Inspection on 23/04/07 for Boscombe Lodge

This inspection was carried out on 23rd April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Boscombe Lodge 19/04/06

Boscombe Lodge 13/12/05

Boscombe Lodge 12/04/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Boscombe Lodge 65 Boscombe Road Southend On Sea Essex SS2 5JD Lead Inspector Trevor Davey Unannounced Inspection 10:00 23rd. April 2007 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 Boscombe Lodge DS0000061944.V336664.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. Boscombe Lodge DS0000061944.V336664.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Boscombe Lodge Address 65 Boscombe Road Southend On Sea Essex SS2 5JD 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) 01702 603444 01702 603377 Boscombe Care Homes Limited Sisinyana Takatso Mutungi Care Home 30 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (30) of places Boscombe Lodge DS0000061944.V336664.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Nursing and personal care for service users who are over the age of 65 years not to exceed 30. To provide nursing and personal care to one service user who is under the age of 65 years and who is known to the CSCI. The Registered Manager should complete a course equivalent to NVQ Level 4 in Management by 2007. 19/04/06 Date of last inspection Brief Description of the Service: Boscombe Lodge is an established care home which provides both personal and nursing care for thirty older people of whom, up to six may have dementia. The home is situated in a residential area and has been extended to provide additional places and facilities for the provision of care for older people. Residents’ accommodation and communal areas are situated on two floors, with a passenger lift provided for assisted access. A secluded garden is provided to the rear of the property. The premises are situated within relatively close proximity to both local, main shopping and other civic amenities. All bedrooms have private en suite shower and w.c. A limited parking area is available to the front of the property. All prospective residents are provided with a Statement of Purpose and Service User Guide with up to date information of the home. Fees range from £465.75p to £621 per week and there are additional charges for hairdressing, chiropodist, taxes, luxury toiletries and sundries. A brochure is also available. Boscombe Lodge DS0000061944.V336664.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Key Inspection site visit covered a period of 9.50 hours and covered all key standards. The Registered Provider, General Manager, and Registered Manager together with other staff, residents and relatives were spoken with during the site visit. Their comments and contributions received were helpful in assisting the Inspector to compile this report. As part of the site visit, a tour of the premises took place and some of the personal care records and other official records within the home were also assessed. The management of the home had conducted their own survey and quality assurance exercise with residents, staff and visitors. Other health care professionals/stakeholders were invited to contribute to the survey. A summary of the feedback received was made available to the Inspector together with a copy of the action plan which had been implemented by the home. Overall, the responses received by the Inspector and other information gathered by the home was complimentary and very positive regarding the standard of care and services provided. A pre-inspection questionnaire had also been submitted by the Registered provider which included other helpful information. What the service does well: The Home has been successful in demonstrating its pro-active approach to meeting the personal care and nursing needs of residents. Conversations with residents and relatives as well as feedback from surveys conducted by the home, show that people who use the service, feel they are treated with respect and dignity and that personal preferences are taken into consideration. The home has a good record of retaining staff who interact well with residents and visitors. Comments from visitors included, staff are good, caring and communicate well. Staff keep me informed and I am consulted regarding care issues. My husband is kept spotlessly clean and I feel confident in the moving and handling skills of staff. Boscombe Lodge DS0000061944.V336664.R01.S.doc Version 5.2 Page 6 Care planning records and pre-assessment information is well documented and includes all relevant information to help staff deliver appropriate care. As part of this process, residents and their families are regularly involved in reviews of and decisions regarding care needs and support required. The home maintains good staff training records and regular supervision takes place. The staff team work well together. Staff are supported by the caring, effective and professional input by management. The management have included, as part of their policy and procedures for the home, a quality assurance exercise of the services provided. A report was made available to the Inspector which included a summary of the findings as well as comments and recommendations to put into place for improving the service. What has improved since the last inspection? What they could do better: Although a Service User’s Guide is available, it did not include the latest information as required by Regulation 5 (as amended) of the Care Homes Regulations 2001. Some of the social history and background information of residents should be recorded in more detail to give staff a greater understanding of residents. Boscombe Lodge DS0000061944.V336664.R01.S.doc Version 5.2 Page 7 The times that staff check on, or provide support to residents at night, should be recorded so that it is easier to verify any queries or incidents which may occur. Staff should be regularly reminded of the reporting procedures and agencies to be contacted in the event of allegations or suspicions of abuse arising. Some form of receipt should be obtained for any drugs that are returned to the pharmacist. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Boscombe Lodge DS0000061944.V336664.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 Boscombe Lodge DS0000061944.V336664.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 & 6 Quality in this outcome area is good. Prospective users of the service have the information they need to make an informed choice about where to live. Pre-admission assessment details for care/health needs had been completed to give staff suitable information and to assure potential residents that their needs could be met. Intermediate care is not provided by the home. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Boscombe Lodge DS0000061944.V336664.R01.S.doc Version 5.2 Page 10 The Homes Statement of Purpose and Service Users Guide were available and copies are given to residents. The information and details of the home’s services were clearly set out and these documents are reviewed/updated periodically. The General Manager was advised by the Inspector of additional information regarding the setting out of terms/conditions and fees which should be included in this document, as set out in an amendment to the Care Homes Regulations in September 2006. Pre-admission assessments had been completed which included clear details of current present social situation, family relationships and existing lifestyle. Other information recorded included history of falls, mobility, current medication and other personal and health care needs. Psychological and social needs were also recorded including behaviour, orientation, insights and disorders. Nursing and daily living assessments were available for inspection which included daily routines, social needs and relationships. The preadmission process includes a visit by the General Manager to prospective residents in their own homes or hospital. Some of the residents and visitors spoken to said the home had been recommended to them and that visitors are always welcome. Other comments confirmed that although some residents had been admitted with serious health needs, their medical conditions had improved and they were pleased with the quality of life they were able to enjoy. Boscombe Lodge DS0000061944.V336664.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 Quality in this outcome area is excellent. The personal care and nursing needs of residents were being met appropriately. Care records were clearly documented and ‘person centred’. Medication administrative procedures were in place to ensure the safety and protection of residents. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A selection of care plans and other case records were looked at which involved case tracking and the sampling of other information. Details recorded were clear, easy to follow and highlighted the identified need of residents, expected outcome and nursing intervention required. Signatures of staff and residents were available to show consultation had taken place regarding decisions made Boscombe Lodge DS0000061944.V336664.R01.S.doc Version 5.2 Page 12 and the way care was to be delivered. Individual care plans had been drawn up at to include fluid intake, hoisting instructions for transfers, personal hygiene, pain management and pressure areas. Monthly reviews had taken place and any changes noted. Health records evidenced appointments, advice and treatment provided by social workers, clinics as well as contacts with local hospitals, doctors and other health care professionals. Daily progress/log sheets recorded the care and support given during different parts of the day and night as well as the response from residents. Many positive comments were made and recorded in survey questionnaires confirming that residents and visitors were happy with the care provided by the staff team. For some residents, health conditions had improved and one resident told the Inspector that the outbreak of pressure areas were far less now compared with what they had been experiencing prior to admission to the home. Feedback from the homes own survey questionnaire on personal care and support, confirmed that 94 of the residents were ‘very’ or ‘quite’ satisfied with the nursing medical care provided, how they were looked after and with the way staff carried out their work. During the inspection, staff were observed to be competent and sensitive in the way they respected peoples’ dignity as they interacted and assisted residents with care and support. Residents spoken to, confirmed that their privacy was respected by staff. A sample check was made of the medication administrative records(M.A.R.) and entries on the M.A.R. sheets had been properly completed. Protocols for P.R.N. (to be taken as required) medication, were included and formed part of the care plan system. The Inspector advised staff that as part of good practice and to ensure accountability, discontinued drugs should not be returned to the pharmacist, without some form of signed receipt indicating that the unwanted drugs had been removed from the premises for disposal. At the time of inspection, no one was administering their own medication. Boscombe Lodge DS0000061944.V336664.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is good. People living at the home benefit from a range of activities to meet social, cultural and spiritual needs. Residents receive wholesome and an appealing variety of meals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Home carried out a survey which indicated that 88 of residents were very/quite satisfied with the social activities provided and the efforts made by staff to keep up with personal interests and hobbies. Since this survey was carried out, an activities co-ordinator has been appointed to specifically focus on meeting the social and recreational aspirations of residents more effectively. Some of the residents spoken to, confirmed that the activities organiser has regularly talked to them to offer alternative activities whilst at the same time, they are able to choose to remain in their own rooms and Boscombe Lodge DS0000061944.V336664.R01.S.doc Version 5.2 Page 14 pursue their own pastimes if they so wish. Some residents enjoy the company of visitors who regularly come to see them. Church services are arranged and local clergy visit residents where this has been requested. Other residents are taken out for walks and recreational games within the home include skittles, dominoes and jigsaw puzzles. Music/dance sessions are arranged as well as therapeutic armchair exercises. The personal care records included an activities assessment and social history but in the samples inspected, there was very little information or detail regarding background history, family information, previous employment, interests or memorable events. Records of meals provided were available and two weekly menus are prepared which take into account the choices of residents and diabetic needs. Overall, residents spoken to, enjoyed their meals and the variety available. Residents are able to ask for alternative meals if they wish. The comments and recommendations from the Home’s survey and action plan, emphasises the need to take into account the opinions and preferences of all residents. Improvements have also been brought about to reassure residents that they can ask kitchen staff directly at any time, regarding any additional snacks or drinks which may be required. During the inspection, staff were observed supporting and assisting residents appropriately who required help with eating their meals. Boscombe Lodge DS0000061944.V336664.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. People who use the service are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse, and have their rights protected. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Residents and relatives spoken with, were aware of the complaints procedure and were confident that they could approach the management should they have any concerns. Since the last inspection, two complaints had been received by the home one of which, had been brought to the attention of the Commission for Social Care Inspection. The issues involved the responsibility of the home for the care and welfare of a resident attending an outside appointment and a complaint raised following the death of a resident in the home. Having looked at the documentation of the investigations carried out by the home and speaking with one of the residents concerned, the Inspector is satisfied that appropriate interviews and correspondence had been completed by the General Manager to indicate that clear outcomes had been achieved with the result that allegations were not upheld and a satisfactory conclusion had been achieved. Boscombe Lodge DS0000061944.V336664.R01.S.doc Version 5.2 Page 16 Although staff had received training relating to the prevention of harm to vulnerable adults and reporting procedures, the homes policy was not compliant with the Public interest Disclosure Act 1998 and Department of Health guidance No Secrets. During the inspection the General Manager updated the policy and the Inspector is now satisfied that clear instructions are available for staff take proper action to ensure that in all cases, the appropriate agencies are contacted should abuse occur or be suspected. Boscombe Lodge DS0000061944.V336664.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. The premises are well maintained to enable people who use the service to live in a safe, comfortable environment. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The premises of the home were clean and hygienic and residents spoken with, confirmed that they like their rooms which were kept tidy and clean. There were no unpleasant odours present in the building at the time of inspection. An ongoing programme of internal decorating takes place and corridors are decorated with suitable colour schemes which have been chosen to take into account the needs of residents who may be partially sighted or have dementia. Boscombe Lodge DS0000061944.V336664.R01.S.doc Version 5.2 Page 18 From the survey returns completed by residents and visitors, all were quite/very satisfied with the decorations and furnishings in the Home. Although not reflected in the survey, comments made by some people have identified a need for better chair facilities for visitors. Additional chairs are to be ordered for this purpose. One of the small lounges/visiting areas has been newly carpeted, decorated and furnished. Boscombe Lodge DS0000061944.V336664.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is good. Staff in the home are trained, skilled and in sufficient numbers to support people who use the service. Robust recruitment policies and practices are in place to ensure residents are supported and protected. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The staff team are led by the General Manager and the Registered Manager of the home. The early shift consists of six care assistants plus a trained nurse and for the late shift, there are four care assistants and a trained nurse, plus managerial support. Night cover is provided by three staff on awake duty one of whom, is a trained nurse. In addition, other staff include two domestics, laundry assistant and two part-time cooks. There is also an activities coordinator who is responsible for promoting social and recreational opportunities for residents. Boscombe Lodge DS0000061944.V336664.R01.S.doc Version 5.2 Page 20 There is very little staff turnover and the Home was able to demonstrate that all recruitment checks had been thoroughly carried out and completed, as required by regulation. Detailed training records were available and staff had covered a variety of courses including dementia care, diabetes, infection control, Parkinsons disease. Nurses have had training in bereavement counselling and 54 of the care staff have completed palliative care training. From the staff team, 77 have obtained N.V.Q. Level 2 in care and others are studying for Level 3. Staff spoken to, were clear about their roles and responsibilities and felt well supported by management. Regular supervision also takes place. Overall, the feedback from the Homes own surveys, showed a general satisfaction with the way staff looked after residents and how they carry out their work. There were some concerns expressed regarding the promptness and general attitude of staff in responding to the call bells when activated and this has been acknowledged by management. This issue is to be raised at staff meetings as well as ensuring closer monitoring by trained nurses. Arrangements are being made for staff in supervision sessions, to have an increased awareness of how to deal with cultural and ethnic issues. Boscombe Lodge DS0000061944.V336664.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38 Quality in this outcome area is excellent. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent Manager. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The General Manager has considerable experience and is competent in discharging her responsibilities for overseeing the day- to -day running of the home. She is also currently studying for the N.V.Q. 4 Registered Manager’s Boscombe Lodge DS0000061944.V336664.R01.S.doc Version 5.2 Page 22 Award. There is also an existing Registered Manager of the home but this post is to become vacant shortly and will need to be filled. The General Manager will continue in the home and will ensure there is consistency in maintaining policies and procedures and will oversee the day-to-day management of the service. The Registered Provider works well and co-operates with senior managers to ensure the level of care is maintained to a high standard. The General Manager has developed positive quality assurance procedures for the home involving survey questionnaires for residents, visitors and other health care professionals. These were made available for inspection and an action plan is to be drawn up to implement any improvements which may be necessary for the service. The action plan and audit report for 2006 was seen which demonstrated the Home’s commitment for improving the service in accordance with the aspirations, comments and needs of residents/visitors. People spoken with by the Inspector, confirmed that they had confidence in the management and were able to raise matters or issues of concern at any time. One-to-one conversations and consultation take place as well as residents meetings which gave opportunity for people to express their opinions and to be involved. Records were available and information in the Pre- inspection questionnaire indicated where health and safety/maintenance checks had been completed including gas and electrical wiring, servicing of hoists mechanical aids and wheelchairs. Control of substances hazardous to health assessments were in place. The General Manager had recently attended a health and safety course and workplace risk assessments are in the process of being carried out. These assessments will eventually include all bedrooms to further enhance the safety of residents and to minimise the risk of hazards in the home. A spot check was made of the records of personal allowances held by the Home on behalf of residents and transactions had been properly and accurately recorded with accompanying receipts. Boscombe Lodge DS0000061944.V336664.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 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 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 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 4 x 3 x x 3 Boscombe Lodge DS0000061944.V336664.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO Boscombe Lodge DS0000061944.V336664.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action 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 OP1 Good Practice Recommendations The Service User’s Guide should be updated to clarify the fees, terms & conditions, as set out in Regulation 5 (as amended) of the Care Homes Regulations 2001. This is to provide more detailed information about charges & the services they cover. Discontinued drugs should be signed for when collected from the Home for return to the pharmacist. This is good practice & in line with guidance from the Royal Pharmaceutical Society. More detailed information should be recorded regarding the background & social history of residents. This enables staff to have a greater insight for meeting emotional needs & building good relationships with users of the service. Additional training should be provided to assist staff in meeting the cultural/diversity needs of residents more effectively. 2. OP9 3. OP12 4. OP30 Boscombe Lodge DS0000061944.V336664.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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