Inspection on 19/05/05 for Ashdowne Care Centre

This inspection was carried out on 19th May 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.

Other inspections for this house

Ashdowne Care Centre 24/09/07

Ashdowne Care Centre 12/07/06

Ashdowne Care Centre 05/10/05

Ashdowne Care Centre 14/10/04

Ashdowne Care Centre 10/06/04

Ashdowne Care Centre 22/01/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

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

CARE HOMES FOR OLDER PEOPLE Ashdowne Care Centre Ashdowne House & Pinnex Moor Orkney Mews Pinnex Moor Road, Tiverton EX16 6SJ Lead Inspector Rachel Doyle Announced 19 May 2005 th 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 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. Ashdowne Care Centre D54 D06 S26697 Ashdowne V217293 190505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ashdowne Care Centre Address Ashdowne House & Pinnex Moor Orkney Mews Pinnex Moor Road Tiverton EX16 6SJ 01884 252527 01884 242194 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ashdown Care Limited Mrs Alison Southcott CRH N Care Home with Nursing 60 Category(ies) of DE[E] Dementia over 65 [34] registration, with number MD[E] Mental Disorder over 65 [34] of places OP Old Age [34] Ashdowne Care Centre D54 D06 S26697 Ashdowne V217293 190505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Authorised Person in Charge Mrs Alison Southcott RGN 2. Notice of Proposal to Grant Registration detailing the staffing and environmental conditions of registration was issued 19/4/2001 3. Registered for 34 - Elderly General Nursing Care 4. Registered for 34 - Elderly Mental Health Care 5. To admit one named person outside the categories of registration as detailed in the notice dated 31st March 2004 6. The maximum number of placements, including that of the named person, will remain at 60 7. On the termination of the placement of the named person, the registered person will notify the Commission in writing and the particulars and conditions of this registration will revert to those held on the 22nd February 2004 Date of last inspection 14th October 2004 Brief Description of the Service: Ashdowne is a purpose built nursing home, which opened in 1993. The present owner acquired the property in 2001. It comprises two units under one registration. The units have recently been linked by an enclosed corridor but continue to accommodate service users with distinct types of nursing needs in each separate unit. Pinnex accommodates 26 service users who are elderly with mental health needs. Ashdowne accommodates 34 elderly persons requiring general nursing care. The Home is managed as a whole by the registered manager, Alison Southcott. The Home also makes provision for respite and convalescence care on Ashdowne. The sides and back of the property are garden areas and the front is a car parking area with a portacabin used for administration, training and meetings. The home is situated in a residential area of Tiverton. The kitchen is housed in Ashdowne and the laundry in Pinnex. Ashdowne Care Centre D54 D06 S26697 Ashdowne V217293 190505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection carried out by two inspectors on Thursday 19th May 2005 at 10.10-16.45. There were 31 residents at Ashdowne and 25 residents living at Pinnex. The lead inspector concentrated on inspecting Ashdowne and spoke in depth with the manager, two relatives and ten residents, spending lunch with a further three residents who were unable to contribute directly and four staff briefly during the inspection. The preinspection questionnaire, reports and other relevant documents were looked at and four residents were case-tracked. Six comment cards from residents and relatives were also received by CSCI. One inspector spent the inspection talking with staff, visitors and residents in Pinnex Moor, as well as looking at care plans and staff rotas. Prior to the inspection, previous inspection reports were reviewed. The inspector spoke with eight residents; two were able to contribute directly to the inspection. For residents who were not able to contribute in this way, the inspector observed how they interacted to their environment, staff and other residents to form a judgement on their well-being. What the service does well: What has improved since the last inspection? Staff have received training in dementia and challenging behaviour and further training is booked. There has been good attendance by staff resulting in improved practice on Pinnex. Management and staff have worked hard to meet the requirements and recommendations made at the last inspection and a regular activities programme has been devised for residents to include outings and other Ashdowne Care Centre D54 D06 S26697 Ashdowne V217293 190505 Stage 4.doc Version 1.30 Page 6 entertainment and stimulation for those with mental health and communication problems on Pinnex. Staff morale was generally more positive and staff spoken to felt supported by the two specialist deputy nurses responsible for each unit and the manager, who overseas the Home as a whole. 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. Ashdowne Care Centre D54 D06 S26697 Ashdowne V217293 190505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Ashdowne Care Centre D54 D06 S26697 Ashdowne V217293 190505 Stage 4.doc Version 1.30 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 standard(s) 3,4,5 Assessments are comprehensive except for spiritual/religious choice to show that residents’ beliefs are being met and that all residents admitted in an emergency receive information about shared rooms. Care staff on Pinnex Moor have benefited from specialist dementia training, which has improved the daily lives of residents. This training on Ashdowne has not yet had an impact on poor practice. Prospective residents and their relatives and friends are able to visit the Home as they wish to assess the quality, facilities and suitability of the Home prior to admission. EVIDENCE: Ashdowne- One relative said that they had been able to visit the Home and that the manager had then visited the prospective resident to assess them. They found the staff very nice and had been clearly informed of the details of the service. One relative and another resident felt that they had been unaware that they would be sharing prior to admission. It is noted that these were both emergency admissions. All four assessments seen were good. Ashdowne Care Centre D54 D06 S26697 Ashdowne V217293 190505 Stage 4.doc Version 1.30 Page 9 Pinnex Moor – All rooms visited had a copy of the service user guide. Three assessments in care plans were read and these were comprehensive, apart from the spiritual/religious needs of residents. Observation of staff talking to residents and the way they supported residents with their care needs showed a marked improvement in their communication skills and practice. This also came across in discussion with staff, who appeared more focussed on the needs of residents with dementia. Staff were in favour of specialist dementia training and committed to attending further training as part of a rolling programme. A daily visitor said that the staff were ‘wonderful’ to their relative. Ashdowne Care Centre D54 D06 S26697 Ashdowne V217293 190505 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9, 10, There is a clear and consistent care planning system in place to adequately provide staff with the information they need to meet residents’ health needs but this does not include residents and relatives or show that physical exercise needs have been met. The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure that residents’ medication needs are met. Staff did not always maintain residents’ privacy by knocking on their doors before entering. EVIDENCE: Medication was inspected. No residents self-medicate at present or are able. There is good liaison with the GP. Records were well kept and accurate. Ashdowne – The manager goes through care plans with carers and carers said that they discussed any issues with the RGNs and offered input as a team, which resulted in appropriate reviews. All care records were good and clearly detailed the care to be given and appropriate liaison with external health care professionals. No residents felt that they were involved in the care planning process, however, and two relatives were also unsure. There is a good bathing Ashdowne Care Centre D54 D06 S26697 Ashdowne V217293 190505 Stage 4.doc Version 1.30 Page 11 policy, which includes risk assessments so residents can safely maintain their privacy. However, some carers were seen to not knock on doors and one resident said that they didn’t always. Residents in their rooms had drinks and call-bells to hand. There was no evidence to support that residents had been assessed for their physical activity needs and some residents did not mobilise at all during the inspection. Pinnex Moor – Care plans are informative and contain comprehensive assessments, as well good practice guidance to address the individual needs of residents. However, during a review for one resident with complex needs it had been agreed to place a bird table by the window of the lounge to provide stimulation but this has not happened. The home does not provide any planned regular physical exercise for all residents, although care plans and discussion with staff did show that the mobility of some residents had improved with encouragement from staff and consultation with health professionals. Pressure relief equipment was seen being used and care plans recorded advice on skin care. Ashdowne Care Centre D54 D06 S26697 Ashdowne V217293 190505 Stage 4.doc Version 1.30 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 standard(s) 12,13,14,15 Social activity arrangements have improved and provide daily stimulation for residents, however further consideration needs to be given to residents on Ashdowne who have difficulty communicating. Staff communication skills are poor on Ashdowne when caring for those residents who have communication difficulties, which does not ensure that their needs are met. Meals at the Home cater for individual likes of residents and provide a wholesome, varied diet. There has been an improvement in the atmosphere of meal times and in the support that residents receive on Pinnex. Residents are encouraged to maintain contact with their families and friends as they wish. EVIDENCE: The home has recently appointed a new activities co-ordinator, who has taken part in some specialist dementia training and demonstrated through discussion an understanding of what activities might be appropriate for the differing client groups. Activities have greatly improved despite one organiser leaving with short notice and care files now include social and spiritual well-being forms. Activities recently were scone making, outing to the lake to feed the birds, making place Ashdowne Care Centre D54 D06 S26697 Ashdowne V217293 190505 Stage 4.doc Version 1.30 Page 13 mats and handling pets. All residents able to communicate said that this had improved. However, there was little evidence that residents on Ashdowne, who were physically disabled or had limited communication skills had been included in any regular stimulation. Staff offered little or no choice to these residents about moving, turning the television or music on or off and ignored one resident when they said they had a headache, turning the music back on. There was little eye contact from staff with these residents on Ashdowne and two carers were unaware of a resident’s diagnosis of dementia, feeding capabilities or why residents had not been offered a place at the table for meals. There was good dialogue with residents who could communicate well. On Pinnex Moor, staff spoke positively about the activities that had taken place, including trips out. A resident spoke positively about making cakes and a trip out. A visitor commented that appropriate music was often played in the upstairs lounge. Four visitors said they were made welcome by staff and could visit when they chose to, and two said they spent time privately with their relative. Staff asked residents before bringing a visitor to see them. Residents and relatives had been consulted about the use of a taxi for outings. Residents were seen being offered choice i.e. with drinks, where they sat and meals. Staff actively listened to residents, instigated conversations and offered reassurance in an appropriate manner, where necessary. For example, one resident became very distressed by another person’s behaviour and was supported in a skilful and caring manner by staff. A lunchtime meal on the upper lounge was managed in a relaxed way with staff altering their approach to suit different residents, which included offering choice, encouragement, active help and information about the meal, as well checking residents’ opinions about the meal. Staff reacted appropriately to problems between residents and diffused any disagreements. Residents got up and moved about during the meal and were gently encouraged to return to their meal. Food was served on plain crockery with the option of ‘seconds’ and a hot drink served afterwards with biscuits offered in a container. Meals on Ashdowne were also managed well and the food was well presented and nutritious with an alternative menu. Again, although staff were kind there was minimal interaction with residents on Ashdowne with communication difficulties. Ashdowne Care Centre D54 D06 S26697 Ashdowne V217293 190505 Stage 4.doc Version 1.30 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 standard(s) 16,18 Complaints are not recorded in a way that shows a clear audit trail or outcome therefore not proving that complaints are addressed in required timescales and with positive outcomes for residents. Vulnerable adult training promotes the protection of residents. EVIDENCE: A recent complaint was not dealt with in the agreed timescale and the original response did not recognise the issues raised. The home’s records of this complaint were not complete. Staff were not aware of the complaints book. The manager and senior said that complaints are generally recorded in care plans rather than in a separate complaints record, which could provide a clearer picture of response time, outcome and how many complaints have been received but the complaints records did not cross-reference this. All care staff spoken to have received vulnerable adult training via a video and could recognise poor practice, and were clear what they would do if they saw abusive practice within the home. The manager and a specialist deputy nurse are going to attend the POVA training course soon and fan out training regularly in-house. All staff have signed that they have read the Alerters’ Guide. Some issues are included in the recent dementia training. Ashdowne Care Centre D54 D06 S26697 Ashdowne V217293 190505 Stage 4.doc Version 1.30 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 standard(s) 19,24,25,26 The Home is clean, comfortable and hygienic. Internal improvements to the décor have been made on both units and external improvements are ongoing to ensure that residents are provided with safe, comfortable surroundings. The choice of inappropriate door-locks does not benefit residents on Pinnex. EVIDENCE: Ashdowne – Locks have been fitted to all residents’ doors and one resident has chosen to hold a key. All areas of the home were very clean, including equipment and residents and a visitor confirmed that this was usual. Hand gel was available throughout the Home and for all visitors for infection control reasons on arrival. The unit has had extensive re-decoration and new furniture. The garden was pretty and tidy, with some rooms opening out onto a patio. Internally, Pinnex Moor has benefited from a redecoration programme, although the lower floor bathroom is tired in appearance. Externally there are windows that still need repair. Carpets in rooms 11,19 and 27 are still in need of repair. This is included in the ongoing maintenance programme. Locks on Ashdowne Care Centre D54 D06 S26697 Ashdowne V217293 190505 Stage 4.doc Version 1.30 Page 16 residents’ door are not appropriate for the client group. Double rooms have screening and the majority of residents’ rooms are personalised. All have radiator guards to protect residents from harm. A member of staff talked about infection control procedures and explained how the laundry was run to promote safe working practices. Ashdowne Care Centre D54 D06 S26697 Ashdowne V217293 190505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,30 Residents’ needs are not always met by staff whose do not speak a good standard of English. Residents generally benefit from trained, friendly staff in adequate numbers but they do not always have a good understanding of residents’ needs on Ashdowne. EVIDENCE: Ashdowne- Staffing levels remain good on the unit with enough staff available at meal times. Call bells were answered promptly. Staff on Ashdowne have received specialist training relating to some residents’ needs but only the night before the inspection and some poor practice reflected this when staff were caring for residents who had limited communication (see NMS 12). The Home also employs a Home Services Manager, which frees up carer time and a new maintenance man. One relative and four residents commented that although staff were very kind, some staff had difficulty communicating effectively with residents due to a poor standard of English. Pinnex Moor – Care staff were positive about the staffing levels within the unit. One person commented that there was now more time in the afternoons to spend sitting and talking with residents. The inspector saw that not all staff were able to communicate well in English. Five members of care staff confirmed that they had access to specialist dementia training and that their mandatory training was up to date. For example, fire training and moving and handling. Staff spoke positively about the impact of a mental health nurse being on day shifts, who also offers supervision, although this is not on a regular basis yet. Ashdowne Care Centre D54 D06 S26697 Ashdowne V217293 190505 Stage 4.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,36,38 The manager is supported well by her senior staff in providing clear leadership throughout the Home resulting in increased staff morale. The garden attached to Pinnex Moor is unsafe and is not user friendly, and does not promote the independence of residents. There are reliable systems in place to ensure that health and safety and welfare of residents and staff, but fire safety measures were not followed correctly nor were staff supervision sessions adequate. EVIDENCE: Each unit now has a specialist deputy nurse in charge and the manager overseas the Home as a whole. They hold regular meetings and work some days as supernumerary whilst staffing levels are maintained. Staff said that they were happier in their work and felt more supported. There is also a new staff team working structure and keyworker scheme. Ashdowne Care Centre D54 D06 S26697 Ashdowne V217293 190505 Stage 4.doc Version 1.30 Page 19 Ashdowne – The accident book records were satisfactory with clear instructions and cross referenced to care plans, which is commendable. There is currently no record that bedrails are checked regularly to ensure residents’ safety, although staff said safety checks took place. The manager said that staff competencies were also monitored during supervision sessions. Window restrictors were in place. Some fire doors were wedged open. The manager said that they had received incorrect information from the Fire Department and this was corrected at the time of the inspection. Pinnex Moor – Care staff said they feel well supported by senior staff but generally have only had one supervision session since December 2004. The garden attached to Pinnex Moor has trip hazards from poorly laid paths and a lack of level access. The ground is uneven and furniture stained. There is no focal point in the garden and the layout does not encourage residents to make full use of the space. A visitor mentioned that their relative was a ‘sun worshipper’ but rarely went outside and another visitor expressed concern about the poor state of repair of the garden and the lack of use. Ashdowne Care Centre D54 D06 S26697 Ashdowne V217293 190505 Stage 4.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 2 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 1 15 3 COMPLAINTS AND PROTECTION 3 x x x x 2 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 1 x 3 x 3 x x x 3 x 1 Ashdowne Care Centre D54 D06 S26697 Ashdowne V217293 190505 Stage 4.doc Version 1.30 Page 21 Yes. 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 16 Regulation 22 (4) Requirement The registered person shall, within 28 days after the date on which the complaint is made, or such shorter period as may be reasonable in the circumstances, inform the person who has made the complaint of any action (if any) that is to be taken. You shall, for the purpose of providing care to residents, and making proper provision for their health and welfare, so far as practicable ascertain and take into account their wishes and feelings. This refers to the communication between staff and residents with limited communication skills on Ashdowne. You shall ensure that all parts of the home to which residents have access are so far as reasonably practicable free from hazards to their safety. This refers to the current standard of garden maintenance on Pinnex. Timescale for action 19/8/05 2. 14 12 (3) 19/07/05 3. 38 13 (4) (a) 19/08/05 Ashdowne Care Centre D54 D06 S26697 Ashdowne V217293 190505 Stage 4.doc Version 1.30 Page 22 4. 38 13 (4)c You shall ensure that unnecessary risks to the health and safety of residents are identified and so far as possible eliminated. This refers to the practice of wedging open fire doors which must stop. 19/06/05 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. 3. 4. Refer to Standard 7 8 10 12 Good Practice Recommendations Agreed outcomes at residents reviews should be carried out. Residents and relatives should be offered involvement in the care planning process. Attention should be paid to meeting residents physical activity and mobility needs on a regular basis. Staff should ensure that residents privacy is maintained at all times including knocking on doors before entering. The activity programme should include all residents, including those who have limited capacity and communication skills to ensure that their social and leisure needs are met and that they are stimulated daily as appropriate. Complaints should be recorded in one place to allow for a clearer audit trail. The home should supply the CSCI with a statement containing a summary of the complaints made during the preceding twelve months and the action taken in response. The garden should be designed to stimulate residents with dementia i.e. through smell, colours, a choice of places to sit and a circular path to encourage physical activity. Locks on residents accommodation should be appropriate to the client group on Pinnex. Staff competencies should be reviewed following training to ensure that residents needs are met. Staff should be able to speak a good standard of English or receive language lessons to ensure that residents needs are met. Records should be kept to show that safety checks have been carried out on bed rails. 5. 16 6. 7. 8. 19 24 4 and 30 9. 10. 11. 38 Ashdowne Care Centre D54 D06 S26697 Ashdowne V217293 190505 Stage 4.doc Version 1.30 Page 23 12. 13. 14. Ashdowne Care Centre D54 D06 S26697 Ashdowne V217293 190505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Suite 1, Renslade House Bonhay Road Exeter EX4 3AY 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. 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