Inspection on 26/04/06 for Blackwell Vale Nursing Home

This inspection was carried out on 26th April 2006.

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

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

Other inspections for this house

Blackwell Vale Nursing Home 21/01/10

Blackwell Vale Nursing Home 10/08/09

Blackwell Vale Nursing Home 30/08/07

Blackwell Vale Nursing Home 30/01/07

Blackwell Vale Nursing Home 09/06/05

Blackwell Vale Nursing Home 06/12/04

Blackwell Vale Nursing Home 25/08/04

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 Blackwell Vale Nursing Home Rear 61 Durdar Road Carlisle Cumbria CA2 4SE Lead Inspector Colette Hibbert Unannounced Inspection 26th April 2006 09:00 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 Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Blackwell Vale Nursing Home Address Rear 61 Durdar Road Carlisle Cumbria CA2 4SE 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) 01228 512456 01228 810994 Laudcare Ltd (a wholly owned subsidiary of Four Seasons Health Care Ltd) Mrs Helen Joyce Smallbone Care Home 60 Category(ies) of Dementia - over 65 years of age (32), Old age, registration, with number not falling within any other category (28) of places Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home is registered for a maximum of 60 service users to include: Up to 28 service users in the category of OP (Older people not falling within any other category) up to 32 service users in the category of DE (E) (Dementia over 65 years of age) Date of last inspection 9th June 2005 Brief Description of the Service: Blackwell Vale Care Home is owned by Four Seasons Health Care Limited and is located on the outskirts of Carlisle near to the racecourse. There is a bus stop nearby and ample car parking is provided. The home is divided into three areas with the ground floor providing nursing care for service users within the category of registration of Older People. The second floor accommodates and provides nursing care for those service users who are within the category of registration of Older People with dementia related illnesses. The home was purpose built and each unit has its own lounge and dining room. There is a conservatory and other lounge areas on the ground floor. Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection of the home and took place over two day, the manager was present throughout. During the inspection time was spent talking with residents and staff in private and in small groups. A selection of records relating to the care of the residents and the day to day running of the home were looked at, and a tour of the building was conducted. The pre-inspection questionnaire that had been sent out to the manager had not been returned before the initial inspection so this information was not available to the inspector therefore a second visit was necessary to follow up the information in the service users questionnaire. What the service does well: What has improved since the last inspection? Some of the residents’ bedrooms have been decorated, new carpets fitted and new bedroom furniture installed. They have also purchased several new beds and bed tables for the rooms. The home has recruited and at present it has a full compliment of staff. Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 Page 6 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. Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 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 Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 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,and 5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The statement of Purpose needs to be updated to provide residents with appropriate information to enable them to make an informed choice. Residents needs are fully assessed prior to admission to ensure the home cater for the individuals needs EVIDENCE: The admission policy and procedure is unchanged since the last inspection. The manager or senior nurse visits the prospective resident to assess their care needs’. Residents within the home and the documentation within the care plans confirmed this. One resident said that their son had visited the home before they came to live here. The statement of purpose and service user guide were in need of updating to provide more current information for the residents. Information from the service user questionnaire suggested that they would have liked more information about the home prior to admission Residents had contract and Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 Page 9 terms of conditions, some of the families had copies and other were stored within the home administration office. Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 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,and 10 The quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The standard of care plans varies through out the units, and need to be monitored to assure that staff have correct and current information to provide appropriate care for the residents. Medication practices and procedures are putting the residents at risk. Residents are treated with respect and their right to privacy is upheld EVIDENCE: Requirements made by the pharmacy inspector at the last inspection will be inspected at the next visit. Residents all have a personal care plan, some improvement has been made on the ground floor, but on the upper units documentation did not always reflect the care needs, but they are reviewed on a monthly basis. During medications being administered on the ground floor the trolley was left unattended for some time in the corridor giving residents easy access to the medication left out on the top of it, so putting the residents at risk. One residents’ medication had been omitted for 4 days. On questioning the staff they said that the resident had been asleep. Staff did not contact the GP to reassess the residents medication until the inspector suggested it. Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 Page 11 There was no documentation within the care plan to support the change in the resident’s condition. The inspector also discovered a wound area on one residents leg, which required dressing - no reference to this could not be found in the care plan. This was brought to the attention of the home manager who said that she would discuss this with the staff. It appeared that none of the residents within the home had a bath during the morning of the inspection, after talking with the qualified staff on each unit this was confirmed. One member of staff said that residents preferred baths in the evening as it helped them to settle. One member of staff gave a resident a shower in the afternoon as they were the residents’ key worker and she had promised the resident that she would. Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 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 and 15 The quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some activities within the home met the resident’s interests and needs but they are limited. Residents are encouraged to maintain contact with family and visitors from the local community are made welcome. Not all the dining areas create a pleasant environment for the residents to enjoy their meals. EVIDENCE: Posters had been placed around the home to advertise a forthcoming musical event. The home has 2 activities co-ordinators, one of which was on duty the morning of the inspection. She said that she based herself down stairs as the residents on that unit got more out of the activities. During the morning papers were read to a small group and later they play dominoes. Records were kept of activities, which were not fed back into the residents care plans. Information from the residents questionnaire suggests that there is a need more varied activities. The residents spoken with said various clergy call into the home for them to talk with if they wished. One resident spoken with said she was sorry that the library bus no longer visited the home as she was unable to change her books she said that she had Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 Page 13 asked the staff but no one had been able to find out about it. The manager said that she would look into this. Meal times were very calm on all three units with residents having the option to eat in their room or join others in the dining areas. One of the dinning rooms was in need of new furniture and the residents meals were served on bare table with no clothes or place settings. There were no curtains at the windows and bare light bulbs without shades. The manager said they had gone to be cleaned and there were no spare curtains available in the inter-rim period. Some dirty breakfast pots remained in the dinning room until lunchtime. Breakfast was a choice of Juice, tea or coffee, Cereals or porridge and fresh toast. Lunch was home made vegetable soup, Scotch pie, mushy peas and mash and gravy, or sandwiches. Residents were given the choice at the mealtime and those unable to make a choice the staff chose for them. Residents were assisted during the meal and the staff made it a quite and calm experience. A four-week menu plan was up in the dinning room, which was difficult for the residents to follow and work out what the available choices were for that day. Residents spoken with said that they had choice of times to go to bed and get up and they could choose what clothes they put on. Families could visit when they wanted at any time, the inspector did not see any visitor during the inspection. The communal areas did not have clocks or calendars to provide orientation for the residents, and in one lounge the TV and the radio was on at the same time with several residents sat in the room. A key worker system is in place but some residents were not aware of the member of staff assigned to them. Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a complaints procedure in place to protect the residents within the home. Staff are aware of the policy and the needs to protect the residents from abuse. EVIDENCE: The manager says that they have only had the one complaint since the last inspection and the investigation had concluded. Residents spoken with said that they would talk to the staff if they had any concerns and felt that ‘the staff would sort it out’. Staff said that they would take work related issues to head of care on shift at the time or if they were not happy with the out come they would go and see the manager. The home has a recruitment policy in place and staff have the relevant checks prior to employment. There is in house training for POVA, which the manager was delivering during the morning of the inspection but she is going to link in to Cumbria Adult Protection Unit and get further training from them. Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 Page 15 Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 Page 16 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,and 26 The quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The environment both interior and externally are in need of some repair and maintenance work to provide a pleasant homely atmosphere for the residents. EVIDENCE: During the day a full tour of the building took place. Outside the back of the building, piles of old furniture had been left for disposal but had been there for some time causing a possible health hazard, and was unsightly. The grounds in general were unattended and the only few flower pots seen contained dead plants. On the Cavill unit the bathrooms seemed to be used more for storage of commodes and walking frames than for the personal care of the residents. There were several general store cupboards, which were so full of equipment that the doors could not shut. Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 Page 17 One of the resident’s bedrooms had a very strong mal odour and the cleaners said they would attend to it. Several of the bedrooms were in need of minor repair to the walls where the bed had taken plaster off the wall. The Chadwick unit had a strong mal odour in the corridor. Several of the bedroom doors had been damaged by wheel chairs with chunks of paint missing and were in need of repair. There is a small sitting room by the nurses’ station, which is very dark and depressing, and the toilet next door did not have washbasin and needed repair, as there were chunks of plaster off the walls. This whole area is in need of some work. The carpets on the corridor felt sticky under foot; the cleaners said that it might be residue carpet shampoo as it is cleaned approximately 3 times a week On the Nightingale unit the linen cupboard had old staff lockers stored on the floor which were unused broken and unsightly. The small residents lounge was used for storage with wheel chairs and staff training flip charts stacked against the wall and was not a homely place for residents to sit. The dining room had no curtains or light shade; the manager said they were being cleaned. The tables and chairs were very tatty and dirty breakfast pots were still in this room at lunchtime. The shower room on the Cavill unit was used as a store room with 2 shower chairs a commode and a wheel chair needing to be removed before the residents could use the shower. The dining room had been redecorated and a welsh dresser had been added, creating a nice homely environment for the residents to enjoy. The bathroom on this unit again seemed to be a storeroom; it contained a large Kirton chair, a stand aid and an old cane wooden display unit that was full of junk. The lift maintenance room is accessed off the main corridor and it has a danger sign on the door but no lock and residents could easily gain access putting them at risk of injury. Several of the resident’s bedrooms were in need of various degrees of maintenance or repair. Since the last inspection 3 rooms have been re-decorated, 6 new carpets have been laid and 5 sets of bedroom furniture, 4 new divan beds and mattresses 1 new profile bed, 5 bedroom tables have been purchased to improve the standard of the home. The temperature on the top floor was very hot and staff commented that it was un bearable at times for both the residents and themselves. This issue needs to be addressed before the summer to make a more comfortable living environment for the residents. During the inspection the large conservatory on the ground floor was being used from 10am to 1pm for staff training so residents could not use this room, one resident was heard to ask on 2 occasions ‘if the room was free yet’ Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 Page 18 Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 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 The quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home had the appropriate number and mix of staff to attend to the care needs of the residents. Robust recruitment policies ensure that residents are cared for by appropriately qualified staff EVIDENCE: There were appropriate staffing levels on the day of the inspection, which consisted of: 1 RGN - 2 Care Assistants on each of the upper units 1 RGN - 4 Care Assistants on the ground floor 1Cook and 1 kitchen assistance 4 cleaners (2 upstairs, 2 downstairs) 1 Laundry assistant. Residents said that in general they did not have to wait long for care, and bells were answered promptly throughout the day. One resident did say that she ‘had to wait her turn, but realised the staff were busy’ Comments were made on the residents questionnaires as to how busy the staff were, and sometimes they did not have time to talk. Staff spoken to say they felt that there was adequate numbers on shift to provide the care the residents needed. Individual staff training profiles were not in place this was a requirement at the last inspection and had not been met, staff said that training was available and they had attended Fire Safety, Moving and Handling, and NVQ training. The Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 Page 20 manager said that she would look into training for staff re medication after the poor practices witnessed during the morning. Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 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): 31,32,33,34,35,36 and 38 The quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The Manager needs to concentrate her attention on leadership and the day to day running of the home to ensure a higher quality of service for the residents within this home. Residents and staff need to have the opportunity to provide input into the service, so promoting independence and autonomy. Poor clinical practices seen did not promote infection control, putting the residents at risk of cross infection. EVIDENCE: The manager stated that she has finished her Registered Managers Award but has not received the certificate yet. Although staff spoke well of the manager it would appear that the home has no strong leadership. The manager needs to start to prioritise her tasks to be more effective and concentrate on day-to-day management of the home. Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 Page 22 At the last inspection a requirement was made on staff supervision, this has not been met. Staff stated that they did not have staff meetings on a regular basis and there is no residents meetings or family meeting to get input from the various groups in the home. There are robust procedures in place to safe guard the residents finances with paper records kept within the home and on the computer. The home has health and safety issues with the amount of furniture stacked in the grounds. During the cause of the morning dirty laundry was found on the floor within one of the sluices and could be a cause of cross infection and needs to be addressed. Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 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 2 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 2 2 3 3 2 2 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 2 3 3 1 X 2 Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 Page 24 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 2. Standard OP1 OP7 Regulation 4 15 Requirement The statement of purpose needs to be updated on a regular basis All documentation must be complete, and consistent Outstanding requirement from 30/06/05 Timescale extended. Residents health care needs must be identified and met Medication must be administered as prescribed. Outstanding requirement from 20.07.05. Timescale extended. 5. OP9 13(2) Records pertaining to administration, receipt and disposal of medication must be accurate. Outstanding requirement from 20.07.05. 6. OP9 13(2) The missing zopiclone tablets must be investigated. 15/05/06 15/05/06 Timescale for action 31/05/06 31/05/06 3. 4. OP8 OP9 15 13(2) 31/05/06 15/05/06 Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 Page 25 7. OP9 13(2) There must be care plans to include appropriate use of when required sedative medication. Social care needs must be identified and documented within the care plan Outstanding requirement from 31/07/05 Timescale extended. All dining areas should provide a pleasant environment. An Action plan must be submitted for improvement to the environment with dated programme of work Outstanding requirement from 23/03/06 Timescale extended The temperature on the upper floors is to hot and some ventilation system must be fitted The grounds and gardens must be tidy and free of rubbish Bathrooms must be free from storage so they can be used by residents Resident’s bedrooms must be repaired and decorated as required. The lift machinery room must be locked A way to combat the mal odour in some areas of the home must be found Staff should have training for administration of medication Staff training must be documented Outstanding requirement from 23/03/06 Timescale extended. Residents and staff should be given the opportunity to have input into the running of the home, with residents and staff meetings DS0000010111.V289237.R01.S.doc 15/05/06 8 OP12 15 30/06/06 9 10 OP15 OP19 23(2g) 23 (2b,d) 30/06/06 30/06/06 11 12 13 14 15 16 17 18 OP19 OP20 OP21 OP24 OP25 OP26 OP28 OP30 23(2p) 23(2o) 23(2l) 23(2bd) 13(4ac) 16(2k) 13(2) 18(2b) 18(2) 30/06/06 30/06/06 30/06/06 30/06/06 30/06/06 30/06/06 30/06/06 31/05/06 19 OP33 12(2,3) 31/05/06 Blackwell Vale Nursing Home Version 5.1 Page 26 20 OP36 18(2) 21 OP38 13(3) Staff must have supervision 6 times a year Outstanding requirement from 23/03/06 Timescale extended. Dirty linen must not be stored on the floor in the sluice area 30/06/06 31/05/06 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 OP9 Good Practice Recommendations It is recommended that a clear tracking system be implemented for recording medication changes. Blackwell Vale Nursing Home DS0000010111.V289237.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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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