Care Home: Mountview Residential Home

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What the care home does well Prospective residents are assessed to ensure the home is able to meet their needs. Staff care for residents in a gentle and professional manner, respecting their privacy and dignity. There were no equality and diversity issues identified. Activities are provided and action has been taken to ascertain individual interests to plan activities around these in addition to general group activities, plus the religious needs of the residents are being met. The home has an open visiting policy and visitors are made welcome at the home. Information on advocacy services is available. The food provision is good, offering variety and choice. Procedures for the management of complaints and adult protection issues are in place and are followed. The home is bright and homely and is being well maintained. Infection control procedures are in place and are adhered to. The home is appropriately staffed to meet the needs of the residents, with good contingency plans in place should staff shortages occur. All the care staff are trained to NVQ level 2 in care and some qualified or undertaking level 3. The home has robust recruitment procedures in place. The home is being effectively managed and the Manager Designate is approachable and works hard with the staff team. Systems for quality assurance are in place to ensure the home is being effectively audited. Personal monies held on behalf of residents are being well managed. The home is being well maintained and health & safety is being well managed. What has improved since the last inspection? It was clear that the Manager Designate and her team had worked hard to address the requirements from the last inspection. Improvements have been made in the completion of the service user plans to include assessments, monthly updating, and involving residents and/or their representatives in the care planning process. Care plans are becoming more personalised and the Manager Designate was aware of the need to progress this work. Wound care information is now clearly documented, with reference to the District Nurse involvement. Staff have undertaken customer care training and had a very caring approach to the residents. Staff are endeavouring to obtain information regarding the wishes of residents and their families in respect of end of life care. Staff training has improved and several more training sessions have been planned. What the care home could do better: The Inspector recommended that where it is necessary to change the menu that this be recorded in the meals diary, with the reason for the change. Some areas of mandatory training have been planned for, however fire safety training must be included in this and action must be taken to complete all the outstanding training in a timely manner. CARE HOMES FOR OLDER PEOPLE Mountview Residential Home Rickmansworth Road Northwood Middlesex HA6 2RD Lead Inspector Mrs Clare Henderson Roe Key Unannounced Inspection 18th December 2007 11:20 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 Mountview Residential Home DS0000068739.V356660.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. Mountview Residential Home DS0000068739.V356660.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mountview Residential Home Address Rickmansworth Road Northwood Middlesex HA6 2RD 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) 01923 824 826 Dr Nizar Merali Shiraz Sultan Ali Merali Norma Vidot Care Home 12 Category(ies) of Old age, not falling within any other category registration, with number (12) of places Mountview Residential Home DS0000068739.V356660.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. As agreed on 28th February 2006, five named service users with a diagnosis of Dementia can be accommodated within the home. This is approved for as long as there is no deterioration of a service user that affects the well-being of any other person living in the home. The rooms used for service users will revert to the listed categories for the home once the service user no longer resides at the home. The home must advise the CSCI when a service user no longer resides at the home. 4th October 2007 Date of last inspection Brief Description of the Service: Mountview is a residential care home registered for 12 older people. The building is set back from the Rickmansworth Road in Northwood and is within easy reach of the local shopping centre and public transport links. The premises is a large family home that has been extended and converted to a good standard and offers twelve single rooms, 10 of which have en suite facilities. The large communal lounge is at the rear of the property and a section of this is used as a dining area. Meals are served at two tables set out family style. The rest of the lounge is furnished with comfortable seating, with a television area. The lounge overlooks the garden which can be accessed via sliding doors from the lounge. The garden is secluded and attractive. Half of the garden is set out in a patio style with seating and the other half is laid to lawn with shrubs. There is wheelchair access to the garden. At the front of the property there is off road hard standing parking for several vehicles. The fees range from £500 - £550 per week. Mountview Residential Home DS0000068739.V356660.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the regulatory process. A total of 5 hours was spent on the inspection process. The Inspector carried out a tour of the home, and service user plans, medication records & management, staff rosters, staff records, financial & administration records and maintenance & servicing records were viewed. 6 residents, 4 staff and 3 visitors were spoken with as part of the inspection process. Prior to the last inspection on 4th October 2007 the home had completed the CSCI Annual Quality Assurance Assessment (AQAA) document and also CSCI surveys were received from residents and representatives/visitors. Therefore this process was not repeated at this inspection. This inspection was primarily to follow up the requirements from the last inspection, however the key standards were all examined at this inspection. What the service does well: What has improved since the last inspection? It was clear that the Manager Designate and her team had worked hard to address the requirements from the last inspection. Improvements have been made in the completion of the service user plans to include assessments, monthly updating, and involving residents and/or their representatives in the Mountview Residential Home DS0000068739.V356660.R01.S.doc Version 5.2 Page 6 care planning process. Care plans are becoming more personalised and the Manager Designate was aware of the need to progress this work. Wound care information is now clearly documented, with reference to the District Nurse involvement. Staff have undertaken customer care training and had a very caring approach to the residents. Staff are endeavouring to obtain information regarding the wishes of residents and their families in respect of end of life care. Staff training has improved and several more training sessions have been planned. 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. Mountview Residential Home DS0000068739.V356660.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 Mountview Residential Home DS0000068739.V356660.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. The home does not provide intermediate care. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are assessed prior to admission to ensure the home is able to meet their needs. EVIDENCE: The home has a pre-admission assessment document that covers each area of need. One viewed had been completed and identified the resident’s needs, which can be met by the home. Mountview Residential Home DS0000068739.V356660.R01.S.doc Version 5.2 Page 9 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 & 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service user plans were being well completed to provide staff with the information to meet each resident’s needs. Medications are being well managed at the home, thus safeguarding residents. Staff care for residents in a caring and professional manner, respecting their privacy and dignity. More information had been obtained regarding the wishes of residents and their families in respect of end of life care to try and ensure these wishes can be respected and met. EVIDENCE: The Inspector viewed 2 service user plans. These had been well completed and gave a picture of each resident and their needs. Work had been done to make each care plan more personalised to the individual. Documentation had been reviewed monthly and when a residents’ condition had changed. Following the last inspection the risk assessments for falls had been reviewed and falls history information included. This document is now being updated monthly and following any falls. There was evidence that the next of kin had read and agreed to the content of the care plans, with signatures present. Mountview Residential Home DS0000068739.V356660.R01.S.doc Version 5.2 Page 10 Assessments for continence, moving & handling, nutrition and pressure area risk were in place and care plans had been formulated for any needs identified. Care plans for wounds were in place and the information reflected input from the District Nurse and the frequency of visits was also recorded. A list of all appointments with healthcare professionals is recorded and there is also a chart in the office to record any appointments. M D Homes has the services of a local GP and where they wish to residents are transferring to this GP who carries out a weekly visit to the home, thus monitoring the medical condition of each resident. Medication management was viewed. The home uses a 28 day monitored dosage system for medications, and the blister packs for medications contain all the medications due at each particular time of day. On the day of inspection a new medication trolley was delivered and this will allow for each medication to be supplied in a separate 28 day blister pack, for ease of identification and additions or removals necessary due to a change in a residents medication. All medication receipts, to include those received mid-cycle, and administration had been recorded. A list of staff signatures and initials was available. There is a photograph of each resident with their name and the Inspector advised that any allergies be recorded on this sheet also. The Manager Designate reported that none of the residents had any known allergies, and any such information would be recorded on their admission records also. Any unused medications are returned to the dispensing pharmacist for disposal. Liquid medications and medicines supplied in boxes had been dated when opened. Medications are being securely stored at the home. A controlled drug register had been purchased since the last inspection and was being appropriately completed. Twice daily checks are also being carried out for all controlled drugs. The room temperature of the office where medications are stored was being checked and recorded daily and was within acceptable range. Any medications requiring refrigeration are stored in a designated box in the main fridge, and daily temperatures are recorded. Medications are being well managed at the home. Following the last inspection staff have attended ‘customer care’ training. Staff were seen caring for and speaking with residents in a gentle and professional manner, respecting their privacy and dignity. Residents were well dressed to reflect individuality. Residents receive their post unopened, and where they are unable to manage their own post it is given to their representative. Residents can have their own telephone, and also have access to the home phone. Following the last inspection the Manager Designate reported that she has started to approach the topic of end of life wishes with representatives, however generally this is not a topic that they wish to discuss at this time. The option of discussing this topic at the time of admission was suggested by the Inspector, so that it becomes part of the admission process. Where information had been obtained, this had been included in the service user plans. Mountview Residential Home DS0000068739.V356660.R01.S.doc Version 5.2 Page 11 Mountview Residential Home DS0000068739.V356660.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. The activity provision for the home is good, providing a variety of activities and entertainments to meet the residents needs. The home has an open visiting policy, thus encouraging residents to maintain contact with family and friends. Information regarding advocacy services is available, thus ensuring the service users right to independent representation is respected. The food provision in the home is good, offering variety and choice, with resident’s choices being respected. EVIDENCE: M D Homes have an activities co-ordinator who works within their 5 homes. One day each week is allocated to each home, however the staff also continue with activities on the other days. There is a weekly activities list on display in the day room. The activities co-ordinator attended the home during the inspection and it was clear that he had taken time to get to know the residents as individuals and also to learn about their life histories and interests. More information was being recorded in each service user plan regarding their interests. An exercise game took place during the inspection and the activities co-ordinator communicated well with the residents. A Christmas Party had Mountview Residential Home DS0000068739.V356660.R01.S.doc Version 5.2 Page 13 been arranged and visitors were invited to attend. The home has links with the community to include the local churches and the religious needs of the residents are identified and respected. There was a good atmosphere throughout the home. The home has an open visiting policy and visiting is encouraged. Visitors are made welcome at the home and offered refreshments. Visitors expressed their satisfaction with the care provision and felt that there have been continued improvements made. All the residents have a representative with Power of Attorney. The home also has information regarding ‘Care Aware’ advocacy services on display and can also access Age Concern for input. The kitchen was clean and tidy. A breakfast list was on display and included the wishes of each resident. The home has a 4 week menu and the meals are varied, with the preferences and wishes of the residents being met. There is one main option for lunch although alternatives can always be provided. The supper choices are recorded in the diary each day, and choice is respected. On the day of inspection there had been a change to the lunch menu, and the Inspector recommended that any changes from the main menu be recorded in the diary so that an accurate record of meals partaken is maintained. There was a good supply of fresh, frozen, dried and tinned foodstuffs available and overall the residents spoken with were satisfied with the food provision. On the day of inspection the residents were observed enjoying their lunch, and vegetables are now presented in serving dishes so that residents can help themselves, giving them choice and independence. Mountview Residential Home DS0000068739.V356660.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has clear complaints procedures in place to address any concerns raised by residents and their visitors. There is a robust system in place for the safeguarding of residents from abuse. EVIDENCE: A copy of the complaint procedure was on display in the entrance and copies are contained in the Statement of Purpose and Service User Guide. The home has not received any complaints since the last inspection. The Manager Designate said that she ensures she has good communication with residents and their visitors and any issues raised are promptly addressed. The home has procedures in place for adult protection and also follows the Hillingdon Safeguarding Adults procedures. Staff had received training from the Hillingdon Safeguarding Adults Officer and those spoken with knew to report any concerns. Mountview Residential Home DS0000068739.V356660.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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 being well maintained, thus providing a clean, homely and safe environment for residents to live in. Procedures are in place for infection control and these are practiced, thus minimising the risk of infection. EVIDENCE: The Inspector carried out a tour of the home. The home was being well maintained with evidence of rooms being redecorated. New moving & handling chairs for assisting residents in and out of the baths had been purchased. The home has a call bell system in place in all bedrooms, en suites and bath & toilet facilities. Bedrooms were personalised and in good order. The Manager Designate said that new carpets had been ordered for the hallway, corridors and landing and that the next phase was to replace bedroom carpets as needed. The external grounds are well maintained. An area of garden is to be planted in the spring by residents who enjoy gardening and this will provide Mountview Residential Home DS0000068739.V356660.R01.S.doc Version 5.2 Page 16 each of them with an area of their own to tend with assistance from staff as needed. The home has a laundry area with 2 washing machines and one tumble dryer. Clear instructions for the laundering of clothes and linen are displayed. Protective clothing to include gloves and aprons are available. Policies and procedures for infection control are in place and there is evidence that these are followed to minimise the risk of infection. The home was clean and bright and smelled fresh throughout. Mountview Residential Home DS0000068739.V356660.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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 home is appropriately staffed to ensure that the needs of the service users are met at all times. Systems for vetting and recruitment practices are in place and protect residents. There has been an improvement in the training provision with an ongoing programme to provide staff with the skills and knowledge to care for residents effectively. EVIDENCE: There were 8 residents accommodated at the home at the time of inspection. There are 2 care staff on during the day and 1 waking and 1 sleep-in member of staff on duty at night. The care staff carry out the cleaning and cooking duties in the home, with additional staff available to assist if needed. The Manager Designate also works full-time and in addition to management duties works as part of the care team. M D Homes has a bank staff facility so that staff employed and trained by M D Homes, thus providing continuity of care, can cover staff shortages. All the care staff are qualified to NVQ level 2 in care. 2 staff have also completed level 3 and 2 are undertaking level 3 at present. Staff have also undertaken customer care training since the last inspection and NVQ level 2 in dementia care is being commenced by 3 staff in the near future. Mountview Residential Home DS0000068739.V356660.R01.S.doc Version 5.2 Page 18 Two sets of staff records were viewed and these contained the information required by the Care Home Regulations 2001. One new member of staff was due to commence work at the home in the near future and the Operations Manager confirmed that all required procedures and checks had been followed and carried out. M D Homes have an induction programme that is based on the Skills for Care common induction standards and this is used for any new staff employed. As previously mentioned, there has been an improvement in the training provision for staff. Mountview Residential Home DS0000068739.V356660.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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 Designate has the experience and skills to manage the home effectively, and is to undertake the required management training to enhance her knowledge. Systems for quality assurance are in place, thus providing an ongoing process of review and feedback. Resident’s monies are well managed and securely stored. Overall the systems for the management of health and safety throughout the home are good, thus safeguarding residents, staff and visitors. EVIDENCE: The Manager Designate is a first level registered nurse. She has 26 years of nursing experience to include 3 years of managing a ward for care of the elderly. The Manager Designate is a qualified tutor and has several years Mountview Residential Home DS0000068739.V356660.R01.S.doc Version 5.2 Page 20 experience in this field. She has undertaken periodic training relevant to the care of the residents and is to undertake the Registered Managers Award, NVQ level 4 in management as soon as a place is available. The Manager Designate works hard to provide a good standard of care for the residents. Due to the fact the home is not registered to provide nursing, nursing input required is carried out by the District Nurse, and the Manager Designate understands this clearly. The Manager Designate is going through the process with CSCI for registration as the Registered Manager for the home. M D Homes have owned the home for 9 months and have a quality assurance system that is used in all their homes. Audits of medications, service user plans, and of the premises are carried out regularly. Regulation 26 unannounced visits to the home on behalf of the Responsible Individual are carried out and reports are available. M D Homes policies and procedures are in use at the home, and these have been adapted specifically for the home. The home has clear processes in place for the management of any personal monies held on behalf of residents. The balances and records for monies held were viewed and were up to date and correct. Bingo is charged at £1 per session and this money is won as prizes for the games of bingo. This is all clearly recorded in the income and expenditure book. Items such as chiropody and hairdressing are billed directly to the representative responsible for managing each resident’s funds. The Inspector viewed samples of the maintenance and servicing records and those viewed were up to date. There was evidence that risk assessments had been completed for 2007 and reviews and updates had since been carried out. There was evidence of regular fire drills having taken place and the Inspector recommended that an evaluation sheet be used to record the effectiveness of the drill and if any training issues had been identified. Since the last inspection all staff had undertaken moving & handling training. The Operations Manager said that plans are also in place for First Aid training, food safety training updates, infection control training and COSHH training to be carried out. The Inspector identified that staff also need updates in Fire Safety training. Mountview Residential Home DS0000068739.V356660.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 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 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 X 3 X 3 X X 2 Mountview Residential Home DS0000068739.V356660.R01.S.doc Version 5.2 Page 22 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 OP38 Regulation 18(1)(a)& (c) Requirement All staff must undergo Fire Safety Training updates and the training planned for other areas of health & safety must be completed to provide staff with the skills and knowledge to maintain health & safety in the home. Timescale for action 01/03/07 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 OP15 Good Practice Recommendations That any changes to the menu be recorded in the meal diary with the reason for the change, so that there is an accurate record of the actual meal partaken. That the outcomes of the fire drills be recorded so that any shortfalls can be identified and action taken to ensure staff have a good knowledge of the action to be taken. OP38 Mountview Residential Home DS0000068739.V356660.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Mountview Residential Home DS0000068739.V356660.R01.S.doc Version 5.2 Page 24 - 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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