Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 26/09/05 for Aylesham Court Nursing & Residential Home

Also see our care home review for Aylesham Court Nursing & Residential Home for more information

This inspection was carried out on 26th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

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

What the care home does well

The home provides a well-maintained, comfortable calm environment, which is conducive to this type of resident. The home employs an activities organisers who provide a good range of activities suitable to the needs of residents accommodated. The service has an excellent quality assurance system in place, which includes internal audits, regular meetings with management and the "Personal Best Programme" which BUPA have recently introduced. The programme is a behavioural programme for staff. A significant investment has been made in the programme by BUPA to ensure that all staff are working in the same manner which supports best practise.The home provides high quality food which service users spoken with stated was "excellent" The home is decorated and maintained to a high standard.

What has improved since the last inspection?

Staff morale appears to have improved significantly since the last inspection and working relationships internally and with other professionals appear to have improved. Staff have received additional care plan training and when case tracking care plans this was evident. The deputy manager and clinical lead nurse are auditing care plans and risk assessments more frequently. Staff and residents meetings are being held more frequently where staff have an opportunity to express views and opinions. A new activities organiser has been appointed, service users now receive a copy of the activities programme in their room each day. A service user has been given the responsibility of completing the daily activities board each day and also for collecting service users comments and suggestions for meetings. A full audit of moving and handling equipment has been undertaken and staff spoken with were fully aware of individual requirements. The registered manager/deputy has facilitated further care planning and record keeping training.

What the care home could do better:

The home could improve outcomes for service users by ensuring that security measures in place are suitable and sufficient to ensure that personal valuables such as credit cards/cash cards etc are stored appropriately. The home could improve outcomes for service users by reviewing the current system for returning laundry to individuals to ensure that personal items of clothing are returned to their owner and are replaced where they are lost/mislaid.

CARE HOMES FOR OLDER PEOPLE Aylesham Court Nursing & Residential Home 195 Hinckley Road Leicester Forest East Leicestershire LE3 3PH Lead Inspector Mrs Gillian Adkin Unannounced Inspection 26th September 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Aylesham Court Nursing & Residential Home DS0000001886.V249217.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Aylesham Court Nursing & Residential Home DS0000001886.V249217.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Aylesham Court Nursing & Residential Home Address 195 Hinckley Road Leicester Forest East Leicestershire LE3 3PH 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) 0116 2395599 0116 2395982 BUPA Care Homes Limited Mrs Amanda Dudd Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (60), Physical disability (14), Physical disability of places over 65 years of age (60), Terminally ill over 65 years of age (60) Aylesham Court Nursing & Residential Home DS0000001886.V249217.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No person under 55 years falling within category PD may be admitted to the home. To be able to continue to accommodate the named person in category PD who is under 55 years of age, subject of variation application V10139, who is currently residing in the home as agreed with the previous registration authority. No person who falls within category PD may be admitted to the home when 14 persons of category PD are already accommodated within the home. The registered manager, Amanda Dudd, undertakes regular formal adult protection training. 16th May 2005 3. 4. Date of last inspection Brief Description of the Service: Aylesham Court is a 60-bedded care home providing personal and nursing care for older persons. The home is purpose built; It is located on a main road on the outskirts of Enderby and Kirby Muxloe Leicestershire and is easily accessed by public transport from the City of Leicester and the County. The home provides nursing care for sixty service users whose care needs fall within the categories of Older Persons and or Physical Disability over 65 years of age, Terminally Ill.The home is purpose built and is accessible to service users with disabilities.Accommodation is located on two floors with a passenger lift between them. The ground floor has two spacious lounge areas, which look out onto landscaped gardens, which are mainly laid to lawn with surrounding shrubbery. The home has two large dining rooms, which are tastefully decorated, and has a private area where service users can have a meal with relatives or friends if they wish. The home has fifty-six single bedrooms and two double bedrooms; all are ensuite, many open directly onto the garden. The home is currently managed by a registered nurse and employs general nurses and care staff. Aylesham Court Nursing & Residential Home DS0000001886.V249217.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was inspected for the tenth time against the Regulations as in the Care Standards Act 2000. This was an unannounced inspection, which took place over one day and commenced at 9.30 am on 26/09/05.The registered manager facilitated the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting four residents and tracking the care they received through review of their records, discussion with them, and their relatives, care staff and observation of care practices. This inspection report additionally addresses specific areas where requirements and/or recommendations were identified at the previous inspection. During this inspection a tour of the accommodation of residents (case tracked) took place and the inspector viewed internal records, and care plans. She also spoke to nurses, care and ancillary staff, residents and relatives. Discussions with the registered manager regarding requirements made at the last inspection indicated that all but one of the requirements and all recommendations had been met. What the service does well: The home provides a well-maintained, comfortable calm environment, which is conducive to this type of resident. The home employs an activities organisers who provide a good range of activities suitable to the needs of residents accommodated. The service has an excellent quality assurance system in place, which includes internal audits, regular meetings with management and the “Personal Best Programme” which BUPA have recently introduced. The programme is a behavioural programme for staff. A significant investment has been made in the programme by BUPA to ensure that all staff are working in the same manner which supports best practise. Aylesham Court Nursing & Residential Home DS0000001886.V249217.R01.S.doc Version 5.0 Page 6 The home provides high quality food which service users spoken with stated was “excellent” The home is decorated and maintained to a high standard. What has improved since the last inspection? 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. Aylesham Court Nursing & Residential Home DS0000001886.V249217.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Aylesham Court Nursing & Residential Home DS0000001886.V249217.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2.3.6 Contracts issued fully detail Terms and Conditions of residency thereby ensuring that residents are fully informed. Appropriate assessment and risk management of service users will ensure that needs are fully met and risks managed appropriately EVIDENCE: Service user s are issued with a Contract/ Terms and Conditions of the home upon admission and according to BUPA policy. One service user case tracked had a contract in place in their care plan. Contracts were not seen in the other plans inspected. Service users tracked were unable to confirm that they had received a copy of their contract. One of the four care plans tracked contained a Community Care assessment BUPA assessments undertaken were not contained within the care plan however were made available to the inspector upon request. Other assessments including risk assessments were in place and were in relation to individual risks identified on assessment. These included manual handling, nutrition, and dependency, pressure sore and falls assessments. Aylesham Court Nursing & Residential Home DS0000001886.V249217.R01.S.doc Version 5.0 Page 9 It was noted that one service user tracked who was newly admitted to the home had not had a moving and handling assessment completed and staff when questioned indicated that they had used a hoist for safety until the assessment had been completed. It was further noted that a service user tracked had a choke risk which although records had been audited were not reflective of professional advice given and the service users refusal to follow this advice. Other assessments undertaken by external professionals were in place in care plans tracked. Three of the four residents tracked were unable to confirm if they had been involved in their initial assessment prior to admission to the home. The outcomes for residents indicated that care needs were mostly addressed and in the main met. The home does not provide intermediate care. Aylesham Court Nursing & Residential Home DS0000001886.V249217.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7.9.10 Service users needs are set out in a plan of care based on assessments made. Policies and procedures and the appropriate training of staff ensures that their privacy and dignity is maintained and that they receive medicines safely. EVIDENCE: Four care plans were case tracked and overall significant improvements have been made to them since the last inspection. Initial assessments in the main were reflected in corresponding care plans however inspection of one care plans did not contain a plan relating to tissue viability. The outcomes of which could result in the resident being placed at risk of pressure sores due to immobility. A further care plan tracked (new service user )did not include a moving and handling assessment and staff when questioned had not been informed of the correct technique/equipment required. Daily records seen indicated that a relative of one resident tracked was unhappy with the management of her relatives urinary tract infection no evidence was found to support that the General Practitioner had been notified or any treatment prescribed. Aylesham Court Nursing & Residential Home DS0000001886.V249217.R01.S.doc Version 5.0 Page 11 One service user tracked was identified as having a choke risk. No evidence was found in evaluated care plans to indicate that the service user was refusing to have thickened drinks and therefore the risk assessment was inaccurate. Adequate evidence was found to support that resident’s healthcare needs were addressed and included the input of other professionals. All residents tracked have a named nurse who has responsibility for the evaluation of their care plans. All residents spoken with stated (where possible) that they were able to see the General Practitioner when required. The registered manager and deputy plus the clinical lead nurse have all been involved in recent audits of care plans and risk assessments. Comparisons of the audits against care plans inspected indicated that three out of four were up to date, however only one care plan contained an initial assessment. Evidence of consultation with relatives and service users was seen in all of the plans tracked. One resident spoken with stated they were involved in reviews of their plans. Medication systems and management were inspected and all areas inspected were well managed and records examined were accurate and up to date. A nurse informed the inspector that they had recently undertaken competency training with the lead clinical nurse. Records seen indicated that this is being conducted with all trained staff annually. Observation of staff at work and discussion with a number of service users including those tracked demonstrated that they are treated with respect by staff. One service user stated, “ They(staff) are marvellous I have never known anything like this before” Aylesham Court Nursing & Residential Home DS0000001886.V249217.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12.13.14 Giving residents’ choices over their daily lives and ensuring that they experience a homely life, which includes flexible routines contact with friends and family and appropriate activities ensures that the experience of living in the care home matches their expectations and individual requirements. EVIDENCE: Four service users were case tracked and discussion with them and other in the home indicated that their experiences of living in the home were positive and met their expectations. Views and opinions are sought at resident and relatives meetings in order to ensure service users feel valued. Observation of staff at work demonstrated that service users are empowered to make choices and supported in decision making. One service user did however state that she would like to be offered the opportunity to sit in the dining room for lunch occasionally. Discussion with the activities organiser indicated that where service users were unable to attend group sessions she did one to one sessions. Service users are offered the opportunity to have locks on bedroom doors if they wish. Aylesham Court Nursing & Residential Home DS0000001886.V249217.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16.17.18 Complaints are managed efficiently and responded to within given time scales. There is an adult protection procedure and safe systems of working in place to respond to suspicion or allegation of abuse this promotes the protection of residents in the home. EVIDENCE: Examination of the written complaint procedure indicated that clear guidance is given to residents and their relatives on how to make a complaint on admission to the home. Complaints records inspected demonstrated that no complaints have been received in the last three months. A copy of the complaint process is posted on the wall in the reception area of the home. Two of the four residents tracked indicated that they knew how to make a complaint (due to their medical condition). Other residents spoken with were fully aware of the process. Relatives spoken with identified either the manager or a senior member of staff whom they would direct a complaint towards. All staff members spoken to were able to demonstrate their knowledge of the home’s adult protection process and had received training during induction and in the NVQ programme. The registered manager has experience of referral and management of vulnerable adult situations. Discussions around safe storage of money were held with one service user tracked, systems are in place to ensure safety of valuables however this particular service user was reluctant to lock her door when leaving her room Aylesham Court Nursing & Residential Home DS0000001886.V249217.R01.S.doc Version 5.0 Page 14 and therefore this would decrease the security measures provided. The BUPA financial policy and Terms and conditions were inspected both documents fully detail roles and responsibilities. Service users are advised that valuables are brought into the home at their own risk and they are advised to insure them independently. One service user tracked was able to discuss their finances` and how it is managed. Concerns regarding security were discussed with the service user and the registered manager. Discussions were held with the registered manager regarding the management of personal clothing and replacement of lost items following discussion with a service user who described how a number of items of clothing had gone missing after laundering. Aylesham Court Nursing & Residential Home DS0000001886.V249217.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 Clean, safe and well maintained living areas and rooms, and provision of appropriate equipment and facilities ensure that residents live in surroundings, which maximise independence and are comfortable and homely. EVIDENCE: All rooms relating to service users tracked were inspected and were noted to be single and en-suite. All rooms inspected were noted to be appropriate to suit individual needs and service users spoken with indicated that they had been encouraged to personalise them. Equipment and facilities provided in service users rooms were noted to be in good condition and well maintained. All rooms were clean, warm and well lit and ventilated. Aylesham Court Nursing & Residential Home DS0000001886.V249217.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27.30 Sufficient numbers of suitably skilled and trained staff ensures that the needs of residents are met. EVIDENCE: Inspection and calculation of staff rosters demonstrated that staffing levels and hours provided meet with the recommended guidelines of the previous registration authority. Dependency needs are assessed and monitored by trained staff. Manager and deputy manager hours are supernumerary. Three of the four residents tracked were assessed with high dependency needs and one with medium dependency needs. All information received from residents indicated that staffing levels were adequate to meet their needs. Staff spoken with and observed appeared to be very busy and responded in a timely manner to resident’s requests for assistance. No concerns were raised with the inspector regarding number or quality of staff. The skill mix of staff identified on duty rosters appears to be appropriate to meet the needs of residents in occupancy at this inspection Discussion with a new member of staff regarding induction training received identified that although on his first day of duty he had received moving and handling training and basic fire training prior to commencing work. The new induction manual was seen and noted to include all aspects of health and safety and caring for service users. An induction package is given to new starters when commencing work this pack was seen and considered to be Aylesham Court Nursing & Residential Home DS0000001886.V249217.R01.S.doc Version 5.0 Page 17 comprehensive. Discussion with the activities organiser demonstrated that she had received the BUPA ancillary staff induction programme and had shadowed the previous person for one week. Both induction programmes include key policies and procedures such moving and handling, health and safety and adult protection. Currently seventeen staff have completed NVQ training and nine of these` since the last inspection. Aylesham Court Nursing & Residential Home DS0000001886.V249217.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35.38 Service users health, safety and financial interests are protected by robust policies and safe systems of working Outcomes for service users would be further improved by the completion of essential risk assessments and accurate evaluation. EVIDENCE: Discussions around safe storage of money were held with one service user tracked, systems are in place to ensure safety of valuables however this particular service user was reluctant to lock her door when leaving her room and therefore would decrease the security measures provided. Lockable drawers are provided in each room The BUPA financial policy and Terms and conditions were inspected both documents fully detail roles and responsibilities. Service users are advised that valuables are brought into the home at their own risk and they are advised to insure them independently. One service user tracked was able to discuss their finances` and how it is managed. Concerns Aylesham Court Nursing & Residential Home DS0000001886.V249217.R01.S.doc Version 5.0 Page 19 regarding security were discussed with the service user and the registered manager. A number of service users (none tracked) are subject to Power Of Attorney processes. A newly admitted service user (tracked) informed the inspector that her daughter looked after all financial matters. Money can be deposited in the homes own system. This is a secure noninterest making facility provided by BUPA for safe and easy access to personal money. The administrator stated that service users are issued with statements regularly to confirm the status of their account. One service user case tracked confirmed that she could see her account balance when she wanted to. Health and safety meetings are held regularly in the home and inspection of staff and training files indicated that all aspects of health and safety are covered during the induction period. A new member of staff informed the inspector that they had completed moving and handling and fire training before commencing work, he was being supervised by a senior member of staff during this inspection. Training records of staff included COSHH, Moving and handling, First Aid, and food hygiene. Equipment provided by the home for safe moving of service users was seen in use and the registered manager stated that following the last inspection full audits were undertaken of equipment. A large number of new slings have been purchased since the last inspection and staff were clearly aware of the correct equipment to use for those service users case tracked. Manoeuvres were observed and were carried out safely. Copies of the audit and equipment required for service users handling needs were seen on display in prominent places around the home. All records inspected relating to the management of health and safety including fire, accident records and water temperature recording were found to be well managed and up to date. Aylesham Court Nursing & Residential Home DS0000001886.V249217.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 X X X X X 3 X X STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 1 Aylesham Court Nursing & Residential Home DS0000001886.V249217.R01.S.doc Version 5.0 Page 21 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 OP7 Regulation 13 Requirement The registered provider must ensure that risk assessment as identified re choking is reflective of current situation. The registered provider must ensure that service users are fully assessed for manual handling needs within 24 hours of admission (or according to BUPA Policy) Timescale for action 31/10/05 2 OP38 13 31/10/05 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 Refer to Standard OP35 Good Practice Recommendations It is recommended that where a service user is identified as being at risk financially that suitable risk assessments are undertaken in consultation with them and arrangements made to ensure safety of valuables such as credit cards etc. Aylesham Court Nursing & Residential Home DS0000001886.V249217.R01.S.doc Version 5.0 Page 22 2 OP38 3 4 OP3 OP35 5 OP14 It is recommended that discussion be held with the fire officer with regard to the inclusion on the homes fire risk assessment of the use of oxygen cylinders in service users rooms and appropriate action taken according to advice given. It is recommended that the initial assessments of service users and subsequent reviews are kept in the care plan It is recommended that the management of service users personal money be fully discussed at induction to ensure that service users are protected from abuse. It is also recommended that this matter be discussed during induction with any ancillary staff that has an involvement in service users personal money. It is recommended that staff routinely offer service users choices regarding seating arrangements at meal times. Aylesham Court Nursing & Residential Home DS0000001886.V249217.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Aylesham Court Nursing & Residential Home DS0000001886.V249217.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!