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Inspection on 13/12/05 for Arden Valley Christian Nursing Home

Also see our care home review for Arden Valley Christian Nursing Home for more information

This inspection was carried out on 13th December 2005.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

A discussion took place with the management team and a commitment was made to address the issues raised by the inspection.

What has improved since the last inspection?

A programme of refurbishment has involved the purchase of new furniture, carpets, equipment and redecorating a number of rooms and communal areas of the home. The appointment of a number of care and domestic staff has reduced the need for staff to work excessive hours. Staff make sure that equipment is being used safely and in accordance with good practice.

What the care home could do better:

The absence of a regular manager has contributed to the home not being well managed. Lack of clear leadership and staff supervision have also affected the quality of care afforded to residents. The recent appointment of a new manager due to take up her role and responsibilities in January 2006 should address some of the issues highlighted during the inspection. Greater effort is required to engage residents with dementia to participate in meaningful daily and life enhancing activities. The environment should take into account and reflect the needs of residents. The home must promote privacy and dignity for residents and improve the services offered in the laundry, the delivery of personal care, infection control and assisting with nutritional needs. Food served to residents should be presented in an attractive manner and personal assistance made available in a timely and appropriate manner. Make sure medication is administered safely and in line with the home`s policy and procedure. When completing tasks staff must work in line with health and safety legislation to prevent accidents. Care plans should be comprehensive and reflect all the aspects of care listed in standard 3 of the National Minimum Standards. Risk assessments should address all high risk issues. These documents should be readily available to care staff.

CARE HOMES FOR OLDER PEOPLE Arden Valley Christian Nursing Home Bearley Cross Wootton Wawen Solihull West Midlands B95 6DR Lead Inspector Jean Thomas Unannounced Inspection 13th December 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Arden Valley Christian Nursing Home DS0000004385.V271753.R01.S.doc Version 5.0 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. Arden Valley Christian Nursing Home DS0000004385.V271753.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Arden Valley Christian Nursing Home Address Bearley Cross Wootton Wawen Solihull West Midlands B95 6DR 01789 731168 01789 731883 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) Trinity Care Limited Care Home 48 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (24) of places Arden Valley Christian Nursing Home DS0000004385.V271753.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th April 2005 Brief Description of the Service: Arden Valley is a purpose built nursing home providing accommodation for 24 people with dementia and 24 people who are frail elderly. Accommodation is provided on the ground and first floor of the property. Service users from both units have access to a secluded garden at the rear of the building. Each unit provides a variety of communal living space with a light and airy conservatory area. The home is located in a rural area, which is not easily accessible without a car. Arden Valley Christian Nursing Home DS0000004385.V271753.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for service users and their views of the service provided. This process considers the care home’s capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. This unannounced inspection took place over six and a half hours on 13th December 2005 and involved: • • • • Discussions with the project manager, regional manager, four care workers, one registered general nurse, the activities coordinator, one domestic assistant and two cooks. Viewing policies and procedures, individual residents’ assessment and care plans, risk assessments, daily records and medication records. Discussion with five residents, two relatives and observation of staff practices. Analysing survey responses from care workers, residents and their representatives. Finally feedback took place with the project manager and regional manager about the inspection findings. What the service does well: What has improved since the last inspection? A programme of refurbishment has involved the purchase of new furniture, carpets, equipment and redecorating a number of rooms and communal areas of the home. The appointment of a number of care and domestic staff has reduced the need for staff to work excessive hours. Staff make sure that equipment is being used safely and in accordance with good practice. Arden Valley Christian Nursing Home DS0000004385.V271753.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Arden Valley Christian Nursing Home DS0000004385.V271753.R01.S.doc Version 5.0 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 Arden Valley Christian Nursing Home DS0000004385.V271753.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4 and 5 Prospective residents have their health and social care needs assessed and have opportunity to visit the care home to assess suitability prior to admission. The absence of staff knowledge and understanding of specialist dementia care may result in residents’ needs not being met in an appropriate or timely manner. EVIDENCE: In discussion the project manager reported that prospective residents are encouraged to visit the home and have a care needs assessment prior to admission. Two residents, one relative and one care worker spoken with confirmed that pre-admission visits were offered but seldom taken up as prospective residents were often very frail and chose not to take the opportunity to visit, preferring instead to accept the recommendations of relatives who had visited the home. Arden Valley Christian Nursing Home DS0000004385.V271753.R01.S.doc Version 5.0 Page 9 Documentation showed that health and social care assessments were undertaken prior to admission and that following admission to the home nutritional screening including recording the resident’s weight takes place. Although staff records indicate that some specialist dementia care training has taken place, there was little evidence to suggest that residents’ needs were being met in a satisfactory manner. Observation of staff practices found limited interaction between residents and staff and no one to one engagement in meaningful, daily life activities. Two members of staff spoken with were not aware of when reality orientation should be used or if at all and were not sufficiently aware of activities that could provide social and intellectual stimulation. There was no evidence to suggest that staff could effectively interpret messages communicated through behaviour. When asked, two staff were unsure as to why one resident spent most of her time walking around the unit and another resident was shouting. Relatives and residents spoken with and those surveyed expressed concern about the high number of overseas staff who have limited English-speaking skills and are unable to fully interact with residents. This issue was discussed with the project manager and regional manager who both showed a commitment to ensuring staff have the necessary skills to undertake their roles and responsibilities. The rural location the home impacts on staff recruitment resulting in insufficient numbers of local people applying for positions. Two relatives spoken with made the following comments: • • • • ‘Generally staff treat residents respectfully, are patient and caring’. ‘When you ring up I can’t understand what the worker is saying as English is very poor’. ‘Most of the girls have a nice attitude, always very nice with my mother when I’m here’. ‘Some staff sometimes short and sharp could be interpreted as bullying’. Arden Valley Christian Nursing Home DS0000004385.V271753.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Care plans are not available for all residents; therefore we cannot be sure individual needs are being met appropriately. Residents have access to a range of specialist community health care services. Policies and procedures in place for the safe management of medication are not always adhered to by staff, therefore some practices are unsafe and place residents at risk. The privacy and dignity of the residents is not always respected by staff consequently residents do not maintain individuality. EVIDENCE: The new owners of the home are in the process of developing new care plans for all residents which are based on the initial assessment of need. Some information on previous care plans, held on computer, was lost during the transfer of ownership and therefore not open to inspection. Arden Valley Christian Nursing Home DS0000004385.V271753.R01.S.doc Version 5.0 Page 11 Three new care plans viewed were generally detailed, informative and some aspects of care were linked to a risk management strategy. In order to ensure oral hygiene needs are met details of individual needs and abilities should be included in the care plan. Care plans for residents requiring specialist dementia care should include known communication techniques and specific behaviours so as to ensure needs are met. One care plan viewed states ‘constantly strips clothes off and consequently gets cold’. The care plan failed to identify possible triggers to the behaviour or details of how the behaviour was to be managed. The absence of detailed information demonstrates a general lack of understanding of the resident, their needs and agreement as to how needs are to be met. Complex or challenging behaviours should be understood and managed to ensure the privacy and dignity of the resident are maintained. In order to ensure the health and safety of residents the management of complex or challenging behaviours should be informed by risk assessment. As the majority of residents do not yet have a plan of care we cannot be sure that individual needs are understood or are being met appropriately. A digital camera is to be used to provide individual photographs necessary for residents’ personal record files and also for recording, monitoring and caring for pressure sores. Documentation held evidence that residents’ optical, dental and chiropody needs are met. Where appropriate, occupational therapists, dieticians and speech therapists would be involved in the resident’s care. Inspection of the storage and administration of medication found a number of discrepancies. Gaps were noted on the medication administration records therefore practices are unsafe. A tour of the premises found that a number of residents had not been fully assisted with their clothing and appearance, therefore privacy and dignity was compromised. In discussion the manager stated that she would be addressing with staff the issues raised and is committed to raising standards in the home to ensure residents are always treated respectfully with their privacy and dignity maintained. Arden Valley Christian Nursing Home DS0000004385.V271753.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 15 Planned activities are available and meet the needs of some residents, however there is a general lack of understanding of the therapeutic and emotional needs of residents with dementia. Meals are varied but not always attractive or appealing. Assistance with feeding is not always provided in an appropriate or timely manner. EVIDENCE: The home employs an activities organiser who facilitates a weekly schedule of planned activities. Three residents spoken with said they enjoyed and looked forward to the activities. Two relatives spoken with expressed the view that residents living on the upper floor and who have dementia would benefit from having some activities to keep them occupied. Activities are available on the dementia care unit but do not include the use of items for promoting mental agility or encourage finer dexterity skills. Staff do not routinely interact with residents in a manner that is engaging or requires a response, the environment therefore lacks stimulation and motivation. A number of individual life histories have been recorded and are to be transferred to the care profile for daily use. Arden Valley Christian Nursing Home DS0000004385.V271753.R01.S.doc Version 5.0 Page 13 Menus are planned in advance and offer a choice of food. The home does not carry large quantities of stock as provisions are delivered three times a week. The kitchen area was clean and reasonably well maintained. Both cooks have completed basic food hygiene training. A cleaning schedule is in place to ensure tasks are completed. Hot trolleys are used to transport food to the dining areas where it is served by the staff. Cooked food due to be served at 12.30hrs was stored in the hot trolley from 10.30hrs. Food stored in hot cabinets for long periods is at risk of contamination and may lead to food being unpalatable. Kitchen staff spoken with were not aware of the specialist dietary needs of a resident with a painful digestive disorder. The absence of an appropriate diet necessary to meet the resident’s health care needs places the resident at risk. Placing meals in plastic bowls compromised the presentation of a number of meals served at lunchtime. Observations on the dementia care unit evidenced residents’ nutritional needs were not always met appropriately. Two residents had lunch taken to their rooms where it remained untouched for at least an hour during which time a pudding was also placed in front of the residents. Two residents in the dining room who also needed support had to wait over twenty minutes for staff to attend to them. The absence of person-centred care and effective management of staff place residents at risk of not having their nutritional needs met. One relative spoken with commented ‘……… often alone in the dining room with residents who often help themselves off each other’s plate’. ‘Some residents don’t know food is there, don’t seem to be aware’. Arden Valley Christian Nursing Home DS0000004385.V271753.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Complaints are handled objectively. Residents and relatives are confident that their concerns will be investigated. EVIDENCE: The home has a written complaints procedure, which is clear. All complaints are responded to within 28 days. Details of the complaints procedure is included in the Service Users Guide and is displayed within the home. The last recorded complaint was 6th December 2005. Five of the eight relatives/visitors comment cards returned to the Commission indicated they had complained about some aspect of the service and four said they were aware of the complaints policy and procedure. Arden Valley Christian Nursing Home DS0000004385.V271753.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22,23 and 26 The home is generally well maintained and most areas are clean and free of offensive odours. Staff do not always adhere to health and safety procedures therefore we cannot be sure practices are safe. The laundry is not well managed and the quality of linen and towels poor. EVIDENCE: A programme of refurbishment is underway and includes some redecoration, new furniture, flooring and ten new profile electric nursing beds. Most areas of the home are clean and generally well maintained but not all are free of offensive odours. The indications were that the home had specialist equipment for moving and handling residents and mobility aids, with adequate numbers of bathrooms. A Arden Valley Christian Nursing Home DS0000004385.V271753.R01.S.doc Version 5.0 Page 16 number of residents’ rooms were viewed and found to be clean and comfortable with personal possessions on display. Furniture within rooms was of a good standard and gave a homely feel, with many residents having personalised them. One resident spent a lot of time in her room and found it very comfortable having her own belongings around her. Signage and illustrations displayed on the dementia care unit are limited and spasmodic. Greater effort should be made to encourage independence and provide assistance for residents to identify specific areas of the home that may be familiar and which meet their needs. The absence of sufficient storage facilities has resulted in wheelchairs being stored in bathrooms. Alternative arrangements should be made to ensure residents are not placed at risk. The absence of a call alarm in one of the residents’ communal areas is unsafe and may result in residents not receiving the care and attention necessary to meet their needs. A tour of the premises found that staff failed to make residents aware of a number of wet floors, therefore placing individuals at risk. On two separate occasions a fire door, that for safety reasons should remain closed, was wedged open. In discussion the manager agreed to address the issues raised immediately to ensure the health and safety of residents is promoted and protected. In order to promote the effective control of infection soiled linen must be laundered separately at high temperature and not washed with other fabrics requiring a lower temperature. Many clothes are unmarked resulting in a number of residents wearing clothes or slippers that belong to other residents. One relative spoken with said that her mother, who required assistance with all aspects of daily living, was wearing slippers that didn’t belong to her and that she didn’t have any under garments on. Many garments worn by residents were creased and in need of minor repairs. Sheets and towels used were often discoloured and shabby. In order to promote safe working practices, disposable gloves and aprons should be readily available in the laundry room. Arden Valley Christian Nursing Home DS0000004385.V271753.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 29 Generally staff are employed in sufficient numbers, but the absence of effective staff management and supervision result in residents’ needs not always being met in an appropriate and often timely manner. EVIDENCE: Rigorous staff selection and recruitment procedures are in place to ensure employment practices are safe. Discussion with the manager and observations noted during a tour of the premises found that four care workers and one registered general nurse (RGN) were deployed to each of the two floors. At night a nurse and two care staff provide specialist dementia care on the first floor and a nurse and one care worker are allocated to the ground floor. Four domestic staff and three kitchen staff were on duty at the time of the inspection. A number of comments made by residents or relatives either directly or indirectly include: • • • • ‘Not always sufficient staff on duty’. Standard of cleaning not always acceptable’. ‘Domestic staff is short and other staff are leaving’. ‘Lack of staff, poor overall standards’. DS0000004385.V271753.R01.S.doc Version 5.0 Page 18 Arden Valley Christian Nursing Home • • • • • • • ‘I realise there must be awful difficulties in finding and keeping suitable staff’. ‘There were long periods this year when the staff were very good and the Indian carers spoke good English. Now I cannot understand some of the present staff’. ‘Staff pleasant, well meaning’. ‘Lack communication skills and understanding’. ‘I feel nurses, carers, kitchen staff and cleaners have done a valiant job over the past few weeks’. The lack of supervision has worried me a great deal’. ‘I can’t understand what the worker is saying as English is very poor’. Four staff spoken with expressed the view that generally there was sufficient numbers of appropriately trained and experienced staff on duty. Arden Valley Christian Nursing Home DS0000004385.V271753.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,35 and 38 The absence of a permanent manager has impacted on the management of the home. Safe, secure systems are in place for the management of residents’ personal finances. A range of health and safety policies and procedures are in place but poor staff practices and the absence of a comprehensive risk management strategy are unsafe and place residents at risk. EVIDENCE: The company has recently appointed a new manager who commences in January 2006. Secure facilities are in place for the safe keeping of money held on the residents’ behalf. No valuables are held as the home’s policy encourages Arden Valley Christian Nursing Home DS0000004385.V271753.R01.S.doc Version 5.0 Page 20 residents’ relatives or representatives to hold personal items for safekeeping. Receipts and records are held of all financial transactions. Some issues around health and safety within the home were discussed. A commitment was made by the manager to address working practices in line with health and safety legislation. The home operates a risk management system that was identified by the manager as requiring a review of efficiency. Evidence was seen of individual risk assessments for residents who are at risk of falls. Arden Valley Christian Nursing Home DS0000004385.V271753.R01.S.doc Version 5.0 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 X X 3 2 3 X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 1 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 1 X X 2 3 X X 1 STAFFING Standard No Score 27 2 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X X X 3 X X 1 Arden Valley Christian Nursing Home DS0000004385.V271753.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? No Arden Valley Christian Nursing Home DS0000004385.V271753.R01.S.doc Version 5.0 Page 23 STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13 Requirement The registered person must make suitable arrangements for the recording, handling and safe administration of medication. (Previous timescale of 13.10.04 and 15.06.05 not met). The registered person must make suitable arrangements to ensure that the care home is conducted in a manner which respects the privacy and dignity of residents. The registered person must meet the needs of the dementia care residents whose nutritional needs were not being met. The registered person must ensure that fire doors are not wedged open and wet floors are clearly identified. The registered person must ensure foul laundry is washed at appropriate temperatures to thoroughly clean linen and control risk of infection. The registered person must ensure that staff are trained in first aid in sufficient numbers so that there is always a first aider on duty. (Previous timescales of 31.12.04 and 31.07.05 not met). Timescale for action 31/12/05 2 OP10 12(4) 14/01/06 3 OP15 12(1)(a) 31/12/05 4 OP19 13(4)(a) (b) 13(3) 31/12/05 5 OP26 14/01/06 6 OP30 13(4) 28/02/06 Arden Valley Christian Nursing Home DS0000004385.V271753.R01.S.doc Version 5.0 Page 24 7 OP38 13(4)(a) (b) The registered person must ensure risk assessments are carried out for all activities that pose a risk to residents including a risk management strategy. 31/01/06 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 2 Refer to Standard OP4 OP15 Good Practice Recommendations Staff should update their knowledge and skills in the provision of specialist dementia care. The use of plastic bowls should be discouraged in favour of the use of plate guards. Arden Valley Christian Nursing Home DS0000004385.V271753.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB National Enquiry Line: 0845 015 0120 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 Arden Valley Christian Nursing Home DS0000004385.V271753.R01.S.doc Version 5.0 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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