Inspection on 23/05/06 for Balmoral Court

This inspection was carried out on 23rd May 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Balmoral Court 17/07/07

Balmoral Court 02/05/07

Balmoral Court 04/10/05

Balmoral Court 07/06/05

Balmoral Court 13/03/05

Balmoral Court 10/09/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Balmoral Court Ayton Street Byker Newcastle Upon Tyne Tyne & Wear NE6 2DB Lead Inspector Aileen Beatty Unannounced Inspection 23rd May 2006 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 Balmoral Court DS0000000493.V290304.R01.S.doc Version 5.1 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. Balmoral Court DS0000000493.V290304.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Balmoral Court Address Ayton Street Byker Newcastle Upon Tyne Tyne & Wear NE6 2DB 0191 265 2666 0191 265 2777 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) Mr Baldev Singh Ladhar Care Home 62 Category(ies) of Dementia - over 65 years of age (62) registration, with number of places Balmoral Court DS0000000493.V290304.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One resident category OP as per variation application 41598, received 24/12/02 may be accommodated. Should this resident leave the home, the Commission for Social Care Inspection must be notified. Three named persons under the age of 65 in the DE category are accommodated in the home. Should any of these residents leave the home, the Commission for Social Care Inspection must be notified. 4th October 2005 2. Date of last inspection Brief Description of the Service: Balmoral Court is a purpose built home providing nursing and social care to elderly people suffering from Dementia. It is a large home providing 62 beds. The home is in Byker close to local shops and other public amenities. There are good transport links. The home is within easy reach of the busy Shields and Chillingham Roads. The home adjoins Kensington, a general nursing care home owned by the same proprietor. Both homes share joint laundering and catering facilities. The fees range from £355 - £365 per week depending on whether social or nursing care is provided. Balmoral Court DS0000000493.V290304.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on 26.05.06 over 8 hours. It involved reading records, talking to staff, residents and visitors and a tour of the building. The inspector ate lunch with the residents. The overall standard of care is satisfactory. 6 service user satisfaction surveys were received. Most said that they are generally happy with the care provided. What the service does well: 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. Balmoral Court DS0000000493.V290304.R01.S.doc Version 5.1 Page 6 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 Balmoral Court DS0000000493.V290304.R01.S.doc Version 5.1 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. No service user moves into the home without having his or her needs assessed. EVIDENCE: The manager carries out Pre admission assessments before anyone is admitted to the home. These were read and are much more detailed than in the past. Admission summaries also contain more detail. Balmoral Court DS0000000493.V290304.R01.S.doc Version 5.1 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. Service user health, personal and social needs are usually set out in an individual plan of care. Health needs are fully met. Homes policies and procedures for administering medicine are not always followed. Service users are usually treated with respect and their right to privacy upheld. EVIDENCE: The care plans of 4 residents were examined. They contain a number of assessments of moving and handling requirements, nutritional needs, pressure area (bed sore) risk, behaviour rating scale and dependency assessments. Most care plans are up to date and evaluated regularly. Some care plans lack detail and should reflect the specialism of the home; that is to care for people Balmoral Court DS0000000493.V290304.R01.S.doc Version 5.1 Page 9 with dementia. For example, care plans that address the risk of someone leaving the home unsupervised should be more detailed. Currently the interventions described are all about alarms, supervision and prevention. Staff should also consider why the person wishes to leave the home and offer diversional activities preferably linking to their past interests. Some daily records had not been completed for a number of days. The 30minute observations of one resident were also not completed for sometimes a whole day. This is not acceptable as it is in place to keep the person safe. Some staff on duty displayed a very good understanding of the problems faced by people with dementia. One member of staff was closely monitoring one person who was very upset and frequently in tears. The staff member explained that the person was re living a very sad period during their life. She was aware that the person was too upset to settle at the table to eat her meal so she ordered sandwiches and finger food and regularly offered the person drinks as they walked around the home. Staff appear to know the residents very well and can describe their likes, dislikes and habits in detail. It is recommended that care staff think carefully about how much of this knowledge is carried in their heads and whether they should include it in care plans. This will help any new or agency staff in the home to care for the person as well as they can and will improve continuity of care for the resident. An episode where restraint had to be used was very well documented and met the regulatory requirements. The information written in care plans does not always match what happens in practice. There is also evidence that staff do not all read the care plans. For example, one resident was being nursed in bed and a large cushion was wedged under the mattress to presumably prevent her from falling out of bed. This is not a safe practice and must not be used. The last care plan evaluation said that rolling from bed was no longer a risk. Social assessments are also completed and there are some lovely examples of really detailed information that has been obtained about people’s past lives and interests. Social care plans are also in place but could be used more effectively. One resident was seen talking to one of the dolls used for doll therapy, and was very animated and settled. Staff reported that she had recently begun to benefit from this, yet no one had recorded this in her care plan. There were some examples of social history sheets with blank spaces e.g. one said there was no information about past sporting interests yet the admission information notes an old sporting injury and the sport that was being played at the time. It is recommended that staff try to complete these as fully as possible and us any way possible to obtain information instead of leaving blank spaces. There has, however been real progress made in this area since the last inspection. Balmoral Court DS0000000493.V290304.R01.S.doc Version 5.1 Page 10 Medication is stored safely and administered by qualified nurses. There were a number of gaps in inspection records. There was an improvement in this area so it is disappointing to see it happening again. The manager agreed to investigate this and discuss it with the unit manager for that floor to ensure there is an improvement. Antibiotics were in the trolley and should have been stored in the fridge. The treatment room was clean and tidy and kept locked when not in use. A satisfactory arrangement is in place for the disposal of medicines no longer required. The dignity of residents is usually maintained. There were, however, numerous examples of unshaven men and people with food on their faces and crusty eyes. One resident was wearing a pullover that buttoned to the neck but the buttons had come off so he was holding it closed and appeared uncomfortable having an open neck. Staff helped him to change once this was pointed out. Care should be taken to make sure clothes fit well and are in a good condition. Some trousers were very short for the person wearing them. During the tour of the building the manager covered the legs of a person who had them raised on a stool with a blanket. Care should be taken that dignity is preserved when people have to sit like this. Staff occasionally speak about a resident while they are there. This should be avoided and if they need to tell somebody something about the person then this should be done in private or they should include the person in the conversation. Some staff wear jeans (even ripped ones) and trainers. It is recommended that staff adhere to the dress code out of respect for the residents, and to present themselves professionally. Staff knock before entering bedrooms and bathrooms and personal information about people is no longer displayed. Balmoral Court DS0000000493.V290304.R01.S.doc Version 5.1 Page 11 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): 12,13,14,15 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Social and recreational needs and interests are satisfied. Contact can be maintained with family and friends. People are encouraged to exercise choice most of the time. A wholesome balanced diet is provided in pleasant surroundings at a time convenient to them. EVIDENCE: A new activity coordinator is in post and has developed some good activities and organised events. Numerous cards of appreciation were sent from visitors thanking her and staff on behalf of residents. She works 30 hours per week, and has made a significant improvement. The home was criticised heavily in the past for not providing meaningful activities. Organised events that have taken place or are planned include Easter party, pie and pea supper, Bingo night, and Body Shop party. Entertainers also come to the home. Balmoral Court DS0000000493.V290304.R01.S.doc Version 5.1 Page 12 The activity coordinator types up a daily record of activities she has carried out and with whom. This is an excellent way to evaluate how well things are going. Unfortunately they are not available to relatives as they contain information about numerous residents. This information should also be included in care plan evaluations. These would then be available to relatives. The link between care plans and the role of the activity coordinator needs to be strengthened. It is recommended that all generic care plans (ones that say the same thing) saying how people with dementia may be at risk of becoming socially isolated, be reviewed to be more personalised. The activity coordinator could help with this. Activities for people with more advanced dementia are being developed. This includes sensory activities, which would involve all the senses. One very good idea is the positioning of bird boxes or feeders for people to be able to watch them. A recent study carried out by an architect specialising in how the environment can help people with dementia, says that access to nature and outdoors is very important in making people feel better. The bird boxes are a good example of how this can be achieved. Social care plan evaluations for people with severe dementia tend to say that they are unable to express whether they enjoy activities or can’t be involved in them. With the development of special activities for these people, evaluations should also be reviewed to e more specialist, and again, demonstrate that the staff in the home do have specialist skills. Evaluations could include, for example, whether they smiled, frowned, laughed or completely ignored the activity. It was evident that some residents are very busy and would, for example, make a bee- line for the tea trolley when it arrived. Usually they are taken away in case they hurt themselves. Some thought should be given to assessing residents who may wish to help with some small tasks in the home, e.g. dusting, giving out biscuits while staff take the tea and risk assessments carried out if necessary. This will ensure that people are not always stopped from doing something they want to and that they are given maximum opportunities to be as independent as possible. Relatives and friends are able to visit at any reasonable time. One visitor comment card said that visits are often interrupted by other residents wandering into the room and would like to lock the door and was worried this may not be allowed. It was confirmed that this is acceptable and they should let staff on duty know. Residents were given choices during the day of the inspection. For example, at meal times residents will have chosen what they would like to eat the previous day. This can cause difficulties, as people may not always remember what they have ordered. When the meals arrived, staff said you have ordered gammon, is that still what you would like or would you prefer cauliflower cheese? This Balmoral Court DS0000000493.V290304.R01.S.doc Version 5.1 Page 13 appeared to work well and meant that choice was offered in a realistic way. Staff must remember to ask people where they would like to sit, although some staff already do this. There is a tendency to use the terms “absconding” and “escaping” in care records when saying that people are at risk of leaving the home unsupervised. As this sounds very negative and implies that they are imprisoned, it is strongly recommended that a more suitable description is used. The radio in the dining room was playing Century FM which plays mainly pop music. It is suspected that this is for the staff and not the choice of residents. Residents should choose what they would like to listen to or staff should try to use their discretion and knowledge to the persons likes and dislikes to help them to choose. The inspector ate lunch with residents. The tables have been stripped and varnished and are much more pleasant. The meal was very tasty, warm and a choice of drink was offered. Staff sat beside people who needed assistance to eat, and the practice of giving out medicines at meal times has stopped. Balmoral Court DS0000000493.V290304.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service Complaints are taken seriously. Service users are protected from abuse. EVIDENCE: There have been 3 complaints since the last inspection. These are all recorded and a copy of the response by the manager is available. Only one of these complaints came direct to CSCI but the home investigated it. Two were upheld and one was partially upheld. There have been no adult protection issues since the last inspection. Most staff have received POVA (Protection of vulnerable adults) training. Criminal Records Bureau checks are carried out before staff are employed by the home. Balmoral Court DS0000000493.V290304.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Service users live in a safe well -maintained environment. The home is clean pleasant and hygienic. EVIDENCE: All communal areas in the home have been redecorated since the last inspection. Bathrooms, that were very bare, are now much brighter and inviting. New carpets are due to be fitted in the main corridors. The windows that have condensation between the panes in the upstairs lounge have still not been repaired. The upstairs carpet that has cigarette burns is being replaced. A door is being put in place at the end of the corridor between the smoking area and corridor. The fire officer has approved this. Balmoral Court DS0000000493.V290304.R01.S.doc Version 5.1 Page 16 A number of windows were open upstairs. It must have been cold for people sitting still and staff should close bedroom doors when rooms are airing or remember to close them. There is some mismatching furniture around the home, some of which belonged to people who have since left or died. It is causing some lounges to appear cluttered and untidy and it is recommended that it is removed. The standard of cleanliness in the home is good. There were no concerns about cleanliness or hygiene identified during the inspection. Balmoral Court DS0000000493.V290304.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service The numbers and skill mix of staff meets Service users needs. Service users are in safe hands at all times. Service users are protected by the homes recruitment policy. Staff are trained and competent to do their jobs. EVIDENCE: There are sufficient staff on duty. The home is not currently full, and staffing levels reflect this. On the day of the inspection there were 11 residents on the ground floor who were being cared for by 2 carers and a nurse. There were 26 residents upstairs being cared for by 4 carers and 1 nurse. Two visitor questionnaires said that they felt there were not always sufficient staff on duty. Staffing rotas checked found that staffing levels are being maintained. Recruitment procedures are followed and staff files were examined. They contained all of the required information such as two references and evidence that Criminal Records Bureau checks are carried out. Staff receive regular training. 13 have almost completed NVQ 2 and 4 already have it. The remainder are registering with the Care Alliance to do the award. Staff have also received training in moving and handling, and food hygiene, safe handling of medication, care planning, dementia awareness, First aid, Balmoral Court DS0000000493.V290304.R01.S.doc Version 5.1 Page 18 POVA and pressure area care in the last 12 months. There is a proposal to appoint a training coordinator in the company who will assist in the organisation of future training. The manager is aware that staff are already very busy with NVQ and does not want to over burden them. A computer system records staff training and when it is due for renewal. Training in Person centred care, Tissue viability (to help with care and prevention of pressure sores) and understanding challenging behaviour is planned. Balmoral Court DS0000000493.V290304.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,and 38 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service A suitable person manages the home. The home is run in the interests of service users. Service user financial interests are safeguarded. Staff are not always adequately supervised. Health safety and welfare of service users are promoted and protected. EVIDENCE: The Acting manager previously managed the adjoining home. She has not yet been through the Fit Person process with CSCI but will be doing so soon. Although a qualified General Nurse, she is experienced in the field of dementia care and has demonstrated to date a good understanding of the needs of people with dementia. There is an expectation that she will undertake some Balmoral Court DS0000000493.V290304.R01.S.doc Version 5.1 Page 20 formal dementia training. She was due to complete the Registered Managers Award in December of 2005 but this was delayed as both tutors have been off. Standards of care in the home have improved since she came into post. The home has also been divided into smaller units and Unit Managers put in place. There remains a slight problem with accountability, such as finding out who should have completed certain tasks. Ways of improving this are being developed including the allocation of staff to care for named residents during the shift. Although staff will still help one another, they will be responsible for checking their allocated residents regularly during the shift, and making sure their records have been filled in. A system of key workers and co key workers is also in place. The home is run in the best interests of service users. There is evidence, especially through use of activities, that staff are trying hard to make the home an enjoyable place to be for residents and their families. Relatives spoken to during the inspection said they are very happy with the way the home is run and feel confident that they can openly discuss any concerns with the manager. Financial procedures are satisfactory. The manager does not act as appointee for any residents. Very large quantities of money are no longer held in the safe, following a theft from the adjoining home. Procedures have otherwise not been changed since the last inspection. A random check on the balance of one resident found that it was correct. Staff supervision has improved. There are still staff who are not receiving supervision every two months. This must be brought up to date. Health and safety procedures in the home are good. Fire records were examined and regular checks and drills are carried out. It is recommended that some comments are made following a drill, such as how quickly staff responded. Regular safety checks are carried out on window restrictors and water temperature. Slings for use with the hoist are checked regularly and staff are aware that they must use the correct size sling for the individual. (If it is too small it could cause bruising, and if it is too large they could fall out). An appropriate contractor has tested electrical wiring, small appliances and the lift in the past 6 months. There were no safety concerns identified during the inspection. Balmoral Court DS0000000493.V290304.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 Balmoral Court DS0000000493.V290304.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 15 (2) Requirement Ensure daily care records are completed on time. Care plans must be detailed, dementia specific and followed by all staff. 2 OP9 13 (2) Medication records must be accurately maintained. Medication should be stored appropriately e.g. in fridge. Residents must be appropriately clean and dressed in clothes that are in good condition at all times. Ensure activities are recorded in care plans. Ensure the radio plays music chosen by residents. Staff should adhere to dress code. Windows in first floor lounge must be replaced. The TV cabinet in the first floor lounge must be replaced. OUTSTANDING 26/05/06 Timescale for action 26/05/06 3 OP10 4 (a) 26/05/06 4 5 OP12 OP14 15 (2) 12 (3) 4 (a) 26/06/06 26/06/06 6 OP19 23 (2) (b) 26/07/06 Balmoral Court DS0000000493.V290304.R01.S.doc Version 5.1 Page 23 7 8 OP36 OP30 18 (2) 18 (c) Ensure the temperature in the home is suitable for the comfort and well being of residents. Ensure staff supervision is carried out two monthly. NVQ level 2 and above must be achieved by 50 of staff. 26/06/06 31/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations Social care plan evaluation for people with severe dementia should be developed. Staff should also make an effort to fill in blanks on social history information. The use of the terms absconding and escaping should be avoided. Opportunities are provided for residents to help around the home if they wish to do so. 2 OP14 Balmoral Court DS0000000493.V290304.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Balmoral Court DS0000000493.V290304.R01.S.doc Version 5.1 Page 25 - 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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