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Inspection on 10/01/08 for Belton Lodge Nursing Home

Also see our care home review for Belton Lodge Nursing Home for more information

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

Residents now live in a more comfortable environment. Residents in the home are happy and content and satisfied with the care and approach of the staff. There is a friendly and relaxing atmosphere in the home.

What has improved since the last inspection?

Since the last inspection visit and following our discussions with the owner there had been a major redecoration and refurbishment programme. This has included completing all the outstanding unfinished work in the home. New flooring has been laid throughout the home and the bathroom and toilets redecorated with new and brighter, less institutional facilities. In addition the conservatory has been completed and a new kitchen installed.

What the care home could do better:

Nurses and the manager need to ensure that care records contain clear information about all the care and support needs of the residents. Quality of the overall service must be addressed. The emphasis must be on obtaining views of the residents about what they want to do during the day and how they wish to spend their lives. Monitoring needs to be provided so that care planning, medication, training, environment and records are of a high standard. The owner/manager must ensure that all staff have a good command of the English language and are aware of the cultural needs and care needs of the residents. All staff need to have the skills to care, engage and help and support the residents.Care staff and nurses must have formal regular staff supervision and receive training both formal (National Vocational Qualifications) and informal (in house training) to meet the changing needs of the residents in the home.

CARE HOMES FOR OLDER PEOPLE Belton Lodge Nursing Home 213 Belton Lane Grantham Lincs NG31 9PW Lead Inspector Tobias Payne Unannounced Inspection 10th January 2008 08:00 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 Belton Lodge Nursing Home DS0000002587.V356645.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. Belton Lodge Nursing Home DS0000002587.V356645.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Belton Lodge Nursing Home Address 213 Belton Lane Grantham Lincs NG31 9PW 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) 01476 579798 01476 579798 R S Medicare Limited Mrs Indra Nathan Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Belton Lodge Nursing Home DS0000002587.V356645.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Condition of Registration The maximum number of service users in the home with nursing does not exceed 10 and the maximum number of service users with personal care only does not exceed 3. 15th August 2007 Date of last inspection Brief Description of the Service: Belton Lodge is a care home providing personal and nursing care for 13 older persons. On the day of the inspection there were 12 people living in the home. The home is a converted bungalow situated in Belton, a village located on the outskirts of Grantham. A garden area is located at the rear of the home and there is car parking space to the front of the property. All accommodation is situated on the ground floor. There are 7 single bedrooms one with en-suite and 3 shared bedrooms each with en-suite. The home has one lounge/dining room and an adjacent conservatory. The fees at the inspection visit on the 10/1/2008 ranged from £400 to £500 per week. Extras are for hairdressing which ranged from £9.75 to £23, chiropody £10, toiletries and personal newspapers and magazines. Information about the home together with the statement of purpose and service user’s guide can be obtained from the manager. Belton Lodge Nursing Home DS0000002587.V356645.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection visit was unannounced and started at 8.00 am. It was done using a review of all the information available to us about Belton Lodge Nursing Home. We spoke with 6 residents, one visiting community nurse, 3 staff and the deputy manager. We telephoned the owner after our inspection visit. The main method of inspection was called “case tracking”. This involved selecting one resident and tracking the care they received through the checking of records, discussion with them, the care staff and observation of their care. As a result of our inspection visit. The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. What the service does well: What has improved since the last inspection? What they could do better: Nurses and the manager need to ensure that care records contain clear information about all the care and support needs of the residents. Quality of the overall service must be addressed. The emphasis must be on obtaining views of the residents about what they want to do during the day and how they wish to spend their lives. Monitoring needs to be provided so that care planning, medication, training, environment and records are of a high standard. The owner/manager must ensure that all staff have a good command of the English language and are aware of the cultural needs and care needs of the residents. All staff need to have the skills to care, engage and help and support the residents. Belton Lodge Nursing Home DS0000002587.V356645.R01.S.doc Version 5.2 Page 6 Care staff and nurses must have formal regular staff supervision and receive training both formal (National Vocational Qualifications) and informal (in house training) to meet the changing needs of the residents in the home. 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. Belton Lodge Nursing Home DS0000002587.V356645.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Belton Lodge Nursing Home DS0000002587.V356645.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 3 and 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is information available about the home but it still does not accurately describe the type of person who can be admitted to the home. People receive an assessment, which results in their needs being met. EVIDENCE: Since the last inspection no new resident had been admitted to the home. We could see that where a new resident was admitted to the home the manager would assess them and written confirmation would be sent to confirm the home was able to meet their needs. There was a detailed statement of purpose and service user’s guide; a copy of which was in a number of residents’ bedrooms. However, it was still not reflecting what the home was registered for. At previous inspections the owner was required to remove any reference to the home being registered to admit residents who were mentally frail and also that the home had ten beds for dementia. We had been given assurances this was Belton Lodge Nursing Home DS0000002587.V356645.R01.S.doc Version 5.2 Page 9 to be done. At this inspection this information was still evident as was information that the registered manager was the acting manager. This needed to be further amended. After the inspection visit we telephoned the homeowner who acknowledged this had not been done but that it would be fully updated as soon as a possible. The home did not provide intermediate care. Belton Lodge Nursing Home DS0000002587.V356645.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 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. Medication is safely given by staff who know what they are doing. However, residents’ health needs are not fully being met, as care planning does not always reflect the actual needs of all the residents. EVIDENCE: All residents had care plans. Records included an assessment of their needs, dependency assessment, risk assessment with the signature of the resident/relative, specific care plan outlining the care and support, daily record and evidence of monthly review. However, when we looked in detail at the care plan for one resident it did not reflect all their care needs. We also talked to a visiting community nurse who was coming to monitor the condition of a resident. She explained that she was treating a minor pressure sore on the resident’s heel. When asked about her views about the home, she commented, “I find there is lack of consistency, haphazard management, staff have poor command of English and do not seem to know about the needs of Belton Lodge Nursing Home DS0000002587.V356645.R01.S.doc Version 5.2 Page 11 the residents”. She had advised that the resident had a programme to change position when in bed to prevent further pressure damage and noted a dressing had come off. We asked the deputy manager whether there was a turning chart to confirm the resident’s position had been changed to ensure her care request was carried out. We were told by the deputy manager that the staff follow instructions left by the nurse but that the information available had not been added to the care plan. We looked at the care plan but there was no information available about the pressure sore and what dressing was required. We were however shown clear records which were also kept in the home from the community nurse in a separate folder. This showed us that the care needs of residents were not always fully transferred and reflected in their actual care plans. Staff were seen to attend to the residents promptly, in a dignified manner and with little fuss. They spoke to them in a kind, calm and friendly manner. The deputy manager confirmed that each nurse was assessed by the manager and considered competent to administer medication. We observed a medication round and saw medication being dispensed from a trolley, checked against the chart, then given to the resident and signed for after this. Belton Lodge Nursing Home DS0000002587.V356645.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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. The catering arrangements have improved by the installation of a new kitchen and meals provided were nutritious and varied. Although there are social activities provided they may not be what the residents want. EVIDENCE: Activities in the home were provided by staff. There was a written activities programme. Activities took place ever day. These included pass the ball, hand massage, gentle movements to music and hairdressing every week. During our inspection visit we saw no activities taking place. Residents were watching the television in the lounge or dosing in front of the television. Other residents were in bed or in their rooms. We saw no evidence that staff were spending time talking to the residents and although 5 of them told us they were happy in the home we saw no staff engaging with them. Comments were, “I am quite happy here” and “staff are very kind”. We noted the last residents’ meeting took place in 2005. The home must find out from residents as a routine what they wish to do and whether they want to watch the television. There was little evidence of choice being shown. Since the last key inspection visit great efforts have been done to improve the catering arrangements. A new kitchen was installed in December 2007. Belton Lodge Nursing Home DS0000002587.V356645.R01.S.doc Version 5.2 Page 13 Storage and cleanliness had improved. The kitchen was clean, tidy, well organised and well stocked with meat, fresh fruit and vegetables. The cook was appropriately dressed and there were clear up to date records of food, menus, food temperatures and cleaning rotas. Lunch was observed in the dining room, which was nicely decorated with residents having lunch attended by care staff who wore plastic aprons and served food in a discreet manner. Tables were set with tablecloths and artificial flower decorations. No resident had any complaints about the food and it was well served and residents were not hurried. Comments were, “I had a very nice breakfast and enjoy the meals”. The menu was displayed on the wall. We had been informed by Lincolnshire County Council’s Quality Monitoring dept. that there was concern brought to their attention that residents’ meals were hurried so that staff could have their meals. We saw no evidence of this and were told that lunch was served at 12 midday with staff meals 1.30 to 2.30 pm. We later saw residents enjoying segments of oranges, which had been served by staff. Belton Lodge Nursing Home DS0000002587.V356645.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints received were treated properly and residents and visitors knew that any complaints they had to make would be addressed and taken seriously. Staff members know to act in order to protect people from abuse. EVIDENCE: There was a complaints procedure displayed at the entrance to the home and each person received a copy of the complaints procedure in the service user’s guide. The home and the commission had received no complaints since the last inspection. No one had any complaints about the home during our inspection visit. We were made aware of an adult protection issue, which was thoroughly investigated by Lincolnshire County Council in November 2007. The issues were not upheld and the home fully co-operated with the investigation. Staff were correctly recruited with an application form, references obtained, and induction. Two new members of staff confirmed they had been recruited with a criminal records bureau check and a well supported induction. Staff knew about abuse and their role and training had been provided for all staff on abuse prevention during 2007. The home also had a copy of Lincolnshire’s adult Protection Policy. None of the residents or staff had any concerns about the home. Belton Lodge Nursing Home DS0000002587.V356645.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Since the last key inspection the environment in the home has been considerably improved and now provides the residents with safe, well maintained and comfortable accommodation. This has improved the overall quality of their lives. EVIDENCE: Since the last inspection we have had a meeting with the owner of the home and impressed upon him the need to improve the environment of the home. At this inspection visit we could see a great deal had been done to improve the decoration of the home. Changes had resulted in a new kitchen. We saw that new wooden flooring had been laid in the corridors, the lounge/dining room and in one bedroom. New carpets had been laid in each bedroom. All toilets had been redecorated; the existing bathroom had been redecorated, retiled and made less clinical with decorative wall tiles. Another bathroom was in the process of being made into a walk in shower. The conservatory was now finished providing a pleasant alternative to the lounge area for residents to sit. Belton Lodge Nursing Home DS0000002587.V356645.R01.S.doc Version 5.2 Page 16 In addition, new PVCu windows had been completed and installed. The home was clean, tidy, well decorated and odour free throughout. We looked at the call system as this was highlighted as needing attention in our last inspection report. We had been assured it was fully functioning. We tested each call point in all bedrooms. All were functioning correctly apart from one of the call panels in bedroom 3 a double room. We also were concerned to see that in bedrooms 2 and 7 the cord was out of reach of the resident. This was also later discussed with the owner who agreed to attend to these issues. There was an infection policy and staff wore gloves and aprons. There were 2 commercial washing machines and one commercial tumble dryer. The laundry room was better organised. The sluice odour had been attended to. Clinical waste was well managed. Belton Lodge Nursing Home DS0000002587.V356645.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents are protected by recruitment practices. However, not all staff are trained or skilled to care and support older people safely. Some staff members lack communication skills and this could put them and residents at risk. EVIDENCE: Since our last inspection visit training had covered fire prevention and health and safety, which was taking place during our inspection visit. The manager had assured us that further training was to take place covering infection control and dementia in the future. This training had not taken place. We discussed the number of staff with qualifications in care (National Vocational Qualifications). No care staff had an NVQ and only one out of 4 care assistants was studying for an NVQ. There was also no training plan in place. There were 4 registered nurses and 4 care assistants employed. There were 2 vacancies 1 for domestic and 1 for care assistant. When talking to staff we were concerned that a new member of staff could not speak English. We had this confirmed by the deputy manager and asked why the person had been employed when she could not communicate in English. We impressed upon the deputy manager that all staff should have the communication skills to both Belton Lodge Nursing Home DS0000002587.V356645.R01.S.doc Version 5.2 Page 18 carry out their work safely and understand the needs of the residents regardless of their role. Belton Lodge Nursing Home DS0000002587.V356645.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 33, 36, 37 and 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The day-to-day management direction and organisation of the home was disorganised, which affected the overall service to residents and support to staff. There was little information available to show that the residents were receiving a quality service. EVIDENCE: The manager was an experienced registered nurse and had extensive care and management experience. She continued to study for a management qualification. The deputy manager told us that regular staff supervision was not taking place. Staff felt that the management however were supportive. Belton Lodge Nursing Home DS0000002587.V356645.R01.S.doc Version 5.2 Page 20 We found the management systems in the office, haphazard, poorly organised with duplicated old policies and procedures. A new policy and procedure folder, which was available at the previous inspection, could not be found initially. This was eventually found on the floor under a desk. The deputy manager had seen it but was not sure whether any of the new policies had been addressed. We noted that we had raised this question with the manager at the previous inspection. New procedures for staff supervision, meal planning and nutrition (which was detailed and made references to culture and dietary preferences), discharge/transfer, equipment register, nutrition, key worker, service user assessment and care planning and admission had been provided in March 2007. However, the deputy manager acknowledged these had still not been introduced. We spoke with 6 of the residents all of whom were satisfied with the care and approach of staff. Comments were, “I like it here” and “I am very happy”. However, we saw no evidence that any quality assurance audits had taken place since our last inspection visit. At our meeting with the owner in November 2007 we impressed upon him the outstanding requirement that monthly unannounced monitoring visits must take place to ensure that the owner was aware of what was going on in the home. We received a letter informing us that this would take place from January 2008 and that we would receive a report of each visit. We could see that the owner carried out quality assurance audits in June 2007 (audit of kitchen, conservatory, risk assessments, fire and health and safety), and in September 2007 (audits to follow up our inspection report and action regarding the kitchen, replacement carpeting and flooring). No further audits had taken place since then. We discussed this with the owner after our inspection visit. We were told he would visit again during January 2008 to follow issues up and reorganise the office and management systems. The owner acknowledged quality assurance needed to be addressed. The deputy manager told us that no resident surveys had been carried out since March 2007. There was a detailed equal opportunities policy, which referred to discrimination, disability and victimisation. We were concerned that there were staff who had difficulty communicating with the residents on account of their poor command of the English language. This had the potential to put them and the residents at risk. Belton Lodge Nursing Home DS0000002587.V356645.R01.S.doc Version 5.2 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X x 3 3 STAFFING Standard No Score 27 2 28 1 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 2 2 X X 2 1 2 Belton Lodge Nursing Home DS0000002587.V356645.R01.S.doc Version 5.2 Page 22 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 4 and 5 Requirement The statement of purpose and service user’s guide and information about the home must accurately describe the registration category of people able to be admitted to the home. References to the home being specialised to provide care for the elderly mentally frail and with dementia must be removed. This will ensure that the correct category of residents will be admitted to the home. The previous timescale of the 15/10/2007 had not been met. The manager must ensure that each resident has a care plan, which has been produced wherever possible with the involvement of the resident or their advocate which accurately describes all their care needs. This will ensure that at all times staff responsible for their care and support know what care and treatment is required and how it is to be delivered. The manager must find out from each resident/advocate about DS0000002587.V356645.R01.S.doc Timescale for action 24/02/08 2 OP7 14(2)(b) 24/02/08 3 OP12 16(2)(n) 24/02/08 Page 23 Belton Lodge Nursing Home Version 5.2 4 OP30 18(1)(a) 5. OP22 23(1)(c) what activities they wish to have provided for them. The emphasis must be on providing activities to suit the residents. These activities should be kept under review. This will ensure that the activities provided in the home are what the residents themselves want and provide a more stimulating atmosphere. The manager and owner must 24/02/08 ensure that suitable staff are employed in the home who have the communication skills and knowledge to understand, communicate and engage with elderly residents and work in a safe manner. Where they do not have these skills training in care formal training (NVQ) and in house training should be provided. 24/02/08 The call system must be accessible (including positioning the cord within reach of residents when in their bed) and function correctly at all times and have regular tests and maintenance. This will ensure that in case of an emergency a resident can summon assistance, staff know from the central display where the assistance is required and can cancel the request. The timescale of the 24/8/2007 had not been met. The manager and owner must introduce and maintain a system for evaluating the quality of the services provided at the care home. The company’s new policies and procedures introduced in March 2007 must be introduced. This includes taking into account the views of residents and their DS0000002587.V356645.R01.S.doc 6 OP33 24 24/03/08 Belton Lodge Nursing Home Version 5.2 Page 24 representatives about the home. This also includes introducing regular professional audits of care records, medication, environment, catering and staff training/supervision. This will ensure that a quality service is provided. 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 OP36 Good Practice Recommendations Care and nurses should receive formal supervision 6 times a year covering aspects of practice, philosophy of care in the home and their career development needs. This will ensure that staff are supported and their practice and performance monitored. Belton Lodge Nursing Home DS0000002587.V356645.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Belton Lodge Nursing Home DS0000002587.V356645.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. 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