Inspection on 01/08/08 for Balmore Country House Care Home

This inspection was carried out on 1st August 2008.

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

Other inspections for this house

Balmore Country House Care Home 08/04/09

Balmore Country House Care Home 06/07/07

Balmore Country House Care Home 04/07/06

Balmore Country House Care Home 12/01/06

Balmore Country House Care Home 07/06/05

Balmore Country House Care Home 31/03/05

Balmore Country House Care Home 25/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Balmore Country House Care Home 245/247 Loughborough Road Ruddington Nottinghamshire NG11 6NY Lead Inspector Karmon Hawley Unannounced Inspection 1st August 2008 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 Balmore Country House Care Home DS0000026415.V369543.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. Balmore Country House Care Home DS0000026415.V369543.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Balmore Country House Care Home Address 245/247 Loughborough Road Ruddington Nottinghamshire NG11 6NY 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) 01159213006 F/P 01159213006 ruddhomes@talk21.com Ruddington Nursing Homes Limited Claramma Thomas Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50), Physical disability (4) of places Balmore Country House Care Home DS0000026415.V369543.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only - Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Older Persons - Code OP Physical Disability - Code PD The maximum number of service users to be accommodated is: 50 2. Date of last inspection 6th July 2007 Brief Description of the Service: Balmore Country House Care Home provides nursing and personal care for up to 50 older people. Balmore is a converted and extended property set in pleasant and extensive grounds in Ruddington village, near Nottingham. There is a welcoming atmosphere for people using the service and relatives as well as professionals visiting the home. There are several sitting rooms and a private sun room offering sufficient space for people using the service. There is a passenger lift providing access to the upper floor and there is access for wheelchairs throughout the home. Regular church services are held within the home and there is also an activities coordinator who provided structured activities. The current fees for the home, which are made available on the point of enquiry are as follows: residential high dependency - shared room £334, single room - £425. Nursing care - shared room £360, single room £525. These fees do not include chiropody or hairdressing fees. Balmore Country House Care Home DS0000026415.V369543.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star this means that people who use the service experience adequate quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people living at the home and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. One regulatory inspector conducted the unannounced visit over 1 day, including the lunchtime period A review of all the information we have received about the home was considered in planning this visit and this helped decide what areas were looked at. The service provided us with an annual quality assurance assessment, which outlines the progress that the service has made over the past year and any improvements that they intend to make. 8 surveys were also returned to us from people using the service, relatives and staff. The main method of inspection we use is called ‘case tracking’ which involves selecting the care plans of 4 people and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. The registered manager, members of staff and people who use the service were spoken with as part of this visit. A partial tour was undertaken, which included looking at the bedrooms of those people who we case tracked and communal areas of the home. What the service does well: People who may wish to use the service are assured that their needs will be assessed and that these can be met before they make a decision to move into the care home. People using the service are supported to access specialist services such as the doctor and district nurse when needed to ensure that their health care needs are met. Balmore Country House Care Home DS0000026415.V369543.R01.S.doc Version 5.2 Page 6 People using the service are treated with respect at all times and they said, ‘the staff are very kind and respectful,’ and ‘the staff are always polite and knock on my door before they come in.’ People using the service are supported to maintain contact with people that are important to them and visitors are welcome at any time. People using the service are protected from unsuitable people being employed by the recruitment policies and practices in place. Staff are aware of people’s needs and continue to undertake mandatory training to ensure that they have the necessary knowledge and skills to meet these. People using the service offered the following comments, ‘the staff are very good and they look after me,’ ‘I can see the doctor if I need to,’ ‘staff are always friendly and approachable, I can talk to staff if I have a problem,’ ‘the staff are very nice’ and ‘I feel settled here and safe as I know that people are here to look after me.’ What has improved since the last inspection? What they could do better: Plans of care must be person centred to ensure that people’s needs are met in the way that they prefer. Risk assessments must be in place for all highlighted risks to ensure that people using the service are fully protected. Further attention to the activities on offer must be given to ensure that people using the service lead a stimulating life and they are able to participate in activities of their choosing. Sufficient staff must be available to fully meet the needs of people using the service. Further training must be arranged for the outstanding mandatory areas to ensure that all staff have the necessary knowledge and skills to meet the needs of people using the service. The quality assurance system must be further developed to demonstrate fully that the service is being run in the best interest of people using the service. Balmore Country House Care Home DS0000026415.V369543.R01.S.doc Version 5.2 Page 7 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. Balmore Country House Care Home DS0000026415.V369543.R01.S.doc Version 5.2 Page 8 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 Balmore Country House Care Home DS0000026415.V369543.R01.S.doc Version 5.2 Page 9 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 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who may wish to use the service are assured that their needs will be assessed and that these can be met before they make a decision to move into the care home. The service does not offer intermediate care. EVIDENCE: An assessment of needs is carried out for all new people who may wish to move into the care home so that staff know that they can meet a person’s needs before they move in. People who may wish to use the service and their relatives can visit and spend time at the care home to get a feel for how it would be to live there before they make a decision to move in. One person using the service said, ‘I looked around before I came to live here, I knew what I wanted.’ Balmore Country House Care Home DS0000026415.V369543.R01.S.doc Version 5.2 Page 10 The service does not offer intermediate care. Balmore Country House Care Home DS0000026415.V369543.R01.S.doc Version 5.2 Page 11 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): 7,8,9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The needs of people using the service may not always be met in the way that they prefer due to plans of care being task focussed. People using the service may not be fully protected from all assessed risks due to the lack of risk management plans in place. EVIDENCE: Plans of care are in place for all highlighted risks and these are now more personalised in the sense that they are handwritten for each individual, however they do remain task focussed rather than being based upon a persons personal preferences and need. Plans of care are updated, as changes occur to ensure the continuity of care. Risk assessments are in place for a number of risks such as wandering and falls, however were not in place when a risk had been assessed in areas such as infection control and manual handling. Within a survey received by us a concern in regard to registered nurses only writing within plans of care and not care assistants was raised, as it was felt that it was dependant upon registered nurses remembering what care assistant Balmore Country House Care Home DS0000026415.V369543.R01.S.doc Version 5.2 Page 12 had said. This was discussed with the staff who stated that they filled in a number of charts so that information was available for the registered nurse so that they could complete the plans of care for each day. These charts were seen and relevant information was documented. One person using the service said, ‘the staff are very good and they look after me.’ A comment received in one survey said that basic care needs are lacking and they had to request oral care. People using the service are supported to access specialist services such as the doctor, dentist, optician and district nurse. Evidence of specialist equipment such as hoists, special beds and mattresses were observed during the brief tour of the care home. One person using the service said, ‘I can see the doctor if I need to,’ and another person discussed how staff help them to move using the hoist. Staff who administer medication have been trained to do so and regular audits take place to ensure that good working practices are maintained. All medication records were maintained correctly and all medication administered had been signed for appropriately. One person using the service said, ‘the staff sort out my tablets for me and give them to me when I need them.’ People using the service spoken with said, ‘the staff are very kind and respectful,’ and ‘the staff are always polite and knock on my door before they come in.’ Staff spoken with discussed how they ensure they maintain peoples privacy and dignity by knocking on doors and by being respectful when offering personal care. Staff were observed to treat people with kindness and respect throughout the visit. Balmore Country House Care Home DS0000026415.V369543.R01.S.doc Version 5.2 Page 13 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 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some people using the service do not feel that their social needs are fully met, as they would like more stimulation and activity. People using the service would benefit from a wider choice range in the breakfast menu. EVIDENCE: People’s views in respect of the activities on offer varied; ‘there is not much to do, I spend my time reading the newspaper and chatting,’ ‘we can go out if we want to, there are activities but I can’t really join in them,’ and ’there is not enough to do, I would like more activities.’ The activities coordinators post has increased in hours and two people are now employed, there is evidence that they have carried out arts and craft work with people as this was displayed around the care home, as were pictures of the recent event when a singer had visited the home. Staff spoken with said, ‘although there are activities on offer, there is still not enough for people to do.’ Balmore Country House Care Home DS0000026415.V369543.R01.S.doc Version 5.2 Page 14 Staff stated that the routine of the home is flexible and people may choose how to spend their time. People using the service confirmed this but one person added that unfortunately they still had to wait for staff as they need help to enable them to do this. Two church services are held every month should people wish to attend. There are no restrictions in visiting so that people using the service can maintain contacts with people that are important to them. One person using the service said’ ‘my family visit me regularly and they are always made welcome.’ Several visitors were seen on the day of the visit, staff greeted them in a welcoming manner. Staff spoken with were able to discuss how they meet the differing needs of people living in the care home. One person using the service discussed how they share a room with their husband and how staff respect their privacy. People using the service said, ‘the food is good, we always have a choice, we can ask for drinks and snacks at anytime in the day,’ ‘the food is passable, but always hot’ and ‘the meal on Friday is always cold.’ Staff spoken with were able to discuss the required temperatures that meals should be served at, they explained that meals are kept in a hot trolley until they are served. They stated that food is not cold, however some people like it very hot but there may be a risk of them burning themselves. The meal on the day of the visit looked appetising and was steaming with heat when served to people using the service. The menu on offer is varied and choices are offered, however apart from boiled or scrambled eggs at breakfast there is no other cooked breakfast available. This was discussed with the manger as comments about this had been received in the surveys returned to us. She stated that they had tried a cooked breakfast before and no one had wanted it, however she would ask people using the service again to see if the menu needs updating. Balmore Country House Care Home DS0000026415.V369543.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service are protected from abuse and they are assured that their complaints will be listened to and resolved. EVIDENCE: People using the service have access to the complaints policy should they need to use it. People using the service said, ‘staff are always friendly and approachable, I can talk to staff if I have a problem,’ and ‘the staff are very nice.’ Staff spoken with are able to discuss the action that they would take if they receive a complaint so that this could be resolved. 16 members of staff have undertaken training in safeguarding vulnerable adults; further training in this area has been arranged. Staff spoken with are aware of their roles and responsibilities in ensuring that people using the service remain safe and they explained what they would do if they suspected bad practice was happening. One safeguarding referral has been made since the previous visit due to an allegation of one person wandering into another’s room and using threatening behaviour. This was reported to the safeguarding adults team and us appropriately, investigated and closed as unproven. Balmore Country House Care Home DS0000026415.V369543.R01.S.doc Version 5.2 Page 16 One person using the service said, ‘I feel settled here and safe as I know that people are here to look after me.’ Balmore Country House Care Home DS0000026415.V369543.R01.S.doc Version 5.2 Page 17 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service live in a comfortable and well maintained environment. EVIDENCE: Both the interior and exterior of the care home is well maintained, comfortable and homely. The garden is landscaped and offers a safe, pleasant environment in which to sit. One person using the service was observed to go out and use the garden on the day of the visit and another person confirmed that they could go out in the garden when they wanted. The upstairs of the care home has been altered, incorporating an extra sitting room and dinning room in anticipation for a change in registration to admit people with dementia care needs. The care home was clean and tidy in all areas observed during the brief tour of the care home and people’s bedrooms were personalised with their belongings. Balmore Country House Care Home DS0000026415.V369543.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): 27,28,29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are insufficient staff available to meet the needs of people using the service. Staff are generally well trained and knowledgeable to meet the needs of people using the service. EVIDENCE: People using the service said, ‘there are not enough staff, we have to wait for long periods of time,’ there are enough staff to help me,’ and there are not enough staff here.’ One person spoken with also discussed their frustrations in respect of the lack of opportunity to carry out activities, as they wished, due to the lack of staff available to spend time with them. One survey received by us also stated that the care home was always understaffed and even if they were fully staffed people’s needs cannot be accommodated because of the high dependency of people living at the care home. Staff spoken with said, ‘staffing levels were increased for a few weeks, however people have since left, there are generally enough staff when we are fully staffed,’ and ‘the staff team work well together, there are a lot of people with high dependency needs, we can not hurry them, this sometimes makes people late up.’ One survey received by us also stated that people are late getting up for breakfast due to the lack of staff. Balmore Country House Care Home DS0000026415.V369543.R01.S.doc Version 5.2 Page 19 Staff were observed to be busy throughout the visit, however they attended to people’s needs promptly. A concern about a lack of communication between staff shifts was highlighted in the surveys returned to us, therefore this was discussed with the manager and staff, all confirmed that handovers take place at the beginning of every shift so that staff are aware of each person’s need. Also a concern about staff taking breaks all together was expressed, again this was discussed with staff and the manager, it was stated that breaks were staggered, however it may seem that there are fewer staff available in the afternoon due to the staffing numbers, however there is always someone on the floor to attend to people’s needs. Staff spoken with said that all new staff work with someone else when they first start so that they have time to familiarise themselves with the care home and the needs of people living there. There is evidence of new staff undertaking an induction within staff files examined. One person using the service said, ‘new staff work with the others when they first start.’ To ensure staff have the necessary skills and knowledge to care for the people living at the care home all have the National Vocational Qualification (a nationally recognised work and theory based qualification) level 2, one person has started level 3 and the deputy managers have commenced the Registered Managers Award, which is designed to develop management skills. There was evidence of this seen within staff files examined and both members of staff spoken with confirmed that they had undertaken this training. Staff files examined contained the necessary documentation required by law to ensure that people are protected from unsuitable people being employed. Staff spoken with confirmed that they had undertaken a Criminal Record Bureau check (a police check to see if an individual has a police caution or criminal record). Staff training in mandatory areas continues to ensure that staff have the necessary knowledge and skills to meet people’s needs. Records showed good attendance rates in all areas with the exception of first aid, where only 35 of staff have attended. Staff spoken with said that they felt supported in their training and development, however they would like training in first aid and food hygiene. One person using the service said, ‘the staff appear to know what they are doing.’ Balmore Country House Care Home DS0000026415.V369543.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): 31,33,35,36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service live in a home that is well run and managed where they are given an opportunity to express their views and opinions. EVIDENCE: The manager has completed the Registered Managers Award (a nationally recognised work and theory based qualification designed to develop management skills). Within one survey returned to us it stated that the manager is not strict enough, lacks experience and does not give staff a sense of direction or leadership. This was discussed with the manager and the staff. Staff stated that the manager is approachable and does give leadership; she works on the floor if short staffed otherwise delegates duties to the deputy managers. The manager stated that she felt that staff were given direction and that she has Balmore Country House Care Home DS0000026415.V369543.R01.S.doc Version 5.2 Page 21 improved upon her knowledge and experience over the last year and that she feels comfortable in her job role. The manager has started to develop a quality assurance programme to ensure that people using the service receive quality care. Questionnaires have been sent out to relatives and people using the service who are able. There was evidence of the manager inviting people to see her to address any issues of concern. Responses were both positive and negative; ‘there is a lack of communication, staff are too busy,’ ‘we would like more meetings,’ ‘we would like more variety in the menu,’ and ‘the care is exceptional,’ ‘the staff are very kind and caring,’ and ‘matron is approachable and the care is exceptional. The service is not responsible for people’s finances; if a cost is incurred relevant others are invoiced for this. There was evidence within staff files that supervision sessions take place on a regular basis. Staff spoken with also confirmed that these take place and that they are helpful in their development. A concern in regard to registered nurses lacking confidence when people’s care needs change was expressed within one survey returned to us therefore this was discussed with the manager. It was stated and confirmed that all trained staff also undertake supervisions sessions to aid in their development and it was felt that if staff seemed to lack confidence it would be that they are seeking additional guidance from other professionals such as the doctor to ensure that the best care is afforded to the person using the service. The annual quality assurance assessment information sent to us before the visit demonstrated that relevant testing and servicing of equipment and services such as the electrics and gas are taking place. On the day of the visit the lift and hoist certificates were examined which confirmed that these had been serviced as required. Balmore Country House Care Home DS0000026415.V369543.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 3 X 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 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X 3 Balmore Country House Care Home DS0000026415.V369543.R01.S.doc Version 5.2 Page 23 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(1) Requirement Plans of care must be person centred to ensure that people’s needs are met in the way that they prefer. Risk assessments must be in place for all highlighted risks to ensure that people using the service are fully protected. Further attention to the activities on offer must be given to ensure that people using the service lead a stimulating life and they are able to participate in activities of their choosing. Sufficient staff must be available to fully meet the needs of people using the service. Further training must be arranged for the outstanding mandatory areas to ensure that all staff have the necessary knowledge and skills to meet the needs of people using the service. The quality assurance system must be further developed to demonstrate fully that the service is being run in the best interest of people using the DS0000026415.V369543.R01.S.doc Timescale for action 20/09/08 2. OP7 13(4,c) 20/09/08 3. OP12 12(1,a) 01/10/08 4. 5 OP27 OP30 12(3) 18(1,a) 18 (1,c,i) 20/09/08 01/10/08 6 OP33 24(1,a,b) 01/11/08 Balmore Country House Care Home Version 5.2 Page 24 service. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP15 OP15 Good Practice Recommendations Liaise with people using the service to discuss any changes in the menu that they would like. Implement any changes in the menu as suggested by the people using the service to ensure that they are given sufficient choice. Balmore Country House Care Home DS0000026415.V369543.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Balmore Country House Care Home DS0000026415.V369543.R01.S.doc Version 5.2 Page 26 - 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!