Inspection on 15/04/08 for Rosemary Lodge

This is the latest available inspection report for this service, carried out on 15th April 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Not yet rated. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Rosemary Lodge 29/11/06

Rosemary Lodge 24/02/06

Rosemary Lodge 26/08/05

Rosemary Lodge 23/11/04

Rosemary Lodge 14/04/04

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Rosemary Lodge 9 The Drive Wimbledon London SW20 8TG Lead Inspector Jean Stuart Unannounced Inspection 09:30 15 & 18th April 2008 th 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 Rosemary Lodge DS0000019118.V361716.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. Rosemary Lodge DS0000019118.V361716.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosemary Lodge Address 9 The Drive Wimbledon London SW20 8TG 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 8946 6963 020 8296 0025 mredway@wimbledonguild.co.uk The Wimbledon Guild Mrs Margaret Redway Care Home 44 Category(ies) of Dementia - over 65 years of age (4), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (4), Old age, not falling within any other category (22), Physical disability (25) Rosemary Lodge DS0000019118.V361716.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home can admit up to four named service users aged 50 years and over. 18th June 2007 Date of last inspection Brief Description of the Service: Rosemary Lodge is situated in a residential area of Wimbledon, close to local bus routes. The home is within a twenty-minute walk to Wimbledon Village and provides nursing and personal care for up to forty-seven older people. Rosemary Lodge is registered to provide care for up to four people with dementia and up to twenty-seven people who may have physical disabilities. It is owned and managed by the Wimbledon Guild a registered charity. Accommodation is provided over three floors and includes a lounge, sun lounge, dining room, thirty-two single bedrooms and four shared bedrooms. Two passenger lifts serve each floor. Rosemary Lodge has access to a large level garden, which is mainly laid to lawn, with a paved area, pond, shrubs and trees. There is limited parking to the front, however parking is also available on the street. The fees range for nursing care from £705 to £840 and for residential from £450 to £675. Rosemary Lodge DS0000019118.V361716.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 people who use this service experience good quality outcomes. This unannounced inspection was completed over two days. It consisted of a visit to the home, discussions with people who use the service, their relatives, staff and the manager. A sample of records were examined, and surveys were provided for people and relatives, staff and professions. The first day started at 3.30pm and finished at 8.30pm, the second day10.20am to 5.40pm. This inspection included the gathering of additional information on safeguarding people. Four people were spoken with individually about how safe they feel at Rosemary lodge. Staff were spoken to about their knowledge of the safeguarding procedure. We spoke with thirteen people, four members of staff, the manager, four relatives, and the chief executive officer. The views of professionals from various care services were sought. People raised no concerns about their safety, staff receive good training in safeguarding people. Records relating to care plans, staff recruitment and medication were seen. A tour of the premises was undertaken. Information from the home’s Annual Quality Assurance Assessment is included in this report. Rosemary Lodge is a large house with extensions on an ordinary street within the local community. The house is comfortable, homely and clean. A relative said there is a “good friendly atmosphere” care is “very satisfactory”. Survey forms were received from seven people living in the home, nine from staff, five from relatives, and three from care professionals. All survey forms agreed that the home meets people’s needs. A relative reported the home is “very relaxed and makes everyone feel welcome”. Another person said “The term home from home seems appropriate. I am so glad I chose Rosemary lodge for my dear relation”. We saw that people appeared calm and settled. They did not display any anxiety through out this inspection. Activities are provided. A trip to a local school to chat with the pupils took place during this inspection. Assessments and care plans are comprehensive and record good quality information about the support needed by each person and how this should be given. Risk assessments are up to date and protect the person from harm. We found the people know about the complaint procedure. People raised no concerns about living in the home or their safety. Rosemary Lodge DS0000019118.V361716.R01.S.doc Version 5.2 Page 6 Appropriate checks are carried out before staff start employment. Staff receive suitable training and provide good support to individuals. Professional indicated on survey forms that staff have appropriate knowledge and skills for the job. The outcome from this thematic inspection is the service takes sufficient steps through staff recruitment and training, policies and procedures to safeguard the best interests of residents. What the service does well: What has improved since the last inspection? What they could do better: The home now has many people with dementia. Good practice in dementia care indicates that the home should consider a review of documents such as the menu, and the service users guide. Terminology such as feeding and using bibs should be reconsidered, as this is not age appropriate. People should feel free to approach staff if they are not happy or feeling unsafe, an illustrated form could be one way of achieving this. Rosemary Lodge DS0000019118.V361716.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Rosemary Lodge DS0000019118.V361716.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rosemary Lodge DS0000019118.V361716.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,6. People who use the service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose sets out what prospective user can expect. The home understands the importance of people having sufficient information when choosing a home. Admissions only take place when the service is confident that staff have the skills, abilities and qualifications to meet assessed needs. The home offers intermediate care. EVIDENCE: We spoke with an individual who reported they stayed at Rosemary Lodge before deciding to move in, moving was “my decision”. A relative said that Rosemary Lodge DS0000019118.V361716.R01.S.doc Version 5.2 Page 10 they had been recommend the home by friends and that satisfactory information was provided by the home. They visited to view the facilities. The Statement of Purpose provides specific details about the home. It is recommended that the service user guide be developed in a format, which is user friendly for people with dementia. The majority of people were satisfied with the information received before moving into the home. An assessment of needs by the manager is completed. This is carried out with the individual and their family. A detailed care plan is drawn up looking at all aspects of a person’s life. Care is taken to ensure that an individual’s life history, their occupation, and social interests are noted. Physical needs for example the condition of persons skin is noted and any special care required. In line with keyworking all qualified staff complete assessments. The home does offer intermediate care. Rosemary Lodge DS0000019118.V361716.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. People who use the service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Care plans for individuals show a complete and current record of need. Records demonstrate that health care needs are attended to. A medication log is maintained, the record of medication shows regular administration. Principals of respect and dignity were seen in the health and personal care that people receive. The person’s right to make decisions is respected. EVIDENCE: People reported, and survey forms confirm that they receive good care and support. One person said “everything is well taken care off and every one is supportive”. Families and health and social care professionals shared the opinion that diverse cultural or disability issues are met. A survey returned from a Rosemary Lodge DS0000019118.V361716.R01.S.doc Version 5.2 Page 12 professional stated that the service could “improve by providing more physical exercise”. All professionals agreed that privacy was respected. People are involved in the care planning process, they or their representative are consulted. A person and one relative confirmed consultation takes place. Survey from families all said they were kept informed of any issues around the care of the relative. Care plans for each person are reviewed monthly, and amended by staff as required. The monthly amendment to care plans allow for people situation to be monitored with regard to health care issues. Care planning includes an entry on how for some individuals, behaviour may manifest itself and how this should be managed. Risk assessments cover all activities including independence and mobility. Other events that put people at risk such as smoking in their bedroom and how to reduce the risk to the person are recorded. An activity organiser is currently building up a user-friendly life history for each individual. Time has been spent with the individual and family to find out about persons past. Research has been carried out to find suitable illustrations for example of a person’s school, and street maps. The expressed needs of a person are respected. People can choose to sit with the group at lunchtime but take all other meals in their room. For people who are not able to make their own decisions information learnt from families about preferences is valued. Staff responded sensitively to peoples needs. The medication charts are well maintained. Signed appropriately with legible signatures. Survey forms show that medical support is always available. Rosemary Lodge DS0000019118.V361716.R01.S.doc Version 5.2 Page 13 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. People are able to enjoy a full and stimulating lifestyle with a variety of options to chose from either at home or in the community. The right of individuals to make choices is actively promoted. Families and friends are encouraged to visit and relationships are maintained. Mealtimes are relaxed, food is appreciated and people are helped as required. EVIDENCE: As indicated in the AQAA ,we found a wide range of activities are provided for people. One person said “activities are there but I do not use them”. Another person reported “the exercise class arranged by the physio is very good, theatre trips are arranged, you can go out for a walk if desired”. Activities are organised in the lounge, the home has three activity organisers. People are Rosemary Lodge DS0000019118.V361716.R01.S.doc Version 5.2 Page 14 involved in daytime activities of their choice according to their individual interests and diverse needs. A visiting theatre group produced an interactive play in the dining room, with contributions from people living at the home. This had been developed over three weeks and had provided a daily activity for people while the organisers learnt about the skills of people. Staff assisted people if they needed help in attending the play. The theatre group were well received by all. On the same day a regular visit to a local school was also happening. The home has a minibus, which is able to take people who use wheelchairs. A few people chose not to follow any of the activities but to spend their time in their bedrooms. People told me of their activities. One person said they “ enjoy chatting and smoking” another person reported they “like to read and keep in touch with friends by letters”. A person has chosen to sit in the small lounge because it is much quieter. It was noted staff took time speaking one to one with people who have dementia. The staff team help with communication skills, to enable people to fully participate in daily living activities. Families and friends visit Rosemary lodge and photographs were seen in bedrooms and in the entrance to the home. Four relatives were spoken with and reported very positively on the service. The serving of meals has improved since the last inspection. People who need assistance are served individually in the small lounge with a dedicated carer to assist. Condiments are circulated around this group. This group were not offered a menu, an illustrated menu would be useful. The meal in the dining room is provided predominantly available for people who do not require assistance to eat. A carer is in the dining room to help if assistance is required. Care staff are sensitive to the needs of people who find it difficult to eat and give assistance as required. It is recommended that inline with good practice the use of terminology which is not age appropriate is reviewed. For example feeding and bibs at mealtimes. Survey forms highlighted that the food was spoken of very positively. One person reported “it has improved recently”, when speaking with three individuals the meals were spoken about as “excellent”. Meal seen was served hot and in different amounts to suit the individuals. For people who have a liquidised diet the food was served attractively placed in different tureens. Staff responded very sensitively to people with varied needs. Rosemary Lodge DS0000019118.V361716.R01.S.doc Version 5.2 Page 15 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. Individuals know how to make a complaint. The complaint procedure is supplied to everyone living at the home. Complaints were seen to be well handled and investigated. All staff complete training on the protection of vulnerable adults which is a key indicator that people are protected from abuse. EVIDENCE: How people are safeguarded from harm was a focus of this inspection. People spoken with have belief in the service and the staff to protect them. If they had any issues they would take them to the head of care, to staff, the family. The majority of people agree that staff listen and act on their wishes. No one expressed any concerns about staying at Rosemary Lodge. The survey returns show that people are aware of how to make a complaint. This was supported by the surveys returned from relatives. One individual said they have “no complaints, every one assists and takes an interest in my needs”. Rosemary Lodge DS0000019118.V361716.R01.S.doc Version 5.2 Page 16 As indicated in the AQAA we found the home has received nine complaints in the last twelve months. The records showed that the management of the home take complaints seriously, carry out a full investigation and make changes in the home if needed. Procedures are also in place for dealing with allegations of abuse. Recent complaints include iissues about the laundry, the use of agency staff, and falls. Complaints were appropiatly investigated, none were substantiated. No issues have been examined under the Protection Of Vulnerable Adults guidance. Three people were asked “Do you know whom to speak to if you do not feel comfortable or safe”. One person pointed to the service users guide. Another individual said family. One person said “I will make sure staff know”. In response to the question on the survey form “Do you know who to speak to if you were not happy”. Half the group that returned survey forms said they would “always” knew who to speak to the other part of the sampled group said “usually” and “sometimes”. The service should find a way of reassuring people that staff are available to deal with any issues. Staff reported they have received training in abuse and neglect, this includes “whistle blowing”. Training protects people from abuse, the training records confirmed that this happened. Rosemary Lodge DS0000019118.V361716.R01.S.doc Version 5.2 Page 17 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. Accommodation that meets the needs of people staying there. It is homely and clean, safe and comfortable. EVIDENCE: People are positive about the environment provided. One person said they are “very comfortable”. Bedrooms are personalised with homely items with pictures on the walls. Bathrooms have been adapted to meet the needs of people with a disability. Rosemary Lodge DS0000019118.V361716.R01.S.doc Version 5.2 Page 18 It is planned that a conservatory will be built this summer, which will enhance the facilities. The paintwork near to and in the lounge will be refreshed once the work is complete. The home was well lit, clean and tidy and smelt fresh; survey forms from people living in the home and relatives supported this. Rosemary Lodge DS0000019118.V361716.R01.S.doc Version 5.2 Page 19 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. Competent and experienced staff team ensure that people who use the service are well supported. All recruitment checks are complete before a person starts work. Staff have benefited from training on person centred planning. This enables staff to produce care plans which address the individual needs. EVIDENCE: During the inspection staff were consistently available to meet the needs of people. Staff demonstrated a good knowledge and understanding of people’s needs. We saw that staff got on well with people and the atmosphere was light hearted and relaxed. Staff have the skills to communicate effectively with people. Individuals reported highly of staff and the work they do, stating “there is always someone to help me”. A person reported that “everyone is very helpful”. People do not have any concerns about staff. Relatives reported that staff have the right skills for the job, and met the needs of the person as agreed on the care plan. Professionals agreed with this. Rosemary Lodge DS0000019118.V361716.R01.S.doc Version 5.2 Page 20 Rotas show staff on duty. Two nurses and six carers in the morning and two nurses and four carers in the afternoon. (There is more staff on duty at the peak times). Two people were on duty in the kitchen and a person was seen working in the laundry. Two activity organisers were also present. On the day of this inspection staff were available to meet the needs of people. Individuals were all calm and spending their time as they wished, with staff help as required. Staff are working towards or have completed National Vocational Qualifications. We heard from staff that a comprehensive recruitment procedure is followed references and a check with the Criminal Record Bureau (CRB) is carried out. We spoke with a senior member of staff who explained that all staff follow safeguarding adults training. The records and individuals confirmed this happened. There is a whistle blowing policy. Staff spoken with were all aware that this enables them to disclosure any issues of potential abuse in a confidential manner. This policy serves to safeguard people. There is wide cultural diversity in the staff team and the manager has a good understanding of equality and diversity. Staff reported that they have taken an equality and diversity course, this was confirmed by the AQAA. The course has improved their knowledge of peoples’ rights in daily life and focused on improving outcomes for people. Staff spoke of receiving regular supervision and regular staff meetings. Confirmed in returned survey forms. People are safeguarded by company policies, which protect both people and staff. Rosemary Lodge DS0000019118.V361716.R01.S.doc Version 5.2 Page 21 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. People benefit from a well run and managed home. The manager has the required qualifications and experience to run the home and has a clear understanding of the key principles and focus of the service. Continuous improvement to the service is sought in the best interests of people using the service. People’s finances are dealt with safely. Rosemary Lodge follows safe working practices. EVIDENCE: Rosemary Lodge DS0000019118.V361716.R01.S.doc Version 5.2 Page 22 The manager has an understanding of the organisations values and principles. The manager is a registered nurse and has the NVQ level four in management. The manager is working continuously to improve the service. As stated in the AQAA staffing at the home has recently improved through employing two more deputy managers, a catering manger and more administrative support. There is now a greater effort to involve people and relatives in care planning and service delivery. The residents support group meets six weekly with a trustee and the manager. Plans for the future includes adding to facilities by providing a conservatory. Carefully monitoring care through listening to people and involving relatives in their care. There is a system to protect people’s finances from abuse. Receipts are maintained for any money handles on a person’s behalf. Only a small amount of money is held for any one person. Guardians are used by some people to handle their money, one individual said “my family look after the money for me”. Policies and procedures are strengthened through staff training. Training is given in essential areas such as moving and handling, infection control, fire safety and safeguarding adults. This provides staff with the knowledge and expertise to provide a feeling of safety for both people at the home and other staff on duty. Rosemary Lodge DS0000019118.V361716.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 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 3 Rosemary Lodge DS0000019118.V361716.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 OP1 OP15 Good Practice Recommendations To increase understanding a service user guide which is user friendly for all people at the home should developed. Inline with good practice the use of terminology for example feeding and bibs at mealtimes should be reviwed. These statements are not age appropriate and removes people’s dignity. The service should find a way of reassuring people that staff are available to deal with any issues. 3. OP18 Rosemary Lodge DS0000019118.V361716.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Rosemary Lodge DS0000019118.V361716.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. 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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