Inspection on 02/10/08 for Ashbourne Lodge Rest Home

This inspection was carried out on 2nd October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Extracts from inspection reports are licensed from CQC, this page was updated on 04/12/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ashbourne Lodge Rest Home Ashbourne Lodge 8 Seventh Avenue Blackpool FY4 2ED     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jacqueline Riley     Date: 0 2 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Ashbourne Lodge Rest Home 8 Seventh Avenue Ashbourne Lodge Blackpool FY4 2ED 01253341424 Telephone number: Fax number: Email address: Provider web address: etone101@hotmail.com Name of registered provider(s): Type of registration: Number of places registered: Miss Jeanette Dervish care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Ashbourne Lodge is situated in a residential area south of Blackpool. The home is registered to accommodate a maximum of 24 persons. The accommodation comprises of 3 double bedrooms and 18 single bedrooms, 13 of which have en-suite facilities. There are two lounge areas. The rear lounge is also a dining room, the front lounge is a smoking area.There is a large rear garden whcih is not overlooked. A passenger lift enables the residents to have access to the first floor and aids are provided throughout the home to assist residents with their daily lives.There is a Statement of Purpose/Service User Guide, which is given to all prospective residents or their relatives. This information explains the care service that is offered and what the residents can expect if they decide to live at the home.A copy of the most recent inspection report is given to all prospective residents and a copy is available in the home for anyone else to read if they wish.Information received on the day of the inspection (2nd October 2008) showed the fees for care at the home at that time were from £300.51 to £361 per week with additional charges for hairdressing, newspapers and chiropody. Care Homes for Older People Page 4 of 29 Over 65 24 0 Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was an unannounced key inspection at the home that took place on the 2nd October 2008. We spoke to the registered provider, registered manager, staff members, and many of the residents. There were also a number of visitors at the home during the inspection and they were spoken to. As part of the inspection process we talked to people using the service and asked staff Care Homes for Older People Page 6 of 29 about those peoples needs. We also looked at their rooms, care plans, records and daily notes this is called case tracking. Other residents are invited to pass their opinions to us if they wish. We had responses from questionnaires sent to residents for their views on how the home is run. Comments were generally positive and some are included in this report. Every year the person in charge or manager is asked to provide us with written information about the quality of the service they provide, and to make an assessment of the quality of their service. We use this information, in part, to focus our inspection activity. We looked at a range of records including four residents records, and recruitment and training records of three staff members. We also spent time in the lounge areas, walked around the building and watched people living and working to see how everyone was supported and talked to each other. What the care home does well: What has improved since the last inspection? What they could do better: Assessment plans showed in some instances that residents have been admitted with a predominant need for dementia care. The home must only admit people for whom they can ensure their needs can be met so that residents receive the care they are assessed for. We found information in residents care plans were limited in respect of recording risk assessments and nutritional needs. There must be evidence on record of how these needs are going to be met, and that this information is kept up to date, to make sure staff are familiar with the information. There were items of medication, which had not been in use for some time. Any unused medication must be returned to the pharmacist on a regular basis and a record kept of this so that there is no accumulation of unused stock. In some instances the level of supplies did not match the amounts listed on administration records. Medication supplies must match the level of supply on the records so that there is a clear audit of drugs. We found there was no formal approach to activities in the home. Whilst some staff played cards with some residents, there is no other stimulation or events occurring. We say this is an areas which must be developed so that residents have a choice of activities to take part in. There is a decorating programme currently in place. This needs to continue to make sure all areas of the home are well maintained and comfortable for residents to live in. Care Homes for Older People Page 8 of 29 There is work being undertaken to develop a number of bathrooms. This will increase the range of bathing facilities for residents. We found water temperatures were excessive and posed a risk to residents. A notice was given to the manager for this work to be carried out with immediate effect. We were notified within a twenty-four hour period this work had been carried out. We say water temperatures must be safe and meet health and safety requirements so that people are safe. The laundry equipment we saw is of a domestic nature and must meet the necessary disinfection functions to control risk of infection. The drying facility was small and could not meet the laundry needs of the level of residents accommodated, and should be improved. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Admission and assessment procedures are taking place however in some instances the needs of residents do not take into account their level of specialist need which has the potential to have a negative impact on people. Evidence: We looked at the records of four residents, they had assessment details recorded, so that staff had an insight into what the needs of residents are and how they will be met, however in two of the four files we looked at, we found residents had a specialist need for dementia care. Whilst the home is managing the needs of these residents the home must be aware of the impact this may have on its resources and on other people living in the home. The records we looked at showed evidence the home is receiving information from the placing authorities so the home has information prior to and during the residents stay. Comments we received included, I came to look round before I decided to stay here. I have information about the home, which they gave me Care Homes for Older People Page 11 of 29 Evidence: when my relative came in. The manager came to see me before I came here from hospital. We talked to the manager who said wherever possible she likes to visit a prospective resident prior to admission to the home to make sure the home is suitable to meet the needs of the resident. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are in place however in some instances information is limited, which has the potential to disadvantage people living at the home. Evidence: We looked at four residents files, they were seen to contain information relating to the health and welfare needs of the residents, however in all instances the nutritional assessment had not been completed, risk assessments were in place however some had not been reviewed or updated and in two instances the information was limited. We saw there is a scoring assessment for risk, which in some cases had not been completed. This could have a negative impact on people living at the home. We spoke to members of staff who had a good understanding of the individual needs of residents living at the home and they told us they use the information on file for guidance, it is therefore necessary the information is updated. Comments included, We use the files to get the information we need. I have had training in dementia care and so I know what their needs are. My relative is confused but the staff are very good. Care Homes for Older People Page 13 of 29 Evidence: We saw there is evidence residents have good access to health services, including doctors, district nurses, chiropody and optical services. In addition some residents have access to specialist health care, which is specific to their conditions, so that residents health needs are being met. We saw staff speak to residents sensitively and with respect. Staff we spoke to are aware of the need to make sure residents rights to dignity and privacy are maintained. They were seen to knock on doors before entering. Comments included, Some residents need to be treated sensitively, and I make sure I help them with personal care in a way I would want to be treated. We looked at how the home manages the medication system for storage and administration. There are two locked medicine cabinets situated in the ground floor lounge secured to the wall for the safe storage of all medications used in the home. Staff we spoke to had a good knowledge of the system and felt confident in carrying out administration of medication. Comments included, The staff have had training for this and work closely with the manager. We looked at the medication records of three people we were following during the inspection process. Their medication records were generally complete, however, some records did not match the stock being carried by the home and there were some items of medication not being used, which had not been returned to the pharmacist. We looked at the returns book, which was not up to date. There must be a review of medication to make sure the recording, storage and any unused medication is returned so that the system is accurate. Care Homes for Older People Page 14 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Daily life and social activities are designed to be flexible to meet the needs of people living in the care home, however lack of an activity programme means it is not in the best interests of the people who live there. Evidence: We found the home is run in a way, which is flexible to meet the needs of the people who live there. We saw some residents choose to get up later in the morning, whilst other residents choose to stay in their rooms for most of the day. Other residents we saw and spoke to prefer to take their meals in their own rooms, and go out when they choose and have their meals when they return. Staff spoken to told us they acknowledge peoples rights to choose how they live their lives. Residents comments included, I like to go out every day at some time, I like to help out by setting the tables for meals. We saw the homes food is prepared on the premises by members of the staff team. The lunchtime meal was seen to be suitably balanced with choice available to residents who do not wish to have the menu option on that day. There were some visitors Care Homes for Older People Page 15 of 29 Evidence: having a meal during the inspection, we spoke to them and they said they have meals at other times and in general the food is good. We spoke to the manager about nutrition, and were satisfied that there is a good understanding of the need for residents to have a balanced diet, using fresh produce wherever possible. Residents spoken to commented on how they like the meals and said, If I dont like something Ill tell them and they find something else for me, If Im out they keep it for me when I get back, theres no problem. We found there is no formal approach to activities in or outside the home. We saw most residents spent their time in the lounge dining area. The television was on throughout the day and in most cases no residents were watching it. The television remained on throughout the lunchtime period, which could be distracting to residents when eating there meals. Some residents were talking to each other, and others liked to sit at dining tables to talk to each other in between meals. As we went around the home we saw there is a smoking lounge at the front of the home, with two residents using this as well as some visitors. Three residents were using their rooms during the day. Comments included, I like to have a few hours in here, its nice and quiet. Ive got my own things in here and like to sit here, I go out most days as well. There isnt a lot going on here. Other than individual members of staff playing cards with a resident there is little stimulation in respect of group or individual activities put on by the home. We say that staff should be using the assessment profiles to gain an insight into what residents liked to do before they came into the home, and to use this information as a basis to identify suitable activities, which would enrich their social activities. Care Homes for Older People Page 16 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for recording and reporting of complaints are good ensuring people feel listened to. Staff have access to safeguarding adults training for the protection of users of the service. Evidence: The home has a complaints procedure, which is made available to them or their relative or advocate during the admission process. All surveys we received confirmed people are aware how to make a complaint, one comment said, I talk to the manager if Im not happy about something. We would know how to make a complaint because of the information we got when our relative went into the home. Ive never had to make a complaint but would do if I thought something was not right. The staff team confirmed they know how to deal with complaints and we found there is an open system of communication so that any concerns raised are dealt with by the manager at the time of the concern. There is a record book, which records any concerns or complaints residents or visitors have raised. It is clear and provides information about the issue, how it was dealt with and the outcome of the investigation, so that there is a clear audit of information showing any trends which might alert the management team to any changes which may be necessary for a better outcome for residents. Care Homes for Older People Page 17 of 29 Evidence: There has been one complaint received by the commission in the previous twelvemonth period. The home investigated the complaint the issues were addressed we were notified of the outcomes. The home has a procedure in place for dealing with allegations of abuse. Staff spoken to are aware of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect, and have received training in this area. Staff comments included, I have had training for it, and so have most of the staff. It helps us to know what to look out for and what to do is we suspect something. Care Homes for Older People Page 18 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises provide an environment in which residents can feel comfortable, however decoration and the condition of some furniture was showing signs of wear and would benefit from improvement so that it is a well maintained environment for people to live in.Water temperatures were excessive posing risk to residents. Evidence: We looked around the home. It is designed to be homely and comfortable for residents to live in, however many of the rooms seen need to be decorated and items of furniture in residents rooms were in some instances chipped or in poor repair and need replacing. We saw there is a decorating programme taking place and this is to take into account all rooms in the home so they are in a well maintained condition for the comfort of people living there. We saw two rooms, which had replacement carpets and furniture. Comments included, Ive had my room decorated and Ive got a new carpet. Most residents have their own rooms, which we saw to be personalised, and some residents said they like to use their rooms whenever they choose. One resident said they choose to stay in their room at all times and that the staff always come when called for. We saw three bedrooms are double rooms and shared by residents. In one instance we Care Homes for Older People Page 19 of 29 Evidence: saw there is no screening to make sure a residents privacy is upheld. We say there must be evidence screening is in place to make sure a persons right to privacy and dignity are upheld so that they are not disadvantaged in any way. Residents can use their rooms as and when they choose and this was confirmed by talking to two residents currently living at the home. Staff spoken to say they encourage residents to personalise their rooms so that they feel homely with personal possessions around them. We saw a first floor bathroom is being used as a storage area and not used as a bathing facility. We were told the bathroom is shortly to undergo development as a wet room, which would be more beneficial for the resident living at the home. There is work being carried out to develop the bathrooms so there is more choice available and better facilities for residents. As part of the inspection process we tested the temperature of the water and found it to be excessively hot. We instructed the home to resolve this matter as a matter of urgency, so that the water temperature could be regulated to a safe set temperature. The manager acted with immediate effect and we were informed the issue was resolved within a twenty four hour period, so that the water temperature is safe. We looked at the homes laundry area, and found that whilst there are washing and drying facilities, they are of a domestic nature and the washing machine does not have a specified programme to meet disinfection standards. The dryer is small and could only dry a small number of items at any one time. This is not sufficient for the number of residents the home is registered to care for. Care Homes for Older People Page 20 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recruitment procedures are in place so that people are protected. Staff training is made available to all staff working in the home, however staff induction and staff training records were not up to date. Evidence: We found there have been a number of changes in the staff team in recent months. We spoke to the manager who said the staff team in place now are flexible in how they work, as part of the team. Some of the staff have worked at the home for a number of years. Comments included, there have been some difficult times but things have settled down now, the home is very good to work in and residents always come first. We looked at three staff files and found they were disorganised and would benefit from a review so that the information is clear. The way staff recruitment takes place has been reviewed and improved so that the provider follows the correct procedures to make sure staff are safe to work in the home We looked at how new staff are provided with Induction training so that they know the policies procedures and practices in the home. We found that in some instances the Care Homes for Older People Page 21 of 29 Evidence: information was limited and there was no evidence the member of staff was competent in any one area, however there have been changes made and the new programme is much more thorough and provides evidence of when the member of staff is competent in any one area, so that they are capable to work in the home. We talked with the manager and homeowner about staff training. We found the staff team have all attained care qualifications at various levels, and other qualifications in meeting the needs of residents who live at the care home. The way staff training is monitored is being updated so that the information relating to any one member of staff is accurate and the manager, can identify where there are any gaps in individual staff training needs. We looked at how the home is staffed and found it is staffed to meet the needs of the people who live there, this is done by making sure there is always a senior member of staff on duty and that staffing levels are adjusted according to the needs of the people living at the home. Comments relating to the staff were very positive and included The staff are always around. Staff are very respectful, and always tell me about whats going on with my relative. The residents are treated with respect at all times. I have worked in other homes and this is very good. Residents always come first, its a good place to work. I am very happy its like being with my own family. I am very happy every day and well looked after Care Homes for Older People Page 22 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed using systems and policies in place for the benefit of staff and residents. Lack of attention to water temperature has the potential to place people at risk. Evidence: The home has a registered manager in day to day control of the home. The manager is qualified and has many years experience in managing care homes. We found in general the management team are committed to make sure the home is run well and the outcomes for people who live and work there are good, and that that there is a business action plan which is making changes to the home to ensure all the systems are working in the best interests of the residents who are living there. The registered homeowner visits regularly and spends time with residents and staff so that there is a working knowledge of how the home is operating on a day to day basis. Comments included, Its always nice to see the owner, she is here an awful lot. If we Care Homes for Older People Page 23 of 29 Evidence: need anything we just tell the management team and it usually gets sorted out. This home does things for the benefit of the residents. The home has a quality monitoring system in place to make sure the way the home is run is flexible and is operated to meet the needs of all users of the service. We saw there are regular meetings with residents and staff, and the information is recorded, so that it can be audited and changes made if necessary for the benefit of the service. The health safety and welfare of users of the service is maintained through a system of making sure equipment is regularly service and well maintained. We looked at Gas Electric and Fire certificates, which were all up to date. As previously highlighted water temperature were not satisfactory at the time of the inspection, however this issues was addressed with immediate effect for the safety and welfare of users of the service. Care Homes for Older People Page 24 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 25 23 The regulation of water temperatures must meet health and safety requirements so that people are safe Excessively hot water temperatures in the bathrooms posed a serious risk of harm to residents. 22/10/2008 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 3 14 The home is managed using 28/11/2008 systems and policies in place for the benefit of staff and residents. Lack of attention to water temperature has the potential to place people at risk. Residents whose assessed needs are beyond the level of care the home can provide must not be admitted. 2 7 15 Service user plans must be complete and include evidence of how nutrition and risk are going to be managed 28/11/2008 Care Homes for Older People Page 26 of 29 The nutritional needs of residents must be identified so that they are provided with a well balanced diet and any specialist dietary needs are identified. The level of risk for each resident must be identified so that this can be managed safely. 3 9 13 Unused medication must be returned to the pharmacy and a record must be kept of all returns on a regular basis. The level of medicinal stock must correspond with the levels recorded so that there can be a clear audit trail. Lack of stock control in medication, and the limited returns of unused medicating has the potential to pose a risk to people. 4 14 16 There must be evidence of an activity plan which is suitable to meet the needs of residents living at the home. Lack of an activity plan means that residents do not have the choice to engage in any social or community activity. 5 19 23 The homes environment must continue to be upgraded so that it is a comfortable and well maintained environment for residents to live in. 28/11/2008 28/11/2008 28/11/2008 Care Homes for Older People Page 27 of 29 Some rooms required decoration and replacement furniture in order to make their rooms comfortable to live in. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 20 There should be more attention to make sure rooms which are shared have necessary screening in place so that residents have their right to Privacy and Dignity upheld. The refurbishment of the homes bathing facilities should continue so that they are pleasant to use and provide a choice of bathing facilities for residents living at the home. 2 21 Care Homes for Older People Page 28 of 29 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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