Inspection on 22/10/08 for Cedar Court

This is the latest available inspection report for this service, carried out on 22nd October 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Cedar Court 05/01/06

Cedar Court 23/06/05

Cedar Court 03/02/05

Cedar Court 08/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

CARE HOMES FOR OLDER PEOPLE Cedar Court Lensbury Way Abbey Wood London SE2 9TA Lead Inspector Ms Pauline Lambe Unannounced Inspection 09:01 22 October 2008 nd 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 Cedar Court DS0000006786.V373271.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. Cedar Court DS0000006786.V373271.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cedar Court Address Lensbury Way Abbey Wood London SE2 9TA 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) 020 8311 1163 020 8311 1193 cedarcourt@schealthcare.co.uk www.schealthcare.co.uk Southern Cross Healthcare Services Ltd Mrs Kim Madeline Brown Care Home 47 Category(ies) of Dementia - over 65 years of age (47) registration, with number of places Cedar Court DS0000006786.V373271.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Dementia - Code DE The maximum number of service users who can be accommodated is: 47 11th October 2006 Date of last inspection Brief Description of the Service: Cedar Court is a purpose built home, which was originally registered in 1996. In 1997 the home was taken over by Southern Cross Healthcare Ltd and was registered for 47 mentally infirm people. At that time, 10 places provided nursing care. On the 4 March 1999, the registration was changed and the home now provides 47 residential places for older people with dementia. The home is located a short distance from Abbey Wood station, bus routes and shops. It has 41 single and 3 double bedrooms. The home is on two floors and has a sitting room and dining room on each floor. There are additional communal rooms on each floor. From the ground floor residents have access to an enclosed garden. On the ground floor there are offices, a laundry, kitchen and storage rooms. The fees charged by the home range from £520.00 - £690.00 per week. Residents are responsible for any additional charges such as hairdressing, toiletries, outings and personal clothing. Cedar Court DS0000006786.V373271.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. An unannounced key inspection was completed on 22nd October 2008. The registered manager was in charge of the home and together with residents and staff assisted with the inspection. The last key inspection of the service was on 11th October 2006 and an annual service review was completed on 24th January 2008. No changes to the registration of this service were made since the last inspection. The inspection process included a review of information held on the service file, a review of the information included in the completed Annual Quality Assurance Assessment (AQAA), a tour of the premises, a review of records, spending time talking to residents, staff and management and reviewing compliance with previous requirements. Prior to the inspection feedback surveys were received from four residents and two members of staff. Currently the Commission do not send surveys to relatives to obtain feedback on the service and no visitors were seen during the course of the inspection. Relative surveys sent out by management on behalf of the organisation were seen and comments made have been included in the report. The service was well managed and staff and management presented as a cohesive team committed to providing quality care to the residents. Records seen were well organised and up to date and the AQAA provided details on how the home improved over the past year and plans for future development. What the service does well: Adequate information was provided for prospective residents and systems in place to accommodate visits prior to admission. Satisfactory systems were in place to ensure residents healthcare needs were met and to manage medicines. Suitable activities were provided. Resident’s privacy and dignity was respected and surveys seen from relatives showed there was a general satisfaction with the quality of service provided. Staff displayed a good understanding of residents suffering from dementia. The home was clean, tidy and well maintained and had a homely and relaxed atmosphere. A stable staff team was in post, which was a benefit to residents. Staff had access to training relevant to their role and staff spoken with had a good understanding of the needs of people with dementia. Recruitment procedures were followed and the service was well managed. Cedar Court DS0000006786.V373271.R01.S.doc Version 5.2 Page 6 Attention was given to providing a safe environment for residents and others. 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. Cedar Court DS0000006786.V373271.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 Cedar Court DS0000006786.V373271.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): Standards 1, 3 and 4. Standard 6 does not apply. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Up to date information about the service was made available to prospective residents and their representatives. Pre-admission assessments were completed for residents and staff displayed a very good understanding of the needs of people with dementia. EVIDENCE: A statement of purpose, service user guide and a dementia care leaflet were provided. These documents were reviewed and updated regularly. Residents were admitted to the home based on a pre-admission assessment of need. Residents received written confirmation that the service was suited to meeting their needs. Arrangements were made for residents to visit the home prior to admission and spend time meeting staff and other residents. Throughout the course of the inspection staff displayed an excellent understanding of the needs of people with dementia and treated the residents Cedar Court DS0000006786.V373271.R01.S.doc Version 5.2 Page 9 with respect and understanding. The atmosphere in the home was homely, warm and relaxed. Cedar Court DS0000006786.V373271.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): Standards 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans seen reflected resident’s current needs. Staff ensured resident’s healthcare needs were met. Medicines were well managed and staff were observed communicating positively with residents. EVIDENCE: The care records for two residents were inspected. Both of the files included an assessment of needs, a care plan and assessments that were relevant to the care of older people. Discussions with staff and residents showed that information recorded in care plans reflected residents’ needs and were up to date. Although the standard of care planning was good overall some areas for improvement were identified. For example one person had been assessed as being at risk of falls but there was no guidance for staff on how to reduce the risk. Care plans seen included guidance for staff on skin care and prevention and detection of pressure ulcers. Residents spoken with were satisfied with the care provided and residents who could not comment displayed that they were relaxed and comfortable with staff and in the environment. Feedback received from residents showed they were satisfied with the care provided. Cedar Court DS0000006786.V373271.R01.S.doc Version 5.2 Page 11 Comments made included “things are very good here” and “staff listen to you”. Recommendation 1. Residents were registered with a GP and from the care records seen it was evident residents received healthcare from the district nurse team, a visiting optician, dentist and chiropodist. A district nurse visited the home daily to administer insulin, attend to wounds and to assess residents when requested by staff. The manager and senior staff said that they had a good working relationship with visiting professionals especially the GP and district nurses. A policy and procedure was provided in relation to medicine management. Medication was stored appropriately and records for the room and fridge temperatures showed medicines were safely stored. Satisfactory systems were in place to record receipt, administration and dispose of medicines. Medicines were supplied in blister packs and individual containers. Administration charts seen were well completed and hand written entries made by staff were countersigned. Medicine stocks for 5 people were randomly checked and found to be correct. Controlled drugs were stored and recorded appropriately and those checked were correct. The GP had agreed a homely remedy list for residents but there was no record for receipt of these items and the list included topical applications. The manager and senior staff said that homely remedies were rarely used and they would discuss the use of these with the GP. The manager completed annual competency assessments on the staff that managed medicines. Management should introduce a medicine profile for each resident and have protocols in place for the administration of ‘as required’ medicines. Requirement 1 and recommendation 2. Staff were observed to communicate effectively with residents and displayed the ability to interpret residents needs. Residents were well presented and staff addressed residents by their name. Staff said that residents were supported to choose their own clothing and accessories where possible. Personal care was provided in private in the resident’s room or the bathroom. Residents presented as comfortable in the home and relaxed with staff. No relative feedback was received but surveys sent out by the provider showed that relatives were satisfied with the care provided. Comments seen on surveys included “staff were caring and considerate to residents and relatives” and “care provided is to a high standard”. Cedar Court DS0000006786.V373271.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): Standards 12 – 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff organised suitable activities for residents. Residents were supported to maintain contact with their family and form friendships in the home. Staff endeavoured to consult with residents about decisions relating to their care and daily lives. EVIDENCE: Care staff were responsible for arranging a programme of activities and outings. The range of activities provided was varied and included both group and one to one activities. Sessions were organised for sessions such as chair exercises, films, walks to local shops, outings to the local pub, reminiscence and aromatherapy. Staff also provided one to one sessions such as manicures and newspaper reading for residents who required this. During the course of this inspection a group of residents made cakes, some residents went to the pub and some joined in with an impromptu music and dance session. Residents who did not want to join in sat and observed. Care records seen for two people showed they regularly joined in the activity session. A record was kept of activities but this could be more detailed and include the names of those who attended and what benefit it was to them. The home hosted an annual summer fete and other social events and at the time of this inspection Cedar Court DS0000006786.V373271.R01.S.doc Version 5.2 Page 13 was decorated for the planned Halloween party. The home had recently acquired two kittens and the residents enjoyed watching and caring for them. A four weekly activity programme was displayed in the hallway on the ground floor. As residents in the home suffer from dementia it may be difficult for them to work out what the current week was. Staff should display one week at a time to avoid residents getting confused. Recommendation 3. As mentioned no relative feedback was received for this inspection. The home had an open visiting policy and relatives were welcomed to attend the social events organised. The satisfaction surveys sent out by the provider indicated that overall relatives were satisfied with the service. Since the last inspection one room in the home had been fitted out as a ‘family room’. Relatives were welcome to use this room for visits, family parties with their relative or to spend more time in the home when their loved one was ill. Staff were observed encouraging residents to make choices. Residents who chose not to join in with activities were not pressured to do so. At lunch staff offered residents a choice of meal and asked how they liked their drinks. Some residents had the ability to voice their choices and staff listened to them and acted on their requests. A four weekly menu was prepared and displayed in the home. Lunch was observed in the first floor dining room. Residents were asked what they wanted to eat from the menu and were offered alternatives if they did not like the menu options. Staff encouraged residents to eat and support was provided for those residents that could not feed themselves. Staff checked residents weight monthly and resident’s nutritional needs were assessed. Residents said or indicated they enjoyed their meal. One resident said they did not like the meal they were given and staff offered the person an alternative. Comments received from residents included “the food is very good” and “meals are well cooked”. A brief visit was made to the kitchen. The cook had been in post since December 2007. The kitchen was clean and tidy and stocks of fresh, frozen and dried foods were seen. Records were kept of fridge, freezer and food temperatures. A cleaning schedule was provided but had not been fully completed since August 2008. The kitchen had been awarded a certificate for hygiene in September 2008. Requirement 2. Cedar Court DS0000006786.V373271.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): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Satisfactory arrangements were in place to safeguard people and to manage complaints. EVIDENCE: The complaints procedure was displayed in the reception area. A system was in place to record complaints made about the service. From information provided in the AQAA 2 complaints had been received in the last year. Records seen showed that complaints were investigated in line with the home’s procedures. No complaints were made to the Commission. The majority of residents in the home would be unable to make a complaint however staff spoken with said that they and relatives would report resident concerns if needed. A policy and procedure was provided in relation to safeguarding adults. Staff spoken with had a good understanding of their responsibility to ensure people were safe. In the last year 3 safeguarding adult concerns were reported to the Commission and social services. One of these was unresolved at the time of this inspection and the other two were not upheld following a full investigation. Staff received regular training on this topic. Cedar Court DS0000006786.V373271.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): Standards 19, 21, 24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All parts of the home seen were clean and comfortable. A redecoration and refurbishment programme was in place. The home was well maintained. Bathing and toilet facilities were satisfactory and bedrooms nicely personalised. EVIDENCE: The home was warm and welcoming and areas seen were clean, tidy and all except one bedroom was odour free. From information provided in the AQAA a programme of decoration and refurbishment was on-going. Areas addressed in the programme were new furniture and fittings to the first floor lounge, corridors and bedroom doors had been redecorated, the activity room and the reception area was repainted and new carpet was fitted to the communal stairs. Communal areas and nine bedrooms were viewed. A malodour was noted in bedroom 10 and the lounge carpet on the ground floor required cleaning. Requirement 3. Cedar Court DS0000006786.V373271.R01.S.doc Version 5.2 Page 16 Bathrooms and toilets seen were clean, tidy and homely. Hot water temperatures checked were within safe limits and assisted bathing equipment was last service on 24/7/08. Bedrooms seen were clean, tidy, personal and all except one were odour free. Personal clothing was neatly stored and well laundered. The home had 3 shared bedrooms and these had screening provided to ensure privacy for the occupants. Currently two couples occupied two of the bedrooms and residents that were happy to share occupied the third room. Staff had access to protective clothing and hand-washing facilities were provided. The laundry room was spacious and airy, all the equipment was working and the area was fit for purpose. Cedar Court DS0000006786.V373271.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): Standards 27 – 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff had good awareness of the needs for people with dementia and received training on this topic. Adequate staffing levels were maintained and recruitment procedures were followed. Staff received training relevant to their work. EVIDENCE: The staff team comprised of a full time manager, administrator, team leaders, senior care assistants and care assistants and ancillary staff. The duty roster for the period from 5/10/08 was inspected and showed that adequate staffing levels were maintained. The residents benefited from having a stable staff team who were knowledgeable about their needs and how these should be met. Staff said the manager maintained a high profile within the home and was accessible to staff, residents and relatives. From information provided in the AQAA the service employed 33 care staff and 17 had achieved level 2 NVQ or above. Seven care staff were currently working towards this qualification. A recruitment policy and procedure was provided. Four employee files were inspected. The files contained all the information required by regulation however a number of references seen had not been verified as genuine. This Cedar Court DS0000006786.V373271.R01.S.doc Version 5.2 Page 18 included both references in two files and one in a third file. Files were well organised and information easily accessed. Requirement 4. Individual training records were maintained for staff and training needs were identified during supervision sessions. Staff spoken with said that they could request training if they felt this was relevant to their work. Files were seen for four people and showed that all had attended at least 3 days training in the last year on topics relevant to their roles. Staff were provided with an induction programme. Feedback received from staff showed they were satisfied with the support and training they received. Cedar Court DS0000006786.V373271.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): Standards 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This home was well organised and managed. The manager of the home was committed to the provision of good quality dementia care. Satisfactory systems were in place to monitor the quality of care, ensure the safety of residents and others and appropriate procedures in place to safeguard residents’ personal money. EVIDENCE: The manager was assessed as a suitably experienced and qualified person to manage a care home for older people and was registered with the Commission. The manager had completed Registered Managers Award and other training relevant to her role. The service was well organised and records seen were up to date and accurate. Staff presented as a cohesive and supportive team. Staff said they were kept informed about management plans and organisation Cedar Court DS0000006786.V373271.R01.S.doc Version 5.2 Page 20 news through staff meetings. The manager was observed interacting in a relaxed and friendly manner with residents and addressing them by name. Systems were in place to monitor the quality of the service provided. The provider ensured visits were made to the home as required by regulation 26. The manager held meetings with relatives and staff and completed internal audits on areas such as the environment, health & safety, medicine management, pressure area care, care planning, activities and privacy and dignity for residents. A care review open day was held in August 2008. Audit outcomes were generally good and were checked by the operations manager. If concerns were identified the manager was required to complete an action plan to show how issues addressed would be resolved. The manager sent out 10 relative surveys monthly and the number returned varied. Responses seen showed a generally satisfaction with the service. Comments made included “staff are hard working”, “Cedar Court is miles ahead of other homes I know” and “staff are considerate to residents and relatives”. A policy and procedure was provided in relation to managing residents finances. Management offered to help residents manage personal allowances and the administrator and manager took on this role. A safe was provided to store personal money or valuable items for residents. Satisfactory systems were in place to manage this money with a record kept for money received and receipts kept for money spent. Individual records were kept for residents and made available to residents and relatives as needed. The manager said that all residents had access to personal allowances. A selection of health and safety records was inspected. These included fire safety, gas, lift service, legionella check and electricity. Systems were also in place to complete monthly in-house safety checks on areas such as hot water temperatures, cleaning showerheads, resident call system and window restrictors. All of the records seen were up to date. At the time of this inspection the maintenance technician was on sick leave and the routine safety checks were being completed by the administrator with repairs being carried out by technicians from sister homes in the organisation. Accident records for a two-month period were inspected. These were fully completed and provided details of the event. Notifications were sent to the Commission as required by regulation 37. The manager monitored accidents as part of the service’s audit system. Cedar Court DS0000006786.V373271.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 4 X 3 4 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 Cedar Court DS0000006786.V373271.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 OP9 Regulation 13 Requirement Timescale for action 29/12/08 2 3 OP15 OP19 16 23 4 OP29 19 Accurate records must be kept for all medicines brought into the home including homely remedy medicines. Topical applications must not be included in the homely remedy list. The cleaning schedule for the 29/12/08 kitchen must be kept up to date. The ground floor lounge carpet 29/12/08 must be kept clean and steps taken to eliminate the malodour in bedroom 10. References received for 29/12/08 employees that require verification must have this done and evidence must be provided to show this has happened. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cedar Court DS0000006786.V373271.R01.S.doc Version 5.2 Page 23 1 2 3 OP7 OP9 OP12 Management should ensure that care plans include the action needed to reduce any risk to residents for example in relation to falls prevention. Management should introduce a medicine profile for each resident and have protocols in place for the administration of ‘as required’ medicines. Management should improve the quality of records kept for activities and include the names of the people who attended, the benefit to them and what activity was provided in the one to one sessions. Staff should display the activity programme for the current week only for residents. Cedar Court DS0000006786.V373271.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Cedar Court DS0000006786.V373271.R01.S.doc Version 5.2 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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