Inspection on 03/10/06 for Apple Court Care Home

This inspection was carried out on 3rd October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Apple Court Care Home 25/04/06

Apple Court Care Home 22/12/05

Apple Court Care Home 29/07/05

Apple Court Care Home 16/12/04

Apple Court Care Home 21/05/04

Apple Court Care Home 13/02/04

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

CARE HOMES FOR OLDER PEOPLE Apple Court Care Home Apple Court Mental Nursing Home 76 Church Street Warrington Cheshire WA1 2TH Lead Inspector Anthony Cliffe Unannounced Inspection 10:00 3 , 4 and 6 October 2006 rd th 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 Apple Court Care Home DS0000046209.V316192.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. Apple Court Care Home DS0000046209.V316192.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Apple Court Care Home Address Apple Court Mental Nursing Home 76 Church Street Warrington Cheshire WA1 2TH 01925 240245 01925 240123 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) Hallmark Healthcare (Warrington) Limited Care Home 67 Category(ies) of Dementia - over 65 years of age (67), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (1) Apple Court Care Home DS0000046209.V316192.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 67 service users to include: * * Up to 67 service users in the category of DE (E) (dementia over the age of 65). Up to 1 named service user may be MD (E) (mental disorder over the age of 65). 25th April 2006 Date of last inspection Brief Description of the Service: Apple Court is a 67-bedded care home providing nursing and personal care to older people diagnosed with dementia and is operated by Hallmark Healthcare. The home is located in Warrington town centre and is on a main bus route and close to all local amenities and facilities. The home is a purpose built twostorey building. Each floor has two living areas that have been combined to provide one larger living group and facilitate the support of a larger group of staff, with a minimum of two registered nurses on duty at any one time. Each floor has two lounges, two dining rooms and recreational areas. Each resident has their own single bedroom with en-suite facilities. Apple Court Care Home DS0000046209.V316192.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place on the 3rd, 4th and 6th October 2006 and lasted 18 hours. A Regulatory Inspector carried out the visit. This visit was just one part of the inspection. Other information received was also looked at. Before the visit the home manager was also asked to complete a questionnaire to provide up to date information about services provided. Questionnaires were provided for residents, families, health and social care professionals to find out their views. During the visit various records and the premises were looked at. A number of residents, relatives and healthcare professional were also spoken with and they gave their views about the service. One requirement from the previous visit had not been met. What the service does well: What has improved since the last inspection? The manager has improved the management of Apple Court to promote the health and welfare of residents so their health and welfare is protected. Staff had completed a variety of training. Communication with residents had improved through staff supervision and staff meetings. So residents were treated with dignity and respect and choice in their lifestyle promoted. Apple Court Care Home DS0000046209.V316192.R01.S.doc Version 5.2 Page 6 Care plans had improved to identify residents were assessed and their needs identified so appropriate health and social care was provided. The management and use of physical intervention was clear so residents were protected from harm. Complaints, concerns and allegations of abuse were acted on appropriately so residents and relatives could be confident that their concerns were treated seriously. The activities coordinators had training on providing suitable activities for residents, and an activities programme provided so residents had a choice of leisure pursuits. The ordering of meals had improved so residents or their relatives could choose meals. The quality assurance system had improved so management of the four units, care practice, standards of recording and management of residents’ monies were managed in the best interests of residents. The maintenance of equipment and access to unsafe areas had improved so residents’ safety was maintained. What they could do better: The recruitment of staff needs to improve so residents are protected from harm. The testing of fire equipment needs to improve so residents and staff are protected from the risk of fire. Care plans could improve with less medical terminology used and reviews of care describing the outcome of the review to verify if it is working or not and staff can understand them. The opportunities for staff to undertake NVQ level 2 training and training appropriate to their role should increase to provided a skilled workforce who can communicate with residents and use appropriate training to manage challenging behaviour. Apple Court Care Home DS0000046209.V316192.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. Apple Court Care Home DS0000046209.V316192.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 Apple Court Care Home DS0000046209.V316192.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 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available for residents and their representatives and their needs are assessed prior to moving in so Apple Court can provide appropriate care to them. EVIDENCE: Residents were not routinely provided with a copy of the statement of purpose due to the severity of their dementia and associated confusion, though a copy of this was available. The statement of purpose was not available in large print or different formats but the manager said this could be done on request. The manager said copies of the statement of purpose were sent out routinely with a welcome pack giving details on the facilities available. Apple Court Care Home DS0000046209.V316192.R01.S.doc Version 5.2 Page 10 Records were examined of two residents who recently moved into Apple Court. The manager or deputy manager had assessed the residents. Appropriate care plans and risk assessments were in place for both residents. Additional information had been obtained from the local council social services department or Partnership Care Trust (PCT), which placed the residents at Apple Court. Detailed life histories were completed on both residents and contained within their care plans. Apple Court Care Home DS0000046209.V316192.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed records of care, liaison with health and social care professionals and good medicine management ensures residents’ health and welfare needs are met. EVIDENCE: Care plans showed a marked improvement with a range of completed assessment documents, with a care plan to address individual identified needs. Care plans record residents` physical and mental health needs. Each care plan had a pre admission assessment and an assessment by the social worker or nurse assessor. From looking at care plans, observing staff working practices and talking with residents, staff, visitors and a visiting health professional the health needs of residents were met. There were good examples of care plans in place that monitored residents’ health. Care plans were in place to monitor eating and drinking, risk of developing pressure ulcers and assistance with personal care. Care plans described how to approach and communicate with residents. Care plans had been revised since the last visit and detailed the best time to provide personal care for residents. Care plans recorded regular contact with health and social care professionals. A review held at the time of the site visit by the local Apple Court Care Home DS0000046209.V316192.R01.S.doc Version 5.2 Page 12 council noted the resident’s mental and physical health had improved. The resident was eating and had a more regular daily routine including regular meals. The resident had put on weight. The only concern about the care plans was the use of medical terminology to describe residents’ needs. Anyone who was not familiar with medical terminology might not understand what they referred to. When resident’s care plans were reviewed they did not record if the care plans was working or not and continued to write ‘continue as planned’. A resident who had recently moved in said “ I don’t know the name of this place. The other people shout out for help and the nurses help them. I can’t remember how long I’ve been here or everyone’s name but it’s very nice”. A visiting nurse assessor from the local PCT said “ There were previous problems here with care planning and staff trying to manage aggressive behaviour in April. Since May there has been a total turn around, care plans have improved and I am impressed with them. Staff ask for advice and act upon it. At the review today the family said the staff could not do any more to satisfy them. I find the staff team has stabilised and the staff team are knowledgeable. The care staff understand residents’ needs and communicate well with them. I visit other care homes in Warrington and this is the best”. Medicine receipt, storage and administration were examined on both floors of Apple Court. Only one minor error was found. Apple Court Care Home DS0000046209.V316192.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 and 15 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents are supported in making choices about their lifestyle and supported to participate in social activities so they have control over their lives. EVIDENCE: Since the last visit an overall improvement had been made in how social and recreational activities were planned and provided. The majority of residents had life histories to tell staff about their lives. Some of these were written before residents moved in and where possible written by the residents’ families. Residents’ care plans contained a care plan for social preferences. These recorded individual preferences about residents’ choices of recreation and social activities. They highlighted positive practice for staff to get to know new residents. For example getting to know a new resident’s life history by encouraging him to talk about himself and his hobbies as written in his life history. Social care plans also detailed residents’ communication difficulties and advised staff on the best practices to use when communicating with residents. An additional activities coordinator had been employed and the two coordinators employed working a total of 41hours a week. The new coordinator was very keen and enthusiastic. A lot of work had been done in providing a new activities programme and converting a former office on the first floor into an activities/ relatives’ room. This had been furnished and drinks making Apple Court Care Home DS0000046209.V316192.R01.S.doc Version 5.2 Page 14 facilities provided. White dry wipe boards had been fitted in the dining rooms and displayed information about the menu, staff on duty and day and date. The activities coordinators had undertaken training on ‘moving more often’ from the local PCT. This training was to provide activities to promote the physical health of residents living in health and social care settings. The activities coordinators provided time for a one to one and group activities. This included day trips out for small groups, shopping in the town centre and having a drink in the pub. A resident said “ I like to go out for a bottle of Guinness and have been out a few times”. Another resident said “ My two boys visit me and I enjoy going out for a drink occasionally. I like it here the meals are good and I eat what they put in front of me”. A resident talked about making choices and said “ The lady who helped me to move in said I could bring my own furniture and most of this it is mine, including the fridge. I like my bedroom and my own company. I enjoy watching sport and have sports channels. Staff pop their heads in to see I’m all right. The staff are great, if I want anything they get it for me. I like pork pies for tea and they will get them as well as fish and chips. I call them using this button and they help me to help myself. The food is great and I enjoy different things. If I change my mind she will cook me something different”. Residents looked cared for. The men were cleanly shaven and their hair neatly cut. The ladies had their hair done and wore jewellery. Residents wore their spectacles and hearing aids and care plans directed staff to ensure these were worn at all times. Residents wore shoes or slippers. Relatives said they were welcomed and enjoyed visiting. A relative said, “ Mum has been here for over a year. She is in the best place she can be and is well cared for. She has been poorly but she received the care she needed. The manager has made a good impression and I can now go away on holiday without worrying about mum. There were problems here before the manager came but she has made improvements. They have put residents names on their bedroom doors. One lady said to me the other day that’s my bedroom with my name on. Some relatives are not satisfied and complain about small things. I can see improvement happening. I am satisfied mum is cared for and looks presentable”. Another relative commented that her husband was in the best place and received very good care. She said “ I know there have been improvements so many it’s hard to say. The atmosphere is very good. I really like the staff overall they are excellent”. The menu offered a choice of meals at lunch and teatime. Meals were pre ordered and the cook served lunch to residents. Staff were on hand to assist residents. The cook said she provided additional portions of meals in case residents changed their choice. She provided alternatives from the main menu for residents who wanted something else. The cook said she did not compromise on the food budget and prided herself on the high standard of meals she provided. The manager had a copy of the ‘Highlight Of The Day’ a report produced by CSCI on the standard of meals provided in care homes. Apple Court Care Home DS0000046209.V316192.R01.S.doc Version 5.2 Page 15 This contained information on nutrition and menu planning. The cook said she had looked at the report and it had given her ideas on getting feedback from residents and relatives on what they think about the menu and meals served. Residents were seen having breakfast and lunch. Pureed meals were appropriately presented in individual portions but some staff were seen mixing the portions together into a single one. These isolated incidents were discussed with the manager. Apple Court Care Home DS0000046209.V316192.R01.S.doc Version 5.2 Page 16 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints and concerns are consistently acted upon to safeguard residents from abuse. EVIDENCE: Complaints records recorded a complaint via the local council that had not been resolved. The nurse assessor from the PCT had looked at the concerns arising from the complaint and said the manager and staff had acted responsibly in meeting the resident’s health needs. The documents of the resident concerned were examined during the site visit. The manager had sought professional advice on the resident’s physical and mental health needs and acted to promote the residents physical and mental health needs. The manager had developed a positive dialogue with a relative who had previously had concerns about the standards of care at Apple Court. The correspondence between them was positive and demonstrated the relative was informed and consulted about the care of her relative. The manager had referred a number of concerns to the local council under the vulnerable adults procedure. The manager had cooperated with the local council, police and CSCI into the investigation of these concerns. There were no issues concerning the challenging behaviour of residents found during the site visit. Residents care plans directed staff on the best practice to use when communicating with residents or managing difficulties such as residents attempting to scratch or pinch then when they were providing them with assistance. All staff had been given a copy of the Hallmark Healthcare protection of vulnerable adults policy and procedure and verified receipt of this. Apple Court Care Home DS0000046209.V316192.R01.S.doc Version 5.2 Page 17 The manager and deputy manager had been on training on ‘Challenging Behaviour in the Elderly’. The manager said this training was to be cascaded down to all staff as required at the last visit but dates had not been set. Apple Court Care Home DS0000046209.V316192.R01.S.doc Version 5.2 Page 18 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a well maintained home, which is clean and hygienic and safe to live in. EVIDENCE: All communal areas and some bedrooms were seen. Bedrooms were personalised with items of the occupants’ furniture, electrical equipment and family photographs. The interior and exterior of the building was well maintained. The home was free from odours. Signage had improved on bedroom and bathroom doors with residents’ named put on their bedroom door and symbols denoting toilets and bathrooms. Apple Court Care Home DS0000046209.V316192.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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of staff are adequate to meet residents’ needs but staff recruitment needs to improve to ensure that residents are protected. EVIDENCE: The manager provided information on the number of staff that held NVQ qualifications. This recorded only five staff having an NVQ level qualification. The manager said the information held at Apple Court was inaccurate and did not reflect the numbers of staff employed from outside the United Kingdom and European Union that held a nursing qualification but did not require an NVQ level 2 or above qualification. Staff recruitment records for five new staff were examined. Records confirmed that all appropriate documentation was in place including a Criminal Records Bureau Check (CRB) and POVA First check for four of the staff employed. One staff member had left the employment of Hallmark Healthcare and applied for her former position and re employed after a break in service. No POVA First or CRB check had been applied for. The manager said this was an oversight and had realised the error of judgement. The necessary applications were completed at the time of the sight visit. Details of staff training were provided during the site visit. Staff had undertaken training in Fire prevention, care planning, managing challenging behaviour, infection control, health and safety and moving and handling. Apple Court Care Home DS0000046209.V316192.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An experienced manager is employed at Apple Court who ensures training, quality assurance and staff supervision are completed so residents’ quality of life is enhanced and they are protected. EVIDENCE: An application to register the manager had been received and processed by the CSCI. Significant improvements had been noted during the site visit and staff comments regarding the improvements were positive. The manager said, “ I have achieved a lot in a short space of time. I have introduced more monitoring of staff via supervision, which my deputy and I do. We communicate better as a team and have got on top of a lot of the problems of record keeping. Staff moral has improved but there is room for improvement. Apple Court Care Home DS0000046209.V316192.R01.S.doc Version 5.2 Page 21 We now need to move forward and change the routines in the home to suit residents. An example of this could be the medicine procedure so it’s not a task”. A registered nurse said, “ There is a much better atmosphere here. The manager is very supportive and approachable. She is keen to make changes and develop the staff team. I have regular supervision when I talk about my personal development, clinical practice and training. The deputy manager is very approachable, available and I trust her judgement. She regularly checks the medicine and care plan records to see we are to make sure we are not making mistakes”. Another registered nurse said “The management style has changed, the manager is much more approachable and not always busy. There is a lot more coordination and organisation. The deputy manager is approachable and gives good advice”. Another registered nurse said that care staff used their initiative more and their practice was monitored in supervision. There is a robust quality assurance process in place with monitoring of records and staff practice by the management team. The manager completed monthly audits of the internal quality assurance systems at Apple Court and this is verified by the Operations Director of Hallmark healthcare every two months. The monthly audits by the manager and Operations Director recorded an overall improvement in how Apple Court was managed and how improvements were being made and monitored. Since he last site visit the management of residents’ finances had improved and monies held on behalf of residents was managed safely and securely. Information provided by the provider in a pre inspection questionnaire and records held on site were examined. The fire systems were not tested as required between July and September 2006 when a handyman was not employed. Safety in the building had improved with security locks fixed to a sluice room to prevent residents having access to a source of scalding hot water. The portable and fixed hoists had been tested as required. Apple Court Care Home DS0000046209.V316192.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 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 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 1 Apple Court Care Home DS0000046209.V316192.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? 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 OP29 Regulation 19(1)(a)( b)(c) Requirement The registered person must not employ a person to work at the care home unless he has obtained in respect of that person the information and documents specified in paragraphs 1 to 9 of Schedule 2. (Timescale 1.2.06 and 1.6.06 not met). The registered person must test the fire alarms, emergency lighting and fire fighting equipment at the intervals specified by the fire and rescue authority. Timescale for action 03/10/06 2. OP38 23(4) (c)(v) 03/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations Residents’ care plans should avoid the use of medical terminology and when they are reviewed describe if the care plan worked or not. DS0000046209.V316192.R01.S.doc Version 5.2 Page 24 Apple Court Care Home 2. 3. OP18 OP28 Training on managing challenging behaviour should be provided to all staff. Further opportunities should be provided to ensure staff have access to NVQ training. Apple Court Care Home DS0000046209.V316192.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Apple Court Care Home DS0000046209.V316192.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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!