s view about the meals and menu planning is held with the people who live there. People were very complementary about the food, they said: • • The food is good, we can always have something else if we did not like what was being served. If we did like something we would discuss it with the manager and the cook. The manager keeps the menus under review by meeting with catering staff and people who use the service to make sure the menus have food that people like. DS0000033211.V359008.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): 16 & 18. Quality in this outcome area is good. A robust adult protection and complaints policy and procedure makes sure that people who live at the home are listened to and are protected from abuse. People are aware of how to make a complaint. Training in Abuse Awareness supports staff in protecting people living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure in place is readily available to people who live in the home and their visitors. People spoken to said: • we feel safe and well looked after and staff were very good to them and always willing to help. • Visitors said if they had any complaint they would go to a member of staff or the manager. People told us that if they were unhappy about any thing they were confident that any concerns they had would be looked into. No complaints had been made to the CSCI or to the home about the care provided since the last inspection. DS0000033211.V359008.R01.S.doc Version 5.2 Page 17 We spoke to staff and we found they were aware of the procedure to follow when reporting and recognising abuse. Staff are aware of adult protection and have received training. There are robust procedures in place to protect people living at the home and whistle blowing procedures to protect staff. DS0000033211.V359008.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): 19 & 26. Quality in this outcome area is good. People live in a very well maintained and safe environment. Peoples’ independence is maintained with the provision of any specialist equipment they need. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The environment is comfortable and well kept. There are good communal toilets, bathrooms and sanitary facilities, that allow for full assistance from staff. Peoples’ rooms are attractively furnished and the addition of personal items makes the rooms homely. DS0000033211.V359008.R01.S.doc Version 5.2 Page 19 It was clear that people have the opportunity to bring with them, personal, items of furniture and other memorabilia i.e. such as ornaments and photos and soft furnishings. The cleaning of people’s room are discussed with them at their meeting so that any areas of concern are highlighted. During the inspection of the building we found that the home was cleaned to high standards, no unpleasant odours were found. People who use the service and their relative said, “ it is very clean here, the staff take pride in their work”. Only personal laundry is carried out at the home. The laundry was well organised and everyone has a personalised basket for their laundry. Good hand washing facilities were provided in the laundry and in all the communal areas. Staff receive training in the prevention of cross infection and a plan is in place to make sure that all staff have completed this training. DS0000033211.V359008.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): 27, 28, 29 & 30. Quality in this outcome area is good. The number and skill mix of staff is said to be sufficient to meet the needs of the people living at the home. Staff are well trained and competent to meet the needs of the people living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Some of the staff have worked at the home for many years, providing consistency and continuity for the people at the home. The staff duty rotas showed: • Three to five staff most of the time and four at weekends. • The day staff are supported by catering staff from 7.30am to 4pm. • Six general domestic who also cover the role of the kitchen domestic. • Presently the home has no staff vacancies, only long term sickness. The issue of the staffing level was discussed with the manager and the principal unit manager. They both said that they feel that present staffing DS0000033211.V359008.R01.S.doc Version 5.2 Page 21 levels during the night are enough to meet the needs of the current people who use their service. We were also told that risk assessment is in place to make sure that there is enough staff and there is a back up plan for either the manager or the Principal unit manager to come out of hours to support night staff if any of the people had to go to the hospital and family was not available. The recruitment and selection is carried out and the home retains copies of documentation to provide evidence of good recruitment practice. Staff do not take up post until all the required safety checks have been completed. Mandatory training is well established although the manager did say that some of it was not up to date. Training records are kept on individual files and it was not possible to get a view of the training provided without looking at all the files. Although there was a system in place that would provide an overview and evidence of staff training, this was not available this however was shown at the last inspection, the manager said there was not an updated copy for 2007/2008. Besides mandatory training staff have access to a range of other courses to make sure that they have the necessary knowledge to care for people properly. 90 of the staff have an NVQ level two or three. Three staff have done palliative care training course. Although there was no written evidence of an up to date training plan seen, the manager said courses like moving, handling and first aid courses have been arranged, and when there are places staff will undertake this. During discussion with some staff they were still saying that they had not had training for some time, whilst others said it had been discussed and training had been arranged for them. The manager who is a moving and handling facilitator was carrying out training so that all staff have up to date training. DS0000033211.V359008.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): 31, 33, 35 & 38. Quality in this outcome area is good. The home is well managed. The interests of the people living at the home are seen as very important to the manager and staff and are safeguarded at all times. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is experienced and provides clear leadership to staff. She has achieved an NVQ in care at level 4 and has also completed a management and leadership development qualification also at level 4. DS0000033211.V359008.R01.S.doc Version 5.2 Page 23 The manager and the senior staff are accessible to people living at the home and their relatives. Staff meeting notes provide clear evidence, that the home is managed in an open and inclusive management style with staff encouraged to be involved in the running of the home. The manager and her staff are committed to the development and improvement of the service. There is an in house annual quality service checks by giving out questionnaires with an action plan form about the outcome, this is displayed in a newsletter which is display on the notice board in the hallway with the service user guide which is available to people and their visitors. When an inspection takes place the report is discussed with people who use the service and a copy put in the service user guide and a copy displayed on the notice board, so that it is accessible to any visitors to the home for them to read. The Principal Unit Manager also looks at quality of service during the monthly visits. People at the home are encouraged and supported wherever possible to manage their own finances. There are good systems in place, where small amounts of money are kept for people, which are subject to in-house spot checks and to external audit. The manager makes sure that staff are aware of their health and safety responsibilities. There is a whole range of risk assessments in place for safe work practice and for the building. There are regular fire drills to make sure that people and staff are aware what to do if a fire occurred. Records are kept of any accidents occurring at the home and the manager produces a monthly summary. The Principal Unit Manager who is line management to the home, as required, makes monthly visits. Reports are produced and copies sent to the CSCI. DS0000033211.V359008.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 3 X 3 X x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 4 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 X 3 X X 3 DS0000033211.V359008.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. 2. Standard OP7 Regulation 15 Requirement Timescale for action 30/05/08 5. OP38 18 & 13 The manager must make sure that clear and detailed care plans are in place for all the residents to provide clear instructions for staff and evidence that care needs are met. This timescale was given at the last inspection some work has started to address this matter 19/04/07. All staff must have up to date 30/05/08 First aid training. Timescale give at the last inspection 19/04/07 DS0000033211.V359008.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. 2. Refer to Standard OP7 OP27 Good Practice Recommendations The manager and her staff should continue to work at developing the care plans to make sure that the individual records consistently provide detail and evidence of care. The manager should make sure that a record is kept, so that updated training is carried out within given timescale. DS0000033211.V359008.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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. 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