Inspection on 15/02/07 for Ashmead Care Centre

This inspection was carried out on 15th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Ashmead Care Centre 28/08/07

Ashmead Care Centre 09/10/06

Ashmead Care Centre 31/05/06

Ashmead Care Centre 07/03/06

Ashmead Care Centre 02/06/05

Ashmead Care Centre 13/12/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Ashmead Care Centre 201 Cortis Road Putney London SW15 3AX Lead Inspector Janet Pitt Unannounced Inspection 15th February & 12th March 2007 10:10 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 Ashmead Care Centre DS0000060799.V335083.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ashmead Care Centre DS0000060799.V335083.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashmead Care Centre Address 201 Cortis Road Putney London SW15 3AX 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) 020 8246 6430 020 8445 3624 ManagerAshmead@lifestylecare.co.uk Life Style Care PLC David Bullock Care Home 110 Category(ies) of Dementia (60), Old age, not falling within any registration, with number other category (50) of places Ashmead Care Centre DS0000060799.V335083.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Nursing Unit Ground Floor - Staffing A minimum of two qualified 1st level nurses and six carers must be available on the ground floor nursing unit on each of the morning and afternoon at all times. A minimum of one qualified 1st level nurse and three carers must be available at all times during the night shift. Nursing Unit First Floor - Staffing A minimum of two qualified 1st level nurses and six carers must be available on the first floor nursing unit on each of the morning and afternoon at all times. A minimum of one qualified 1st level nurse and three carers must be available at all times during the night shift. Nursing Unit Second Floor - Staffing A minimum of two qualified 1st level nurses and four carers must be available on the second floor nursing unit on each of the morning and afternoon at all times. A minimum of one qualified 1st level nurse and two carers must be available at all times during the night shift. Each unit of the home must be co-ordinated as a separate unit and staffing levels must not fall below those stated above for each unit at any time. The qualified nurses must not have any management responsibilities for the home other than within the unit in which they are working. 2. 3. 4. Date of last inspection Brief Description of the Service: Ashmead Care Centre is a purpose built care home with nursing that provides care for persons who may have dementia. The home is able to accommodate up to one hundred and ten residents. The home is organised into six units, each containing communal areas, comprising of a lounge and dining room. Residents have single room with ensuite toilet and washbasin facilities. Bathroom, shower and other toilet facilities are situated at intervals in the units. In addition to communal lounges the home has quiet lounges. The accommodation is situated on the ground, first floor and second floor, with the kitchen, staff rooms and some offices on the second floor. Ashmead Care Centre is situated in Putney, close to the main A3 road and has access to local bus routes within walking distance. There is provision for car parking on site. Ashmead Care Centre DS0000060799.V335083.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Three inspectors carried out this unannounced inspection. Site visits were conducted over two days. Residents care documentation. Staff records and training files were examined. Discussions took place with several residents, visitors and staff. A tour of the premises was undertaken and observation of mealtimes. The site visits lasted a total of thirty-five inspection hours. Fees range from £581-44 to £750-00 per week dependent on needs and funding. What the service does well: What has improved since the last inspection? What they could do better: Detailed below are some areas where the home needs to improve, others are detailed in the main body of this report. The manager demonstrated awareness of these concerns when feedback was given at the end of the site visits. Ashmead Care Centre DS0000060799.V335083.R01.S.doc Version 5.2 Page 6 Residents need to be suitably dressed, some residents were well presented, but others were unkempt with untidy hair and clothing. Care documentation needs to be individualised, resident centred and holistic to make sure needs are identified and met. Staff have received mandatory training, specific training in dementia care, however sexuality training is needed, to make sure staff are able to support residents. Residents need to be confident that complaints are handled and addressed appropriately. Activities offered within the home must be resident focussed and compatible with their hobbies and interests. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ashmead Care Centre DS0000060799.V335083.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ashmead Care Centre DS0000060799.V335083.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents need to be confident that all their needs will be identified on admission to the home. Evidence of assessments becoming resident focused was in place, but needs further development. EVIDENCE: Residents are assessed prior to moving into Ashmead. The manager said that he plans to take nursing staff out with him, to make sure that nurses have the necessary skills. The manager also reported that one aim is to make sure that principles of person centred care are implemented at the point of assessment. For example by establishing residents’ strengths and preferences in addition to their care and health needs. Resident admission assessments examined during the site visits were completed. There was some evidence of them being resident focused, for example; ‘He likes to go to bed, at his own request.’ Residents and their representatives are involved in the assessment process. Ashmead Care Centre DS0000060799.V335083.R01.S.doc Version 5.2 Page 9 Specific details of need are evident in assessments. However, staff need to make sure that assessments consistently detail identified needs and are revised when new information is obtained. Improvements are needed to make sure that residents’ preferences are accurately recorded. One resident was assessed as requiring a bath weekly, but there was information that the resident preferred showers. Another resident had expressed a preference for a female carer, but a separate sheet stated there was no preference. Residents’ personal interests and communication needs are documented, but this needs to be consistent. Care must be taken with use of language, entries such as: ‘She is fed’ and [needs] ‘feeding’, do not promote resident dignity. There was also very little information about residents lives before they moved into the home, such as relationships, employment, interests and significant events. Some plans contained a tool designed to record this information but these had not been completed. Ashmead Care Centre DS0000060799.V335083.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 9,10 & 11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents care plans include some detail of how care is to be given. This needs to be continued in order that residents are confident that all their needs are addressed. Specific detail in care plans will aid all staff to deliver care consistently. Daily records must detail what care has been given and whether interventions are appropriate for the residents. EVIDENCE: Residents care plans were examined across all units. Care plans had a wellstructured format and evidence regular review, with the involvement of the resident or their representative. There were some examples of good recording, but this was not consistent across the home. On one unit where care needs had been identified, there was evidence that they were met. However, some care plans required more detail to indicate how care should be given. For example ‘oral care twice a day’, does not indicate how this is to be achieved. Ashmead Care Centre DS0000060799.V335083.R01.S.doc Version 5.2 Page 11 Specific targets for food and fluid intake must be included in care plans consistently. Some plans detailed continence care, this enables staff who may not be familiar with a particular resident to assist appropriately. Equipment needed to meet residents’ need was detailed in plans. However use of bed rails was not always clearly risk assessed. One resident’s care plan did not evidence fully why they needed bed rails, but it was apparent on seeing this particular resident that it was necessary. Staff must make sure that use of bed rails is appropriately assessed and reviewed at least monthly. Residents’ health care appointments were recorded. This demonstrates that residents are supported to see appropriate health care professionals when necessary, such as the general practitioner and dietician. Residents’ plans were health focussed and contained little information about residents’ social and cultural needs, preferences and how they like to spend their time. More detail of how residents wish to spend their time needs to be included in plans. Details on how all needs are to be met are required. Specific instructions are needed to make sure that all staff are able to deliver care to meet residents needs. In particular diet, behaviour, wound care and sexuality need good details of how to address needs. In general daily records tended to include bland statements, such as ‘ pad soaking wet’, ‘comfortable day’ and ‘slept well on bed’, do not evidence whether needs have been met and whether interventions are appropriate. The were some examples of good daily recording, for example: ‘I assisted [the resident] to the toilet…[the resident then] had a cup of tea and biscuits. We played snake[s] and ladder[s] and later went for supper.’ The manager reported that ongoing audits of documentation are in place and action plans are being developed. This will be monitored on future inspections. One relative spoken with said that the resident had been in the home for about a month and was satisfied with care given. The relative stated that he had been made aware of previous inspections and has had no concerns since the resident had been admitted. The relative confirm that they had been involved in care planning. No issues with medications were found on the site visits. The manager had reported two ‘drug errors’, these were dealt with appropriately. Ashmead Care Centre DS0000060799.V335083.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13, 14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Routines in the home are becoming resident focused and staff are developing awareness of meeting individual resident need and choice. Mealtimes are a social occasion and some minor improvement only is needed to make sure that all residents are able to enjoy meals. Residents are consulted on their interests, but this needs to be consistent and staff need to engage proactively with residents. EVIDENCE: Residents are able to take meals in pleasant surroundings. Tables were attractively laid and cloth napkins were available for residents to use. Mealtimes were observed on the site visit. Residents were offered a choice of meal. Staff plated up the two main course options and showed them to residents so they could choose which they preferred. In one dining room, the atmosphere was calm and relaxed. Popular music was playing and a member of staff switched this off. It was not clear whether the type of music was the residents’ choice and if they wanted it switched off. Ashmead Care Centre DS0000060799.V335083.R01.S.doc Version 5.2 Page 13 Staff were noted to be seated to assist residents with their meals. One resident requested a cup of tea, which was provided immediately. Beverages were readily available, but staff must make sure that a choice is offered. The manager said that meal times are protected, so no medicine rounds or telephone calls are taken during these periods. Messages are taken and relayed to staff. Residents were consistently asked whether they had finished their meal prior to plates being taken away. Staff did not consistently interact with residents. On one unit staff only interacted when a resident had a specific need. On another unit staff interacted positively and asked questions about whether residents had enjoyed their meal. Some residents were in wheelchairs whilst dining, it was not apparent whether this was their choice. The quality of food served was good. One resident commented that the food ‘is excellent-more than adequate’; whilst another person said ‘it is usually very good’. The chef and her team have regular contact with residents to discuss meals and meal choices. It was noted that lunch lasted for over an hour on all units inspected. Residents are able to participate in activities, but improvement is required to make sure that the programme is varied and reflects residents’ choice. One resident commented to the manager that they had come back from their walk too early, so the manager arranged for a member of staff to take the resident out again. Unit managers manage activities co-ordinators and staff are now taking a more active role in the provision of activities. Interests are note on admission, but specific detail such as type of television programme or newspaper read is needed. This will make sure that residents are able to continue with interests and hobbies. Some staff were observed to be interacting with residents on a one to one basis, for example looking at magazines and playing board games. The manager acknowledged that this needs to be continued and all residents, particularly those who stay in their rooms, can be supported on how they chose to spend their day. From discussion with staff and examination of care plans, staff need to be supported to enable residents to maintain significant relationships and discuss intimate issues, such as death and dying. (see also section on Health and Personal Care). Ashmead Care Centre DS0000060799.V335083.R01.S.doc Version 5.2 Page 14 Discussion was held with the manager regarding those residents that smoke, he confirmed that he is supporting residents who make this choice. Ashmead Care Centre DS0000060799.V335083.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents and their representatives need to be confident that complaints and concerns will be listened to and acted upon. Residents are protected form harm by good Adult Protection Policies. EVIDENCE: Residents are able to access a clear complaints procedure, which details steps to be taken. The complaints log was inspected. It was noted that although complaints had been logged the procedure had not been followed. Complaints had not been acknowledged, actions taken and outcomes were absent. Residents and their representatives need to be confident that concerns they raise will be acted upon and a conclusion reached. During the course of the inspection a Protection of Vulnerable Adults investigation was commenced. The home responded to requests for information and acknowledged areas where improvement can be made. The home provided a detailed report of the concerns for the CSCI; this information was noted to be satisfactory and addressed al concerns raised. An action plan has been implemented; this will be monitored by CSCI on future inspections. Ashmead Care Centre DS0000060799.V335083.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to personalise their rooms and attention is being paid to make sure communal areas are comfortable and homely. EVIDENCE: Residents live in an environment, which provides a homely atmosphere. Residents’ lounges have large photographs of London and film stars. Mantelpieces have mirrors above them and books on them. Chairs were grouped around coffee tables. Residents spoken with said they had favourite places to sit. Residents said that can personalise their rooms. Another resident spoken with said: ‘We enjoy the garden in the summer’. On one of the site visits residents were seen sitting in the sunshine, with carers assisting them to have a choice of beverages. Ashmead Care Centre DS0000060799.V335083.R01.S.doc Version 5.2 Page 17 Corridors of the home have oil paintings and abstract pictures, there are also texture boards and scarves. Doorways to specific places, such as bathrooms and toilets have yellow frames, to aid identification. One carpet was noted to have an odour; a member of staff was aware of this and stated that the carpet was cleaned regularly. Ashmead Care Centre DS0000060799.V335083.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are supported by adequate numbers of staff. Staff must make sure that routines are resident focused. Training is being provided which should make sure that staff have appropriate knowledge and skills to meet residents care needs. EVIDENCE: Residents are supported by adequate numbers of staff. Staff spoken with said that they get good support to do their jobs well. Staff attend an induction programme, have access to ongoing training and regular one to one supervision. One unit manager confirmed that they supervise staff monthly and observe practice to make sure that staff are consistent in their approach to caring for residents. Residents spoken to during the site visits said that staff are available when they need them. One resident said of the staff:’ They’re all very good-they always help me.’ Routines within the home show evidence of becoming resident led, rather than task focused. This needs to be continued to make sure that residents are supported. Ashmead Care Centre DS0000060799.V335083.R01.S.doc Version 5.2 Page 19 Staff training files were inspected. The files need to be organised to make sure that information is easy to access. Training had been given on Protection of Vulnerable Adults, Health and Safety, infection control and food hygiene. However, not all staff had been recorded as receiving mandatory training. Fire training had occurred, but not twice yearly as required. The manager stated that training on the Mental Capacity Act is being planned. Training on Dementia Care is needed, to help staff understand the condition and be able to effectively care for persons with dementia. Areas which require specific attention for persons with dementia are diet, behaviour and activities, to make sure residents have quality of life. Residents are protected from harm by good recruitment procedures. Staff files examined contained information as required in the Schedules. Evidence of health checks and Criminal Records Bureau checks were in place. Records of interviews were contained within the files. Ashmead Care Centre DS0000060799.V335083.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32,33 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that the new management of the home will operate in their best interests. Staff on each unit are being empowered to take control of care provision and staff feel supported to do this. EVIDENCE: Ashmead has had a new manager since the previous inspection. The new manager was welcoming during the sites visits. He has had experience in many fields relevant to care. Also during the course of the inspection the home was bought by Southern Cross PLC constituting a change of owner. The manager had been made aware of previous reports on Ashmead and was conscious that any ongoing issues need to be addressed. Ashmead Care Centre DS0000060799.V335083.R01.S.doc Version 5.2 Page 21 The manager stated that he has been auditing aspects of the running of the home and identifying areas for improvement. The manager is confident that the staff team are willing to adopt the necessary changes to ensure a person centred approach to care. The manager reported that he walks the floors at different times and has identified some issues with infection control, which are being addressed. No issues relating to health and safety were identified during the site visits. Ashmead Care Centre DS0000060799.V335083.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X X X 3 Ashmead Care Centre DS0000060799.V335083.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/A 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 2 Standard OP3 OP3 Regulation 14 12 (4) (a) Requirement The registered person must ensure that assessments are reviewed and up dated regularly. The registered person must ensure that language used in care documentation is appropriate. The registered person must ensure that resident assessments are completed fully and include details of life history, interests and significant events. The registered person must ensure that instructions on how to meet needs are detailed in care plans. The registered person must ensure that care plans lead from the assessments of residents and specific details of care given are included in the daily records. The registered person must ensure that bed rails are only used after a full assessment has been undertaken. Use of bed rails must be reviewed at least monthly. The registered person must ensure that residents’ wishes on DS0000060799.V335083.R01.S.doc Timescale for action 30/07/07 30/07/07 3 OP3 14 30/07/07 4 OP7 12 (1) 30/07/07 5 OP7 15 30/07/07 6 OP8 13 (7) 30/07/07 7 OP11 12 (3) 30/07/07 Ashmead Care Centre Version 5.2 Page 24 8 OP7 17 (1) (a) & Sch 3 (m) 12 (4) (a) 18 (1)(c) 9 10 OP10 OP10 11 OP12 16 (2) (m) & (n) 12 OP12 16 (2) (m) & (n) 13 OP14 12 (4) (b) 14. OP14 12 (3) 15 16 OP15 OP15 12 (5) (b) 16 (2) (i) 17 OP16 22 (3) & (4) death and dying are recorded sensitively. The registered person must ensure that special food and fluid requirements are detailed in care plans and this is evidence as being given. The registered person must ensure that residents are well presented in their appearance. The registered person must ensure that staff are competent in dealing with challenging behaviour and have a good understanding of specific needs of persons with dementia. The registered person must ensure that activities are developed to ensure that all residents benefit and have individual time. Residents who tend to stay in their rooms must be provided with choices about how to spend their day and be supported in this. The registered person must ensure that staff are supported to discuss intimate issues with residents, such as death and dying and sexuality, in order that residents retain autonomy. These wishes must be acted upon where necessary. The registered person must ensure that residents are not seated in wheelchairs for meals, unless this is evidenced as their choice. The registered person must ensure that staff interact positively with residents. The registered person must ensure that a choice of hot or cold beverages are available at all times. The registered person must ensure that complainants receive DS0000060799.V335083.R01.S.doc 30/07/07 30/07/07 30/07/07 30/07/07 30/07/07 30/07/07 30/07/07 30/07/07 30/07/07 30/07/07 Page 25 Ashmead Care Centre Version 5.2 18 19 OP27 OP30 12 (1) 18 (1) (c) 20 OP30 18 (1) (c) appropriate formal responses and a check is made to make sure that the complainant is satisfied with the outcomes and actions. The registered person must ensure that routines in the home are residents focused. The registered person must ensure that training in dementia care is given to staff and put into practice. The registered person must ensure that all staff received training on fire awareness at least twice a year. 30/07/07 30/07/07 30/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ashmead Care Centre DS0000060799.V335083.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ashmead Care Centre DS0000060799.V335083.R01.S.doc Version 5.2 Page 27 - 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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