Inspection on 02/10/07 for Abbeydale Nursing and Residential Care Home

This inspection was carried out on 2nd October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Abbeydale Nursing and... 02/01/07

Abbeydale Nursing and... 12/06/06

Similar services:

Chirnside House

Sunny Bank (P.R.S.) Ltd

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Ashwood Court Unit 1

Langrigg House

Parkside

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Abbeydale Nursing and Residential Care Home Croylands Street Kirkdale Liverpool Merseyside L4 3QS Lead Inspector Jeanette Fielding Unannounced Inspection 09:20 2 October 2007 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 Abbeydale Nursing and Residential Care Home DS0000067386.V337404.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. Abbeydale Nursing and Residential Care Home DS0000067386.V337404.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbeydale Nursing and Residential Care Home Address Croylands Street Kirkdale Liverpool Merseyside L4 3QS 0151 298 2218 0151 2982665 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) Doson Limited Care Home 36 Category(ies) of Dementia - over 65 years of age (36), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (36), Old age, not falling within any other category (36), Physical disability over 65 years of age (36) Abbeydale Nursing and Residential Care Home DS0000067386.V337404.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 36 service users to include: *up to 36 service users in the category of OP (Old age, not falling within any other category). *up to 36 service users in the category of MD(E) (Mental Disorder, excluding learning disability or dementia over 65 years of age). *up to 36 service users in the category of PD(E) (Physical Disability over 65 years of age). *up to 36 service users in the category of DE(E) (Dementia over 65 years of age). 2nd January 2007 Date of last inspection Brief Description of the Service: Abbeydale is a care home registered to provide residential or nursing care for 36 older people. The ownership of the home changed on 31st March 2006. The home remains privately owned. An application to register a manager of the home is currently being processed by CSCI. The home is located in the Kirkdale area of Liverpool and has easy access to bus routes, churches, shops and other local amenities. Abbeydale was originally a school and retains the outward appearance of a school building. Converted into a care home some twelve years ago it has car parking to the front and an enclosed rear garden. Accommodation is provided in single bedrooms on three floors. Access to all floors is provided via a passenger lift and stairways. Fees at Abbeydale Nursing and Residential Care home range from £385 to £490 depending upon service required. Abbeydale Nursing and Residential Care Home DS0000067386.V337404.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted in one day over a period of eight hours. This was the key unannounced inspection and was carried out as part of the regulatory process. As part of the inspection process, all areas of the home were viewed including many of the service users bedrooms. Assessments and care plans were inspected together with staff records and certification to ensure that health and safety legislation was complied with. Discussion took place with the appointed manager, nurses, care staff, service users and visitors to the home. What the service does well: What has improved since the last inspection? What they could do better: The format for recording information in care files would benefit from review to ensure that all information is accessible to nursing and care staff. The number and range of activities offered to service users is currently lower than preferred due to a vacancy for an activities co-ordinator. All persons working in the home, and have unsupervised access to service users, should be appropriately vetted. Abbeydale Nursing and Residential Care Home DS0000067386.V337404.R01.S.doc Version 5.2 Page 6 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. Abbeydale Nursing and Residential Care Home DS0000067386.V337404.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 Abbeydale Nursing and Residential Care Home DS0000067386.V337404.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 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents have sufficient information to make a decision about admission to the home and may be assured that their needs will be assessed prior to admission. EVIDENCE: Abbeydale has a Statement of Purpose and a Service User Guide. These documents have recently been reviewed and updated to reflect recent changes within the home. The documents are well presented and easy to read and contain sufficient information for prospective service users to enable them to make an informed decision regarding their care provision. Prospective service users are assessed by the acting manager or one of the senior nurses prior to admission to ensure that full information regarding their Abbeydale Nursing and Residential Care Home DS0000067386.V337404.R01.S.doc Version 5.2 Page 9 needs is identified. Pre admission assessments inspected were found to contain information gathered from the service user, their family and other health care professionals. The format for gathering information on prospective service users has improved since the last inspection. Discussion took place with the acting manager regarding alternative formats of recording information to enable additional information to be gathered to give a greater picture of the service users needs and preferences. The initial plan of care is prepared on admission based on the information gathered at the pre admission assessment. The home does not offer intermediate care. Abbeydale Nursing and Residential Care Home DS0000067386.V337404.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 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Information about service users care and social needs is not easily accessible to care staff which may result in some needs not being met. EVIDENCE: Individual care plans are prepared for all service users. A new format of recording information has been put in place since the last inspection. The format currently in use is now the Standex system. This format does not provide the necessary pro formas to enable the staff to prepare plans in sufficient detail. Risk assessments are not sufficiently detailed within this format and the risk management plans are not sufficient. Staff are still using the old care files in conjunction with the new format to ensure that full information is readily available to ensure that service users needs can be met. In view of this, the information necessary to enable staff to have easy access to relevant information is compromised. Additional information regarding Abbeydale Nursing and Residential Care Home DS0000067386.V337404.R01.S.doc Version 5.2 Page 11 moving and handling of service users is to be recorded to ensure that service users are moved safely and comfortably. The daily reports written by the majority of staff is minimal. Little information is recorded regarding how and where service users spent their day, what they did with their time and how this has impacted on their daily life, particularly in relation to choices and preferences. Medication Administration Record sheets (MAR’s) are completed as required. Information recorded on MAR’s must give the same details as given on the label provided by the dispensing pharmacist i.e. Paracetamol should also identify that a maximum of four doses to be given within any 24 hour period. Insulin is to be stored in accordance with the manufacturers recommendations and not stored in the refrigerator when in use. The refrigerator thermometer is to be reset each day after the reading has been taken to ensure that accurate records are maintained. Leaflets with information on specific medications, issued by the dispensing pharmacist, should be held in the home to give staff full information about the medications that have been prescribed to service users. Regular audits of medications should be undertaken and records of these maintained to avoid the risk of errors being undiscovered. Training updates in the administration of medications have been given to some of the nurses and this training is now to be given to others. Evidence of an assessment of practice should be held on their files to demonstrate their competency. Personal care is given to service users in the privacy of their bedroom or in the bathroom as appropriate. Abbeydale Nursing and Residential Care Home DS0000067386.V337404.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 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a lack of activities and social stimulation which would enhance service users lives. EVIDENCE: The home does not gather information from service users regarding their individual social history or preferences to enable staff to meet those preferences. No activities co-ordinator is currently employed and is advertising for a person to fill this post for 30 hours each week. All activities are currently provided by the staff but staff spoken to said that they had difficulty finding time for activities, particularly on a one to one basis. Ministers visit the home on a weekly basis and will provide services on request. Visitors are welcomed at any time and service users may meet with their visitors in one of communal areas or in their own bedroom as they choose. All service users are accommodated in single bedrooms. Abbeydale Nursing and Residential Care Home DS0000067386.V337404.R01.S.doc Version 5.2 Page 13 Choices are offered in many aspects of daily life, particularly in relation to the time that service users go to bed or rise. It is recommended that service users are given the opportunity to express their individual preferences in the form of a social assessment to provide staff with essential information regarding those preferences to enhance their daily lives. Meals are served in the dining room or in service users bedrooms as they wish. The meals served on the day of the inspection looked and smelled appetising. Service users spoken to confirmed that they enjoyed their meals and could choose from a selection of options. Special diets are provided on the advice of the GP or dietician or on request of the service users. The menus provide evidence that a balanced and nutritious diet is provided. The meals are prepared in the main kitchen which was found to be clean and organised. Food stocks were good and a good supply of fresh fruit and vegetables were available. Staff were observed to assist service users with their meals in a sensitive way. Abbeydale Nursing and Residential Care Home DS0000067386.V337404.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a robust complaints procedure to ensure that service users are protected. EVIDENCE: The home has a robust complaints procedure which is displayed in the foyer of the home and is also detailed in the Statement of Purpose and Service User Guide. One complaint has been made to the home since the last inspection and the records held show that the complaint was dealt with appropriately and within the required timescale. Many of the staff have been given formal training in the Protection of Vulnerable Adults and arrangements are in place for training to be given to the remaining staff. This topic is also covered during the induction training programme and staff spoken to were aware of the different types of abuse and of the action to be taken in the event of abuse being suspected. There is also a whistle-blowing policy and all staff have been made aware of this to ensure that service users are further protected. Abbeydale Nursing and Residential Care Home DS0000067386.V337404.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Investment in the home has provided service users with a homely and pleasant environment in which to live. EVIDENCE: Considerable work has taken place since the last inspection to improve the environment for the service users. Corridors have been redecorated on the ground and second floor corridors and is due to commence on the first floor. Some bedrooms have been provided with new carpets and the programme of redecorating bedrooms continues as necessary. The home provides a passenger lift to give full access to all areas for service users and visitors who require to use a wheelchair or have mobility difficulties. Abbeydale Nursing and Residential Care Home DS0000067386.V337404.R01.S.doc Version 5.2 Page 16 A ramp is provided at the front of the home to give access and egress. Grab rails are provided within the home to assist service users as necessary. A programme of improvement has been prepared and includes the provision of shower rooms on the ground and first floors, new bedroom furniture, new bedding and replacement curtains and curtain rails. The lounge has been redecorated and provided with new carpets and furniture. One of the baths is not used by service users. This is a Parker bath and is designed for persons who have mobility difficulties, but none of the service users like this bath as it requires them to sit in the bath whilst it is filled and emptied. One service user said that it only got her feet wet and staff had to use the shower to wash her. She felt that a shower is much more comfortable and a lot quicker. The home also has a Medi-bath in bathroom 7 which is not used by service users. Consideration should be given to providing more appropriate bathing facilities that will be used by service users. The hot water system is ineffective with some areas of the home having water that is not sufficiently hot. Arrangements are to be made to ensure that water of a suitable temperature is available for service users at all times. The hoist used for transferring service users now requires to be serviced and issued with a safety certificate. Many of the pillows provided for service users had been damaged by the laundering process and were extremely lumpy. These should be replaced as a priority to ensure the comfort of service users. The home is strongly advised to provide liquid soap dispensers at all communal washbasins in toilets and bathrooms to prevent the risk of cross infection. The home is maintained in a good condition and all safety issues are dealt with as soon as they are identified. Service users bedrooms are bright and welcoming and it is evident that service users, their families and the staff have made every effort to personalise the rooms. The lounge area is also used as the dining room but does not have a view from the window for service users to look out on. There is garden at the rear of the home which is provided with seating. Considerable work has taken place in the garden but more is required to provide service users with a pleasant place to sit during the warmer months. The home was found to be clean and fresh throughout with no unpleasant odours. Abbeydale Nursing and Residential Care Home DS0000067386.V337404.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Additional training is required to be undertaken by some staff to ensure that service users are protected. EVIDENCE: The home employs qualified nurses and care assistants to provide care to the service users. The staff rota provides evidence that the home is employing and deploying staff in sufficient numbers to meet the needs of the service users. Training continues to be given to staff although some staff still require training on Manual Handling, Fire Safety and the Protection of Vulnerable Adults. The home has a robust recruitment procedure and the files of staff recently employed showed that this procedure has been followed. All staff are required to complete an application form prior to being called for interview. Two references are taken together with checks through the Criminal Records and Protection of Vulnerable Adults Bureaux. There is no evidence to show that other persons who work in the home i.e. the hairdresser and aroma therapist, has had a CRB check undertaken. Any Abbeydale Nursing and Residential Care Home DS0000067386.V337404.R01.S.doc Version 5.2 Page 18 person who works in the home, or any volunteer who has unsupervised access to service users, must be appropriately vetted prior to them working in the home. The manager, who has not been at the home for very long, has made considerable progress is arranging training for staff and has had to make some training sessions compulsory to ensure attendance. Staff meetings are held on a regular basis but are not attended by all staff. Service users spoken to spoke highly of the care they were given and each had their own favourite carer. Two carers were the favourite of most of the service users who commented on their kindness and professionalism. It was observed that the manager had to remind some of the nurses of particular tasks that required to be undertaken during their shift. It is suggested that a daily work programme is prepared for the nurses, in addition to the one prepared for care staff, to ensure that all tasks are undertaken in a timely manner. Abbeydale Nursing and Residential Care Home DS0000067386.V337404.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clear leadership by the acting manager has ensured that service users are protected. EVIDENCE: The acting manager at the home has not been at the home for very long. She is a qualified nurse who has experience of managing a care home for older people who require nursing care. She is planning to commence training to NVQ level 4 in management very soon. An application to register the manager has been submitted to CSCI. Abbeydale Nursing and Residential Care Home DS0000067386.V337404.R01.S.doc Version 5.2 Page 20 It is evident that the acting manager has made considerable improvements within the home since she started working there but is compromised by the attitude and practices of some of the senior staff who are not supporting her. It was observed that some of the nurses needed to be reminded, on a number of occasions, to undertake tasks in a timely manner and to ensure that service users were supervised. The manager was able to demonstrate that she had a good knowledge of service users needs and was in control of the home and the care. The care of the service users was clearly her first priority, whilst ensuring that they had a pleasant place in which to live. Formal supervision is given to all staff every two months. Staff meetings are held every two months. Meetings with service users and their relatives are held every two months but these have not been well attended. The acting manager speaks with service users and their relatives on a one to one basis to give information and to gather their views of the home. Annual quality assurance audits are undertaken through Satisfaction Survey Questionnaires which are issued to service users, relatives and other health care professionals. The response from the health care professionals is generally poor. The result of the surveys is displayed on the notice board within the home. A separate bank account is held for service users money where no relatives are available or willing to deal with their money. This is a non-interest bearing account and information regarding this is detailed in the Service User Guide. Monthly visits are made to the home by the registered person who makes a written report of his findings. Health and safety of staff and service users is assured through regular checks and issuing of safety certificates. All certification, with the exception of one hoist, was found to be in place and up to date. Abbeydale Nursing and Residential Care Home DS0000067386.V337404.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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 2 3 X 3 X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 3 X 3 Abbeydale Nursing and Residential Care Home DS0000067386.V337404.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement The registered person must ensure that all care plans are reviewed and updated to include all information necessary to enable staff to meet service users needs. The registered person must ensure that the daily report identifies the nursing care given to service users. The registered person must ensure that full information about medications is recorded on the MAR sheet. The registered person must ensure that staff authorised to administer medication receive appropriate medicines management training and have an assessment of their competence, prior to performing these tasks. This remains outstanding from the last inspection. The registered person must ensure that medications are stored at the appropriate temperature. This is in relation to Insulin in current use. DS0000067386.V337404.R01.S.doc Timescale for action 31/12/07 2. OP8 17 30/11/07 3. OP9 13(2) 31/10/07 4. OP9 13(2) 31/10/07 5. OP9 13(2) 31/10/07 Abbeydale Nursing and Residential Care Home Version 5.2 Page 23 6. OP12 16(2) 7. 8. 9. OP19 OP19 OP28 23(2) 16(2) 18(1) 10. OP28 17 11. OP30 23(2) The registered person must ensure that a programme of activities is provided and that evidence of the activities that service users participate in is recorded. The registered person must ensure that there is an adequate supply of hot water. The registered person must ensure that lumpy pillows are replaced. The registered person must ensure that all staff are given training on the Protection of Vulnerable Adults. The registered person must ensue that all persons working in the home, including the hairdresser and aroma therapist, are appropriately vetted. The registered person must ensure that the mobile hoist is assessed and appropriate certification in place. 31/10/07 31/10/07 31/10/07 31/12/07 31/12/07 31/10/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 4. 5. 6. Refer to Standard OP9 OP9 OP12 OP21 OP21 Good Practice Recommendations Information leaflets on medications should be held. Full audits of medications should be undertaken on a regular basis and a record of the findings held. A record should be held of service users individual preferences in relation to activities and social stimulation. Consideration should be given to replacing unused baths with more appropriate facilities. Liquid soap dispensers should replace bars of soap at communal washbasins to remove the risk of cross infection. DS0000067386.V337404.R01.S.doc Version 5.2 Page 24 Abbeydale Nursing and Residential Care Home 7. OP30 The role and responsibilities of the nurses is established with them. Abbeydale Nursing and Residential Care Home DS0000067386.V337404.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Abbeydale Nursing and Residential Care Home DS0000067386.V337404.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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