Inspection on 11/07/06 for Birch Heath Lodge Nursing Home

This inspection was carried out on 11th July 2006.

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

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

Other inspections for this house

Birch Heath Lodge Nursing Home 17/04/07

Birch Heath Lodge Nursing Home 13/01/06

Birch Heath Lodge Nursing Home 14/06/05

Birch Heath Lodge Nursing Home 18/01/05

Birch Heath Lodge Nursing Home 03/08/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Birch Heath Lodge Nursing Home Birch Heath Lodge Birch Heath Lane Christleton Chester Cheshire CH3 7AP Lead Inspector Wendy Smith Key Unannounced Inspection 11th July 2006 9:45 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 Birch Heath Lodge Nursing Home DS0000018712.V299509.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. Birch Heath Lodge Nursing Home DS0000018712.V299509.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Birch Heath Lodge Nursing Home Address Birch Heath Lodge Birch Heath Lane Christleton Chester Cheshire CH3 7AP 01244 335503 01244 335503 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) ThName of registered manager (if applicable) Type of registration No. of places registered (if applicable) Birch Heath Lodge Limited Mrs Ann Evans Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places Birch Heath Lodge Nursing Home DS0000018712.V299509.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 38 service users in the category of OP (Old age, not falling within any other category) 13th January 2006 Date of last inspection Brief Description of the Service: Birch Heath Lodge is a listed building that has been converted and extended into a nursing home for older people. The home consists of the main house and the Greenwood unit, which is a separate building in the same grounds. It is situated in a conservation area in the centre of the village of Christleton, approximately four miles from Chester. The home enjoys close links with the local community and some amenities are provided in the village. There is a bus service to Chester. The home can accommodate up to 38 residents in bedrooms on two floors. A passenger lift provides access to most, but not all, levels of the building. There are also two stair lifts. Part of the first floor in the main part of the building is used for office and staff facilities. There are two lounges, a conservatory, a dining room and other communal areas. The current weekly fees are from £462 to £604. Birch Heath Lodge Nursing Home DS0000018712.V299509.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection process for Birch Heath Lodge included a site visit to the home on 11th July 2006 which was unannounced and was completed in one day. Time was spent talking with the manager, staff and residents, and observing the day-to-day routines of the home and care staff as they provided support. The building was looked at to assess its suitability to provide a comfortable, homely environment for the enjoyment of everyone and ensure their safety. A sample of care plans and other records was looked at and the arrangements for medicines were reviewed. Before the visit, comments cards were sent to residents and relatives and some very positive comments were made including ‘the staff are always cheerful and helpful; I am very happy here; I could not be in a nicer place than this’. Comments cards have also been sent to GPs and other professionals who visit the home. The home manager completed a pre-inspection questionnaire. The home promotes equality by treating people as individuals and ensuring that diversity needs such as impaired mobility and gender are appropriately met. People who use the service confirmed that care staff are kind, caring and responsive to meeting individual’s needs. The home had 34 residents who were receiving nursing care. There was one vacant room which had been prepared for a new resident who was due to be admitted to the home the day after the visit. All rooms were singly occupied although some may be used as a shared room for two people by choice. What the service does well: No new residents are admitted to the home without a full assessment to demonstrate that their needs can be met. A number of residents were able to confirm that they had made a positive choice to live at Birch Heath Lodge and had received enough information to enable them to make this choice. Residents were satisfied that their health needs are met and the care plans showed that they receive regular visits from GPs and other health professionals who support the nurses employed at the home. This home has always taken pride in providing a high standard of catering and in meeting individual dietary needs and preferences. Residents confirmed that the standard has been maintained. Birch Heath Lodge Nursing Home DS0000018712.V299509.R01.S.doc Version 5.2 Page 6 Staffing levels were increased in 2005 and are maintained to meet the care needs of residents. More than 50 of care staff have achieved a national vocational qualification in care. What has improved since the last inspection? What they could do better: Ensure that all parts of the care plans are filled in and provide evidence that residents and/or their relatives have been consulted about the care plan. Ensure that all medicines are given as prescribed and are signed for properly on the medication administration record. Investigate any missed doses and missed signatures. As part of the ongoing development, the provider plans to upgrade two of the bathrooms in the main house to provide better bathing facilities for residents who have mobility difficulties. If the kitchen doors are open it is advisable that suitable screens are put in place to prevent flying insects from entering the kitchen and contaminating food. Birch Heath Lodge Nursing Home DS0000018712.V299509.R01.S.doc Version 5.2 Page 7 Following the installation of new laundry equipment there is a patch of floor in the laundry that needs to be repaired to ensure that it can be properly cleaned and disinfected. Obtain two written references for all new staff. Ensure that all staff have regular moving and handling updates and that new staff can have moving and handling training before they move any residents. Continue to develop a quality monitoring system that is appropriate to the size and nature of 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. Birch Heath Lodge Nursing Home DS0000018712.V299509.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 Birch Heath Lodge Nursing Home DS0000018712.V299509.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 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 judgement has been made using available evidence including a visit to this service. Residents have chosen to live at this home and their needs can be met. Intermediate care is not provided. EVIDENCE: A new resident was to be admitted to the home on the day after this visit. Information about this gentleman’s needs, preferences and abilities were available for staff. He had been to visit the home with his relatives and was pleased with the room available which is light and airy and has en-suite facilities. The last resident to be admitted had come into the home as a matter of urgency but a full assessment was received from a social worker. The pre-inspection questionnaire completed by the home manager recorded that two residents have dementia. Their needs were discussed with the manager and it was evident that they required nursing care due to health needs and did not require a more specialist environment. Birch Heath Lodge Nursing Home DS0000018712.V299509.R01.S.doc Version 5.2 Page 10 The manager said that either she or her deputy goes to visit all prospective residents before admission is agreed. Nine residents who completed a questionnaire said that they had received sufficient information about the home prior to admission. Birch Heath Lodge Nursing Home DS0000018712.V299509.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 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 judgement has been made using available evidence including a visit to this service. Residents expressed their satisfaction with the care they receive but there is room for some further improvement to the care plans. Arrangements for the storage and administration of medicines have improved but some more work is needed. EVIDENCE: Nine residents completed comments cards and of these, three said that staff are always available when needed and six said that staff are usually available. Eight said that they always receive the medical attention they require and the other one said usually. A sample of four care plans was looked at. All of the care plans contained a good assessment of the resident’s needs but none were signed or dated at the bottom by the nurse who did the assessment and none had been signed by the resident or their relative to demonstrate that they had been consulted and that the care plan had been shared with them. The assessment for a resident who has lived at the home for a number of years and is now very poorly had been Birch Heath Lodge Nursing Home DS0000018712.V299509.R01.S.doc Version 5.2 Page 12 updated in May 2006 to reflect the change in her condition. The care plan for another resident recorded in detail his personal choices and preferences in daily living. The care plans consist of a set of documents in a ‘Standex’ form. There were a number of documents that were either not completed at all or were filled in spasmodically. Some of the forms are not relevant to the needs of all residents and it is advisable to remove those that are not needed. The section in the care plan to record the resident’s wishes in the event of their death had not been filled in on any of the care plans looked at. It is important that the care plans should reflect the wishes of the resident. The care plan looked at for a relatively independent resident contained a meaningful comment each day about what she had done and how she was feeling. The care plans recorded visits by GPs and other health professionals. A speech and language therapist was visiting one of the residents on the day of this visit. Pressure sore risk assessments are recorded and pressure relieving mattresses are available for those residents who need them. One resident was admitted to the home with a grade 4 pressure sore on her heel. The treatment and progress of the wound was well recorded. One of the home’s nurses has lead responsibility for wound care. Residents have a moving and handling plan and a range of equipment is provided to enable staff to move residents safely. The deputy matron takes lead responsibility for ordering medicines. Medicines systems have been reviewed and updated over the last few months and the medication administration records are now pre-printed by the supplying pharmacy. A much better system is now in place. Medicines are supplied in bottles or boxes and there are two new medicine trolleys for the main building. Both on the Greenwood unit and in the main building there were some unexplained gaps in the administration records and there was no evidence that these had been investigated. One resident had been prescribed a course of antibiotics. The tablets were to be given three times a day and she should have received 15 tablets from the start date but only 12 had gone from the pack. There were several instances where residents had gone out with a friend or relative during the day and had missed their medication. These were coded ‘L’ for leave on the medication administration sheet. This is not acceptable. The home’s staff must ensure that arrangements are in place to ensure that all medicines are given as prescribed. There were also some examples of ticks being used instead of signatures. These concerns were discussed with the manager who agreed that there should be a more effective method of auditing medicines and investigating any Birch Heath Lodge Nursing Home DS0000018712.V299509.R01.S.doc Version 5.2 Page 13 missing signatures and any missed doses. She has confirmed that immediate action has been taken to address the short-comings with all of the nurses. The deputy matron said that she will be attending a Safe Handling of Medicines course with Halton College starting in September. Birch Heath Lodge Nursing Home DS0000018712.V299509.R01.S.doc Version 5.2 Page 14 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy a good quality of life with their choices respected and a high standard of catering. EVIDENCE: Residents who completed a questionnaire and those spoken with during the visit expressed their satisfaction with the home. Comments received included: the staff are always cheerful and helpful; I am very happy here; I could not be in a nicer place than this; the care, food and staff are all brilliant; staff will always act on any reasonable request; there is a very good quality of food at all times; the food is excellent in every way, special care is taken to meet individual needs. The home has a social activities organiser who arranges a group activity for residents twice a week. A monthly programme is displayed. This includes gentle exercises and visiting speakers. The home is within very close proximity to the local church and a number of residents enjoy going to church. A mobile library visits regularly. Several residents go out regularly with friends and family. Birch Heath Lodge Nursing Home DS0000018712.V299509.R01.S.doc Version 5.2 Page 15 The activities organiser keeps a record of what events have taken place and which residents participated. She said that she would benefit from more training and sharing ideas with other people who do the same job. She has received a letter from the Primary Care Trust who are proposing to facilitate a forum for activities organisers working in care homes. She has also visited another home to share ideas. Most residents have taken the opportunity to personalise their bedroom with their own belongings including pictures and small items of furniture. Residents were smartly dressed and the laundry assistant said that she takes great pride in looking after resident’s personal clothing. Birch Heath Lodge Nursing Home DS0000018712.V299509.R01.S.doc Version 5.2 Page 16 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 judgement has been made using available evidence including a visit to this service. Residents and their relatives are aware of how to make a complaint but none have felt the need to do so. EVIDENCE: All of the residents and relatives who completed a questionnaire indicated that they knew how to make a complaint, and the home’s complaints procedure is displayed in the entrance area. No complaints have been recorded at the home and none have been received by the Commission for Social Care Inspection. The home has policies and procedures for the protection of vulnerable adults. Two training sessions have been provided for staff and a third is planned for 28th September 2006. The manager said that all staff will then have received the training. Birch Heath Lodge Nursing Home DS0000018712.V299509.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 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 judgement has been made using available evidence including a visit to this service. Residents live in a comfortable, safe, clean and well maintained environment. EVIDENCE: There have been considerable improvements to the environment. The main lounge and reception area have been refurbished to a very high standard and have comfortable new chairs. A number of bedrooms and the communal areas on Greenwood unit have been redecorated and have new soft furnishings. On the day of this visit the home’s maintenance person was decorating a corridor in the main building. He was aware of plans to re-carpet the corridors when the decorating is completed. The gardens are well tended by a contract gardener. Birch Heath Lodge Nursing Home DS0000018712.V299509.R01.S.doc Version 5.2 Page 18 There have also been improvements in the laundry and kitchen. An ozone system for the control of infection is used in the laundry. Following the installation of new equipment, a patch of flooring needs to be replaced in the laundry. The kitchen has been re-arranged and new fridges and freezers are housed in a store room close to the kitchen. There is some new shelving that is designed to be easy to clean. The chef said that he had been consulted about changes to the kitchen and he had implemented new kitchen cleaning schedules. During this visit, the internal and external kitchen doors were wide open. Fly screens need to be fitted to keep out insects. The manager said that they were intending to install a chain system. Two bathrooms would benefit from upgrading and the manager said that this is included in the future development plan for the home. Eight residents who completed a survey said that the home is always clean and fresh and one person said usually. All parts of the home were clean on the day of this visit and there were no unpleasant odours. Birch Heath Lodge Nursing Home DS0000018712.V299509.R01.S.doc Version 5.2 Page 19 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Suitably qualified staff are provided to meet the needs of residents EVIDENCE: The home employs nine registered nurses, with two others who provide occasional cover. There are 22 care staff, 12 of whom have a National Vocational Qualification in care and four are working towards this. Two nurses and six care staff are on duty in a morning. In the afternoon there are usually two nurses four carers, and in the evening one nurse and four carers. At night there is one nurse and three carers. There is very little use of agency staff. There are also ten ancillary staff. Staff spoken with were friendly and seemed well-motivated in their work. They were smart and professional in their appearance. A ‘small things make a difference’ award has been introduced, which rewards staff who have taken some special initiative to enhance the daily lives of residents. The manager arranges a monthly social event, for example a meal out, for staff. Birch Heath Lodge Nursing Home DS0000018712.V299509.R01.S.doc Version 5.2 Page 20 Personnel files for the three most recently recruited staff were looked at. All had a completed application form and a Criminal Records Bureau disclosure but two had only one written reference, although there was evidence that a second reference had been sent for. The manager said that these were both staff who were already known to her but she was pursuing a second reference for them. The home has joined the Cheshire Consortium for staff training and there was evidence that a wide range of training opportunities had been provided for staff in recent months including fire safety, protection of vulnerable adults, moving and handling, infection control, tissue viability, oral health care, nutrition, food hygiene communication, and eye care. There is an induction programme for new staff and each member of staff has an individual training record. There is a training area in the staff room and information is available for staff to read. New policies and procedures are put out for staff to read and sign. The records showed that most staff had not received a moving and handling update in recent months and the home needs make arrangements to address this and to ensure that new staff have training before they assist any residents with moving. Birch Heath Lodge Nursing Home DS0000018712.V299509.R01.S.doc Version 5.2 Page 21 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 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and there is an ethos of openness and inclusiveness, with commitment to taking the service forward. EVIDENCE: The home has an experienced manager who is a registered nurse and is registered with the Commission for Social Care Inspection. She is working towards a management qualification. The manager works alongside staff three days a week and uses this opportunity to monitor standards of care and to supervise staff. The home’s administrator is also a nurse and has worked at Birch Heath Lodge for 21 years. The home owner is also present in the home for three days a week and is very involved in the day to day running of the home. Birch Heath Lodge Nursing Home DS0000018712.V299509.R01.S.doc Version 5.2 Page 22 A notice in the staff room showed that a staff meeting, followed by a training update, was arranged for 20th July 2006. The manager said that there are also plans for an event with relatives and visitors. Some more formal auditing tools have been piloted. A comment from a resident was that the matron or deputy frequently call on residents in their rooms and allow time to talk, but another resident felt that people are always in a hurry and don’t have time to talk. The home’s policies and procedures are being updated. Staff do not assist residents with their finances but small amounts of personal spending money can be put in the home’s safe and records are kept. The preinspection questionnaire indicated that three residents are able to control their own finances and 20 have a power of attorney arrangement. A considerable amount of new equipment has been provided during the last year including a new nurse call system. Information provided in the preinspection questionnaire indicated that all plant and equipment are regularly tested, serviced and maintained by contractors. The fire book showed that the alarm system is tested weekly by the maintenance person and the emergency lighting is tested monthly. Bedroom doors are fitted with automatic closing devices. Birch Heath Lodge Nursing Home DS0000018712.V299509.R01.S.doc Version 5.2 Page 23 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 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 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 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Birch Heath Lodge Nursing Home DS0000018712.V299509.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO 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 OP9 Regulation 13(2) Requirement Ensure that residents always receive their prescribed medication. Ensure that accurate records of medicine administration are kept. Obtain two written references for all new staff. Ensure that all staff providing direct care to residents are up to date in the principles and best practice of safe moving and handling. Timescale for action 17/07/06 17/07/06 2 OP9 13(2) 3 4 OP29 OP30 19 schedule 2 18 17/07/06 30/09/06 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 Ensure that all sections of the care plans are filled in. DS0000018712.V299509.R01.S.doc Version 5.2 Page 25 Birch Heath Lodge Nursing Home 2 3 OP26 OP26 Fit fly screens to the kitchen doors. Repair the laundry floor. Birch Heath Lodge Nursing Home DS0000018712.V299509.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Birch Heath Lodge Nursing Home DS0000018712.V299509.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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