Care Home: The Old Rectory

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What the care home does well This home is well maintained, providing clean and comfortable accommodation for residents. Residents comments were positive about the care and services provided and staff members were observed carrying out their duties with kindness and sensitivity towards the residents. One person said they only came for a weeks respite break and decided not to return home, other people said they felt their current needs were being met and a relative spoken with said they `couldn`t fault the care given`. What has improved since the last inspection? The provider has taken action to address the requirements and recommendations given during the previous visit. The statement of purpose and service user guide have been updated, care plans are being re-written but still require more work to ensure staff have sufficient information to care for people living in the home. A training programme has been implemented and staff have undertaken statutory training. Priority has been given to the environment to minimise the risk of cross infection and to ensure all parts of the home which residents have access are free from hazards to their safety. CARE HOMES FOR OLDER PEOPLE The Old Rectory Sturton Road Saxilby Lincoln Lincs LN1 2PG Lead Inspector Elisabeth Pinder Key Unannounced Inspection 19th November 2007 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 The Old Rectory DS0000064006.V347419.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. The Old Rectory DS0000064006.V347419.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Rectory Address Sturton Road Saxilby Lincoln Lincs LN1 2PG 01522 702346 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) theoldrectory@mandmcare.co.uk M & M Care Ltd Post Vacant Care Home 24 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (24) of places The Old Rectory DS0000064006.V347419.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. No one falling within the category OP should be admitted into The Old Rectory when there are 24 persons already accommodated within the home No one falling within the category DE(E) should be admitted into The Old Rectory when there are 6 persons already accommodated within the home The approved training on Dementia from the Alzheimer`s Society is given to all members of staff in The Old Rectory as soon as it is possible to do so. The maximum number of persons to be accommodated at The Old Rectory is 24 5th December 2006 Date of last inspection Brief Description of the Service: The Old Rectory cares for older people is a detached property situated on the edge of the village of Saxilby. The home is approximately five miles from the historic city of Lincoln. The property is a converted rectory and stands back from the road in it’s own grounds and gardens with car parking facilities to the rear of the building. The home has two floors and there is a stair lift to the bedrooms on the first floor. There are a variety of aids and adaptations around the building to allow residents to move around the home more independently. Eighteen of the bedrooms are single, three bedrooms have an en-suite toilet. There are seven communal toilets and three communal bathroom/shower rooms. The current weekly fee range is £348.00 - £460.50. Additional costs are made for hairdressing, newspapers, and chiropody, these are all private arrangements and costs are met by individual residents. The Old Rectory DS0000064006.V347419.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit to the home was undertaken by one inspector and formed part of a key inspection, focusing on all the key standards. Throughout this report the terms ‘we’ and ‘us’ refer to The Commission for Social Care Inspection (CSCI). The visit lasted approximately six hours and took into account previous information held by us including the previous inspection report and the providers written response. Prior to the visit the providers had returned their Annual Quality Assurance Assessment (AQAA) and this will be mentioned throughout this report. The main method of inspection used was ‘case tracking’ which involves selecting three residents and tracking the care they received through looking at their records and observing staff that provide their care. A period of time was spent observing the care being given to residents and the interaction between staff and residents. One of the providers is currently working as manager and both her, the deputy manager and one staff member were spoken with to as well as one visitor. ‘Have your say about’ questionnaires were given to us on the day of the visit and these were from three residents, four staff members and one relative. One specific comment regarding what the care home does well read ‘respect the persons needs and are friendly and very caring’. Other comments will be mentioned throughout this report. What the service does well: This home is well maintained, providing clean and comfortable accommodation for residents. Residents comments were positive about the care and services provided and staff members were observed carrying out their duties with kindness and sensitivity towards the residents. One person said they only came for a weeks respite break and decided not to return home, other people said they felt their current needs were being met and a relative spoken with said they ‘couldn’t fault the care given’. The Old Rectory DS0000064006.V347419.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. The Old Rectory DS0000064006.V347419.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 The Old Rectory DS0000064006.V347419.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): 1, 2 & 3 Standard 6 is not applicable Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People coming into this service have access to information to help them make a decision about moving into the home and procedures are in place to ensure people are only admitted after a full needs assessment has been carried out. EVIDENCE: Information written in the AQAA indicated that sufficient information is available to inform people of the services offered and details the procedures taken to ensure the care needs of new admissions will be met. This was confirmed by resident and relative surveys, one specific comment read ‘stayed for a weeks respite and decided not to return home’. The Statement of Purpose and Service User Guide were both updated in August of this year to help people understand what they can expect from the service and give clear information about the fees payable and any additional costs. However, neither detailed how prospective residents can access copies The Old Rectory DS0000064006.V347419.R01.S.doc Version 5.2 Page 9 of our reports or how the service will meet the equality and diversity needs of people and the provider agreed to address this. The records of two new residents admitted since the previous inspection showed that information had been obtained before their admission to provide staff with a good knowledge of their needs, however, these could be expanded to include information taken from all involved in the persons care and include any equality and diversity needs. This was discussed with the provider who agreed to address this issue. Terms and conditions/contracts were available on these files. The Old Rectory DS0000064006.V347419.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans contain sufficient information to ensure peoples’ health and care needs are met but there is a lack of resident involvement in this process. Medication is given using safe procedures and staff respect the wishes and preferences of people living in this home while maintaining their privacy and dignity. EVIDENCE: Care plans are currently being re-written and those completed give clear information on how residents’ needs should be met. However, further work must be done to ensure all risks are identified and clear actions are documented to minimise the risk. For example, one resident admitted from hospital with Methycillin Resistant Staphylococcus Aureus (MRSA) did not have a risk assessment written and limited information was available in their plan of care. Care plans are signed and dated by care staff and evaluated monthly, The Old Rectory DS0000064006.V347419.R01.S.doc Version 5.2 Page 11 however, they do not show that residents have been involved in their reviews and the provider agreed to address this. Comments from staff indicated that some felt there was not enough staff and time to be able to keep care plans up to date, (please refer to the staffing section of this report). A discussion was held around using body maps to show any pressure areas or bruising/injury. Although some have been included in the records completed by the district nurse, the provider agreed to ensure these are put into residents’ main records. Three residents ‘have your say about’ questionnaires identified that two felt they ‘always’ receive the care and support needed and one indicated ‘usually’. One specific comment read ‘there is always someone on hand to help and support my needs’. People spoken with during the visit said that they felt their current needs were being met and they were very satisfied with the care they received. One relative spoken with said they ‘couldn’t fault the care given’. Medication policies are available and these had been reviewed last year. Medication given to residents was given using correct, safe procedures and the staff member administering medicines confirmed that she had received relevant training and felt confident with this task. Staff spoken with had a good knowledge of residents’ needs and the action required to meet these and they were observed carrying out their duties with kindness and sensitivity towards the residents, especially when attending to their personal needs. The Old Rectory DS0000064006.V347419.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 adequate. This judgement has been made using available evidence including a visit to this service. Residents privacy is respected and well-balanced meals are provided which cater for individual needs and preferences. Residents are supported to keep contact with relatives and visitors are welcome. Whilst there are some activities and leisure opportunities for residents to participate in, these are not consistent or person centred. EVIDENCE: Information written in the AQAA reads ‘residents are encouraged to rise at an appropriate time and in accordance with their wishes’. This was confirmed during the visit and people spoken with said the staff offered them choices such as, what they preferred to eat, the time they preferred to get up and go to bed and felt staff respected their privacy if they wanted to stay in their own rooms. Three residents questionnaires were received and their responses regarding appropriate activities being available which they could take part in varied. One identified ‘always’ and a written comment read ‘I always enjoy quiz afternoons The Old Rectory DS0000064006.V347419.R01.S.doc Version 5.2 Page 13 on Wednesdays’. Another identified ‘sometimes’ and another ‘never’. One person spoken with said they ‘get bored as there is nothing to do’ whilst another said ‘ we have plenty of word searches and books available to read, there is always something I can do’. Comments from staff confirmed that entertainers visit the home periodically. Care records contain a ‘tick box’ list of activities or visits undertaken but little information was available to demonstrate that they are linked to a person centred approach. The provider said she is currently advertising for a part-time activities co-ordinator but to date she has had little response. The AQAA read ‘all food is home cooked and freshly prepared taking into account individual needs’. The cook was spoken to and she confirmed this, however, up to date information was not available regarding residents likes/ dislikes. This was discussed with the provider who agreed to ensure up to date records are kept. A varied response was received regarding the meals, one questionnaire identified that they ‘always’ like the meals provided and two ‘usually’. A comment read ‘well cooked and if not my choice there is always an alternative’. Menus seen showed that a varied, well balanced diet is offered and the midday meal was observed to be nutritious. Tables were nicely laid with tablecloths/napkins and condiments. Staff spoken with said they had to prepare and serve the tea time meal and this is having an impact on the availability of staff to meet residents needs during this time. The provider said she is currently advertising for a tea-time cook to address this issue, (please also refer to the staffing section of this report). The Old Rectory DS0000064006.V347419.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. Although procedures are in place, people living in this home are not all sure how to make a complaint. All staff should know the correct procedure to report an allegation of abuse. EVIDENCE: Information provided in the AQAA indicated that all residents and their relatives are aware of the complaints policy and all staff receive training in adult abuse and read all relevant policies and up to date information. The complaints procedure was available in the Statement of Purpose and Service User Guide. Since the previous inspection there has been one complaint and part of this was passed to Social Services and was investigated under safeguarding adults procedures. A random inspection was undertaken on 23rd February 2007, no new requirements were made, one recommendation was made regarding staffing levels, however, at the time of this inspection the provider had not received the report for the random inspection. Subsequent to this visit we have ensured the provider has received this report. Resident and relative questionnaires gave a mixed response regarding the process to take should they wish to make a complaint, however, people spoken to during the visit said they knew who to speak with and how to raise any The Old Rectory DS0000064006.V347419.R01.S.doc Version 5.2 Page 15 concerns and felt these would be taken seriously. The provider plans to hold minuted resident meetings every two months to improve this. Since the previous inspection some staff have completed safeguarding adults training and staff spoken with had a good knowledge of abuse. However, they were unsure of the reporting process should an allegation be made and the provider agreed to obtain a copy of Lincolnshire County Council’s Safeguarding Adults procedure and ensure all staff know this procedure. The Old Rectory DS0000064006.V347419.R01.S.doc Version 5.2 Page 16 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. People living in this home live in a clean, pleasant and hygienic environment and they are able to personalise their rooms. EVIDENCE: Information provided in the AQAA showed that systems are in place for the maintenance and renewing of furnishing and equipment when needed. Risk assessments are carried out on the premises to ensure that residents are safe from any potential hazards. The bedrooms of residents ‘case tracked’ were viewed and all were clean and tidy and well personalised and specialist equipment was provided where needed. Residents said that they found their rooms to be comfortable and had been able to make them more homely with their own personal belongings. Staff were seen wearing protective clothing and people spoken with were very The Old Rectory DS0000064006.V347419.R01.S.doc Version 5.2 Page 17 satisfied with the cleanliness of the home, with specific comments ‘the cleaners are very good’. Areas of the home seen were clean, pleasant and homely with no unpleasant odours. The Environmental Health Officer visited on 16/04/07, the report identified that no problems were seen in the kitchen and the service was given a three star rating. During the previous visit some residents said they felt cold and a recommendation was made for regular checks to be made of the temperature in the home and more comments that residents felt cold were made during this visit. This was raised with the provider who showed us records of temperature checks, but also agreed to contact the heating engineer. Improvements over the last 12 months have included the removal of communal towels in toilets and bathrooms, redecoration and recarpeting the majority of the downstairs communal areas and two bedrooms. The laundry walls have been washed and future plans are in place to upgrade the laundry. The Old Rectory DS0000064006.V347419.R01.S.doc Version 5.2 Page 18 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 adequate. This judgement has been made using available evidence including a visit to this service. Residents are protected by robust recruitment procedures but their health, safety and welfare is potentially compromised by a lack of consistent care staffing arrangements. EVIDENCE: Staffing rotas examined showed that there are usually three care staff on duty from 07:30 – 14:00 hrs and two staff until 21:30 and throughout the night. Two residents questionnaires identified that staff are ‘always’ available when needed and one ‘usually’. One specific comment read ‘ they always make time to listen however busy they are’ Staff questionnaires varied in their response regarding whether there are enough staff to meet individual needs, one identified ‘always’, two ‘usually’ and one ‘sometimes’. Staff felt there should be more of them available to spend quality time with residents and to enable all the work to be done. People spoken to during the visit also commented that ‘at times they are short staffed, especially at the weekends when care staff have to do the cooking’. A complaint was made in January 2007 regarding insufficient care staff being available to meet residents’ needs as care staff undertake kitchen duties in the The Old Rectory DS0000064006.V347419.R01.S.doc Version 5.2 Page 19 afternoons/evenings and at weekends and cleaning staff are not employed at weekends. A random inspection was carried out and a recommendation was made. However, to date this has not been addressed. The provider said she is currently advertising for a tea-time and weekend cook, but has not had much response. The records of one new member of staff employed since the previous inspection were examined and these showed that they had been recruited using safe, robust procedures and had completed induction training. Currently there are no male carers and therefore residents are unable to choose who provides their personal care. The AQAA identified that all but two permanent staff have a National Vocational Qualification (NVQ), which is a recognised training award in care, one person has recently enrolled for this training and another plans to commence in January 2008. Staff spoken with have completed statutory training but require further training in dementia care and equality and diversity. Annual training from the Alzheimer’s Society has been delayed due to sickness but the provider is hoping to confirm a further date with them soon. All care staff have been given copies of The General Social Care Council Codes of Practice, which sets out their responsibilities as care workers looking after vulnerable adults. The Old Rectory DS0000064006.V347419.R01.S.doc Version 5.2 Page 20 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, 36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management arrangements are satisfactory. There are some systems in place to obtain residents views in order to monitor the quality of the service and procedures are in place to promote the health and safety of residents. EVIDENCE: Since the last inspection the acting manager has resigned and the service is being run by one of the providers who has the necessary qualifications and skills to manager the home and has completed The Registered Managers Award. However, she registered as provider and is aware that she must The Old Rectory DS0000064006.V347419.R01.S.doc Version 5.2 Page 21 submit an application to register as manager or appoint another manager as soon as possible. Residents, relatives and staff all gave positive comments about the support the provider gives. One specific comment read ‘Maggie is always there for you if you need a confidential chat. I feel she is very approachable’. Staff supervision is not being carried out at the moment and the provider said she plans to train the deputy manager and team leader with the skills needed to undertake supervision. Although there has not been any resident meetings for a considerable time people spoken with said they were satisfied with the way the home is run and felt they could talk to the provider at any time. However, the provider agreed to hold regular meetings with an agenda and minutes. The provider wrote to us after the last inspection detailing how requirements would be addressed and although quality assurance questionnaires have been updated they have yet to be circulated to residents, their relatives/representatives and other stakeholders and the provider agreed to action this. Information given in the AQAA read that policies were updated in 2006 and staff on duty knew where to find them and confirmed that they were always accessible. The AQAA also showed dates when equipment was serviced and fire alarms checked. The last fire alarm test was carried out on 17/11/07 and the fire risk assessment was reviewed 07/11/07. Records seen also showed residents’ and staff health and safety is being promoted. However, the provider said she plans to review the infection control policy to ensure it is in line with The Department of Health ‘Essential Steps’ to access infection control management. The finances of residents ‘case tracked’ were checked and found to be in order. The Old Rectory DS0000064006.V347419.R01.S.doc Version 5.2 Page 22 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 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 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 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 The Old Rectory DS0000064006.V347419.R01.S.doc Version 5.2 Page 23 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 OP7 Regulation 15 Requirement Care plans must show that all risks are identified and clear actions are documented to minimise the risk. Reviews of care plans must be improved to show that residents and/or their representatives have the opportunity to be involved. The provider has taken action to address part of this requirement. Appropriate activities and leisure opportunities for residents to participate in must be provided to meet individual needs. Staffing levels must be monitored on a regular basis to reflect residents’ needs. In addition, sufficient domestic and catering staff should be employed as occupancy has increased to ensure that care staff can respond quickly to needs. All staff must be adequately trained to carry out their roles. Training should include all DS0000064006.V347419.R01.S.doc Timescale for action 31/01/08 2. OP12 16[2][n] 31/01/08 2. OP27 18 [1][a] 31/01/08 3. OP30 18 [1][c] 31/01/08 The Old Rectory Version 5.2 Page 24 4. OP31 8[1][b] 5. OP33 24[1] 6. OP36 18[2][a] statutory training and specialist training regarding safeguarding adults and equality and diversity This requirement has been met in part – outstanding training includes dementia care and equality and diversity. A manager must be appointed and an application for their registration must be submitted to the Commission. It is acknowledged that since the last inspection the manager has resigned. A system must be in place to assess and review the quality of care provided at the home. The provider has taken action to address part of this requirement. All staff must be appropriately supervised to ensure they have the necessary skills to care for residents. 31/03/08 28/02/08 31/01/08 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 OP1 Good Practice Recommendations The statement of purpose and service user guide should detail how people can access copies of our reports or how the service will meet the equality and diversity needs of people. Pre-admission assessments should include information gathered from all people involved in caring for the resident. The cook should have up to date information of resident’s likes/dislikes and allergies. Regular checks should continue to be made and records maintained of the temperature in the home. 2. 3. 4. OP3 OP15 OP26 The Old Rectory DS0000064006.V347419.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Lincolnshire Area Office Unity House, The Point Weaver Road Lincoln LN6 3QN 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 The Old Rectory DS0000064006.V347419.R01.S.doc Version 5.2 Page 26 - 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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