Inspection on 15/02/06 for Birchwood House Rest Home

This inspection was carried out on 15th February 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Birchwood House Rest Home 22/07/08

Birchwood House Rest Home 03/03/08

Birchwood House Rest Home 27/11/07

Birchwood House Rest Home 11/07/06

Birchwood House Rest Home 14/06/05

Birchwood House Rest Home 20/12/04

Birchwood House Rest Home 24/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Birchwood House Rest Home Stockland Green Road Speldhurst Tunbridge Wells Kent TN8 5DB Lead Inspector Mrs Ann Block Announced Inspection 15th February 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Birchwood House Rest Home DS0000023895.V260488.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Birchwood House Rest Home DS0000023895.V260488.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Birchwood House Rest Home Address Stockland Green Road Speldhurst Tunbridge Wells Kent TN8 5DB 01892 863559 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) Malvirt Limited Mrs Janice Eileen Collins Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places Birchwood House Rest Home DS0000023895.V260488.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th June 2005 Brief Description of the Service: Birchwood House provides accommodation for up to 38 older people. The house is a detached property with accommodation on four floors, standing in its own large landscaped grounds. The home is located in a rural area on the outskirts of a small village. The nearest public transport, pub, church and post office are approximately one mile away. There is car parking to the front of the premises. All bedrooms have en suite facilities with WC, call points and TV points. Many rooms have telephone points. There is a shaft lift to all floors in the main house and a stair lift to the three rooms in the annex. A few rooms require access up stairs. There is no designated guest room but if a room is free, arrangements can be made for guests to stay overnight. Communal facilities include two lounges, a conservatory and dining room on the ground floor with a smaller lounge on the first floor. A domiciliary care service is run from offices in the house. Birchwood House Rest Home DS0000023895.V260488.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The commission was represented by regulatory inspector Ann Block who carried out an announced inspection of the home between 9.30 am and 22.40 pm on Wednesday 15th February 2006. Some residents, staff, the manager and provider agreed to speak with the inspector both privately and in small groups. Judgements for this report have been made from these conversations, observation, a partial tour of the home, pre inspection information provided by the manager and relevant records. As the inspector is familiar with the service, some assessments include information gathered at previous inspections where still relevant. Feedback was given to the manager and provider during and at the end of the inspection. Opinions of the service from relatives included: ‘My great aunt is very happy in the home and the staff seem to be very caring and attentive’ ‘My mother in law is happy and contented at Birchwood House which makes us her family happy and reassured’ ‘An excellent rest home, my mother in law was at Birchwood for nine years and my aunt has been at Birchwood for two years’ What the service does well: Prospective residents have good information to decide whether they wish to move into Birchwood House. Residents like having the opportunity to ‘test run’ the home by trial stays or respite care. Residents’ needs and wishes are well understood by staff. Health care is accessed both in house and locally. Residents consider that staff treat them with dignity and respect with privacy maintained. Care is provided as far as possible throughout all the stages of older age. Residents feel that the home meets their expectations, being in a lovely rural setting and nicely decorated. They have opportunities for activities which they can choose whether to attend. Contact with friends and family is encouraged with visitors made welcome. Residents are encouraged to make decisions about their lifestyle. Food is plentiful, well liked and home cooked. Each room has a private toilet and washbasin. Bathrooms are provided that meet the needs of older people. Domestic staff keep the home clean. Staff have good relationships with residents and are expected to work to high standards. The home is managed by a person with many years experience in Birchwood House Rest Home DS0000023895.V260488.R01.S.doc Version 5.0 Page 6 the care sector. Residents have people who they can talk to about life in the home. Regular servicing of supplies and equipment promotes safety. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Birchwood House Rest Home DS0000023895.V260488.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Birchwood House Rest Home DS0000023895.V260488.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 & 6 Prospective residents can make an informed choice whether Birchwood House is suitable for them through good information and sound admission procedures. EVIDENCE: Prospective residents have access to a statement of purpose and service users guide which gives good information about the service. Copies are placed in residents’ rooms. A resident said that family had visited various homes in the area on her behalf and had chosen Birchwood House for her, she felt they had made the right decision. During the inspection arrangements were being made for the manager to visit a prospective resident to assess whether Birchwood House would be suitable. Assessments also take place following hospital stays. The manager is clear about the care that can be provided and staff skills and experience necessary to meet identified needs. Supplementary information is obtained from other professionals, such as care management and health professionals, as part of this assessment process. Each resident will be admitted for a trial period. The assessment and trial period is confirmed through a contract. Often residents have periods of respite care before making Birchwood House Rest Home DS0000023895.V260488.R01.S.doc Version 5.0 Page 9 the final decision to move into the home. Permanent residents have mentioned how they like having someone new to talk to. Residents appreciate the opportunity to have a ‘trial run’ and to extend an initial trial period. Respite care is also used to give the primary carer a break or to offer a transition between a hospital stay and returning home and may link to the Company domiciliary care service. The home does not formally provide for rehabilitative intermediate care. Birchwood House Rest Home DS0000023895.V260488.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 & 11 Care and health needs are well met, developments to records of care would better evidence how they are met. EVIDENCE: Each resident has an individual plan of care with separate records of daily life. Care plans for two residents were assessed in detail. Care plans contain a range of information and wherever possible are signed by the resident concerned. Staff use the main care plan as core information to care for the resident, staff have a greater knowledge of the resident than is routinely recorded in the care plans. Care plans are divided into key aspects of daily living with each area regularly reviewed. Staff are diligent in recording in daily notes, key information is usually transferred into the main care plan. Staff understand residents rights to take risk with some risks assessed through a well structured format, this process would benefit from being customary practice. Health care is well managed with the assistance and support of local health professionals. A GP visited during the inspection as staff were concerned Birchwood House Rest Home DS0000023895.V260488.R01.S.doc Version 5.0 Page 11 about the health of a resident. Residents spoke of seeing the district nurse and of attendances at specialist services. Outcomes from visits arranged by the home are recorded in daily notes under a separate health section. Care files hold some detail of medical and health needs but are not sufficiently comprehensive. Weight monitoring is used as part of health awareness. Medication is administered via the Nomad monitored dosage system. Following a specialist CSCI pharmacy inspection, the manager said that recommendations made had been carried out. That residents receive the right medication at the right time was properly recorded in medication administration records. A resident said he was happy that overall his medication was administered correctly and at the right time. Care is taken to ensure any changes to dose or time are suitably validated by the prescriber. Residents felt that staff treated them with respect. One resident confirmed that without exception staff knocked at his door. He felt that his right to privacy was very well acknowledged. Privacy is also maintained by the use of lockable toilets and bathrooms. Locks can be provided for bedrooms on request. Residents have a payphone for exclusive use and a mobile phone which is shared with the office line. Many have their own phones installed. The manager recognises that for many residents Birchwood House becomes their home, hence wherever possible residents are cared for throughout the stages of older age, often with the support of the local General Practitioner and district nurse. Records of last wishes are not reliably incorporated in the care plan. Birchwood House Rest Home DS0000023895.V260488.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Residents have the satisfactory quality of life they expect when they choose to move into Birchwood House. EVIDENCE: A number of residents moved into Birchwood House having known the home or liking the rural setting, period style of house and large gardens. One resident mentioned that family commented positively that the home ‘didn’t smell’ and didn’t feel like their view of an ‘old persons home’. Staff provide activities when time allows during the day with one carer designated having activity coordinator role. Activities include reading aloud, craft work, video films, gentle exercise and weekly piano entertainment. Residents said they felt occupied during the day often reading or watching TV. A number of residents have a daily paper delivered. A trolley shop is to be reinstated as residents found this very useful. One resident said that she felt she would like to go out more but recognised that in reality she found going out quite tiring and preferred to spend time in her room where she could meet with family and friends when she chose. Visitors are welcomed with the visitors’ book recording many visitors to the home. A lounge with dining table on the first floor can be used for private visits. A number of residents maintain Birchwood House Rest Home DS0000023895.V260488.R01.S.doc Version 5.0 Page 13 contact with local churches, one resident spoke of having communion brought to her. Residents felt they were able to make choices about their lives, for example one resident spoke of going to bed around 10.30 which was the time he was used to at home. Some residents felt that staff availability and the needs of other residents meant they had to wait. A new cook was appointed recently. Residents spoke of her food as being ‘wonderful’. Mention was made of Eccles cakes and Danish pastries being made for tea, the quality of the beef and dumpling casserole for the day’s lunch where the dumplings were ‘as light as a feather’. The main meal is provided at lunch time, carers oversee supper which is usually a light meal or sandwiches. Jugs of drink are provided in each bedroom with drinks offered at other times. Individual dietary needs are met. One resident had requested a liquidised diet and this was being provided. Whilst this is by the choice of the resident, a referral should be made to a dietician or speech therapist for advice and support. Breakfast is brought to residents’ bedrooms, other meals can be taken in the lounge, dining room, conservatory or bedrooms. Birchwood House Rest Home DS0000023895.V260488.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17 & 18 Residents are protected from the risks of harm or abuse and can make comment about the quality of service provided. EVIDENCE: Complaints are seen as an integral part of monitoring that the service offers good care. Complaints are taken seriously with both verbal and written response provided to the complainant. Key records are held but would benefit from structuring to ensure that all stages of the complaint are recorded. Residents spoken with said they had people to whom they voice any concerns, but felt usually these were of a minor nature as overall they were happy to be at the home. A complaint procedure is on display and gives correct contact detail. Each resident is placed on the electoral roll and has the opportunity to make a postal vote if they choose. A number of staff have had adult protection training, others are booked for training later this year. The manager is to request the latest Kent and Medway adult protection policy as she takes protection of residents seriously and ensures residents in her care are protected and safe. Birchwood House Rest Home DS0000023895.V260488.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 & 26 Residents live in a pleasant and safe external and internal environment. Observation of small maintenance tasks would further improved safety. EVIDENCE: Residents like the décor of Birchwood House. The owner considers that provision of a quality environment is essential and ensures money is available to maintain these standards. Rooms are redecorated as needed, usually when there is a change of occupant. Two bedrooms have been joined to make a larger bed-sitting room. The annex is being upgraded in stages. The kitchen was refitted during 2005. A maintenance/gardener works two days a week. Some deficits in maintenance and garden tidiness spoil the otherwise good standards. A new system for reporting and accountability for maintenance tasks is in place. The manager carries out a regular walk round tour of the home to look at environmental standards, a system to include maintenance deficits would be useful. A fire risk assessment has been carried out. Birchwood House Rest Home DS0000023895.V260488.R01.S.doc Version 5.0 Page 16 A number of residents like to sit in the conservatory, others prefer one of the two good sized ground floor lounges, one of which has a TV. Many residents choose to spend time in their rooms which they are able to personalize. A number of bedrooms have views over the surrounding countryside. One room can be used for shared occupancy on request. Since the last inspection some beds have been replaced, other beds are being replaced as necessary. The conservatory gives stepped access to the rear garden, a separate door has level access to a patio area. The conservatory has recently had part of the glass roof replaced and the bougainvillea and grapevine pruned back. Aids and equipment are provided as assessed. An assistance call system is fitted. A lift provides access to each floor with a stair lift to the annex rooms. Even after extensive upgrading the lift has been unreliable, prompt action is taken to return it to working order. Three bedrooms require access via a short flight of stairs. There are three bathrooms in the main house, two with a Parker bath and one standard bathroom which is little used. The sit in bath in the annex is not used. Each room has its own toilet and washbasin. A toilet is sited near to the communal areas with a separate toilet for visitors and staff. Radiators and hot water pipes which have been risk assessed as presenting a risk have been covered. The majority of radiators can be controlled by the room’s occupant. Residents spoken to said they were warm enough, one said that she was a ‘hot bodied person’ hence had a floor standing fan for use if necessary. Domestic staff are employed for weekdays and are expected to maintain a good standard of cleanliness. Residents spoken to said that the standard of cleanliness was good, including keeping their toilet and washbasins clean. A laundry is provided with storage for clean linen and personal clothing. Residents commented that there had been problems with the laundry with a delay in items being returned, going missing or put in the wrong wardrobe. The manager explained delays had been due to faulty tumble driers which had been replaced, clothes which went missing (which she felt was a rare occurrence) would always be replaced. Birchwood House Rest Home DS0000023895.V260488.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Residents’ care and support needs are met by staff who are expected to work to high standards. EVIDENCE: The manager insists on high standards from staff and will take action where such standards are not met. Residents spoke well of contract staff who they felt were caring and took a pride in their work. Residents had a less positive view of some of the agency staff, also mentioning that whilst they had the same agency staff for a period, inevitably these would change and they would have to get used to new people again. One person has responsibility for running each shift. The planned roster allows for four care staff on duty each morning, three each afternoon/early evening with two waking night staff. The manager said that additional staff would be allocated to meet specific need such as where a resident required a higher level of care and attention. Shifts run from 7am until 1pm, 1pm until 7pm (which may be combined into a long day) and 7pm until 7am. A roster is held of both planned and actual hours. A cook and cleaning staff are employed. Care staff are responsible for some cleaning and catering duties within their rostered hours. Some staff work for both the residential home and domiciliary care service. Residents thought that staff were very busy but agreed that call buzzers were answered promptly. Bathing is normally done in the morning. Birchwood House Rest Home DS0000023895.V260488.R01.S.doc Version 5.0 Page 18 There have been some recent staff changes with new staff recruited. Recruitment records for two new members of staff were comprehensive with systems in place to protect residents. Setting out and recording interview questions and answers would better evidence equal opportunities are being met. Staff are only fully employed following POVA first checks and satisfactory references, staff undertake supervised induction before employment starts. A minor deficit was noted in that proof of identity had not been maintained as required, the manager omitted to copy the documents when used for the criminal records bureau application. Training records are held to enable the manager to monitor staff training needs. Whilst new staff are required to bring with them their training records, it would be useful to provide space on the application form to record training undertaken by prospective staff. Recent training included moving and handling, fire training, medication, COSHH and first aid training. Parkinsons and MS awareness training is booked. Care planning and risk assessment training is to be arranged. 6 staff hold NVQ level 2 or above in care. Birchwood House Rest Home DS0000023895.V260488.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37 & 38 Residents have access to experienced management who promote a good standard of living. More attentive notice to maintenance defects would enhance safety. EVIDENCE: The manager has worked at the home for some 6 years, holds qualifications relevant to care and management and has many years experience in the care field. It is planned for a deputy manager to be employed who it is hoped will improve administration and records maintenance and support the manager. The manager is regularly available in the home and works some shifts in a hands on capacity, carrying out supervision of staff in this manner. Residents said they felt she was very busy and had a ‘lot to do’. One of the directors of the owning company is in frequent contact with the home and available for residents and staff to talk to. Residents meetings are held supplemented by Birchwood House Rest Home DS0000023895.V260488.R01.S.doc Version 5.0 Page 20 recorded one to one talks with residents. Quality assurance questionnaires are sent to families and available in the entrance hall. The provider is very keen to maintain the good reputation of the home and to monitor that the standard of service is as he expects. As noted at previous inspections, whilst work on files and record keeping has been undertaken, they would benefit from better structure and for there to be more efficient office administration. A computer is available for use. Systems are in place for records as required to be available for inspection at all times. The home has very limited involvement in residents’ financial affairs, holding a small amount of money for one resident only. The resident was happy that her money was properly managed. Records of servicing of supplies and equipment evidenced timely and current action to maintain safety of residents and the environment. Regular fire safety equipment checks are carried out and recorded. Annual staff fire training and supplementary drills and practices are held. A training matrix would better evidence staff undertake regular drills. Portable appliance tests had been carried out by a contractor with those deficits identified addressed, it would be useful for such deficits to be noticed and rectified promptly through regular maintenance audits. Birchwood House Rest Home DS0000023895.V260488.R01.S.doc Version 5.0 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 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 2 2 Birchwood House Rest Home DS0000023895.V260488.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP37 Regulation 17 (1 & 2) 19 Requirement All records detailed in Schedules 2,3 & 4 must be complete, this will include proof of identity including a recent photograph for all staff. Timescale for action 28/02/06 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 OP7.2 Refer to Standard Good Practice Recommendations As a developmental issue greater detail should be recorded in the care plan, for example, the actual process of bathing and subsequent personal care needs. This recommendation is repeated from previous inspection reports dated 8 July 2003, 4 December 2003, 24 May 2004, 20 December 2004 & 14 June 2005 The care plan should include all relevant health and medical needs. The risk assessment process should be further developed to include areas of risk as identified both at the time of admission, form daily records and general observation. Detail of the provider of ancillary health services and dates DS0000023895.V260488.R01.S.doc Version 5.0 Page 23 2 3 OP7.2 OP7.2 4 OP8.11OP1 Birchwood House Rest Home 2 of last and due appointments should be recorded in the care plan. This should include visits arranged by family. This recommendation is repeated from previous inspection reports dated 24 May 2004, 20 December 2004 & 14 June 2005 5 OP15.5 6 OP29 7 8 OP29 OP38.3 Where a liquidised diet is requested by a resident, a referral should be made to a dietician or speech therapist for advice and support. To evidence equal opportunities are met during the recruitment procedure it is recommended that a record of interview questions and responses be maintained. The application form should include space to record details of training in addition to qualifications obtained. It would be useful for maintenance deficits to be noticed and rectified promptly through regular maintenance audits Birchwood House Rest Home DS0000023895.V260488.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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