Inspection on 16/12/05 for Brightbow Lodge & Brightbow Court

This inspection was carried out on 16th December 2005.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Brightbow Lodge & Brightbow Court 23/11/07

Brightbow Lodge & Brightbow Court 04/01/07

Brightbow Lodge & Brightbow Court 15/08/06

Brightbow Lodge & Brightbow Court 29/06/05

Brightbow Lodge & Brightbow Court 10/03/05

Brightbow Lodge & Brightbow Court 30/06/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOME ADULTS 18-65 Brightbow Lodge & Brightbow Court 11-16 Philip Street Bedminster Bristol BS3 4EA Lead Inspector Sam Fox Unannounced Inspection 16 & 29 December 2005 10:00 th th Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 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 Brightbow Lodge & Brightbow Court DS0000020271.V279151.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 Adults 18-65. 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. Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Brightbow Lodge & Brightbow Court Address 11-16 Philip Street Bedminster Bristol BS3 4EA 0117 9636409 0117 9464470 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) The Lodge Rest Limited Ms Angela Sankey Care Home 57 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (57) of places Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 57 persons aged 18 - 64 years with mental disorder requiring nursing care excluding persons detained under the Mental Health Act 1983 May accommodate up to 19 persons aged 18 - 64 years with mental disorder requiring personal care excluding persons detained under the Mental Health Act 1983 Manager must be a RN on parts 3 or 13 of the NMC Register Staffing notice dated 28/4/1994 applies May accommodate up to 10 people aged 65 years and over with mental disorder requiring nursing and/or personal care within the existing registered numbers, excluding persons detained under the Mental Health Act 1983 29th June 2005 2. 3. 4. 5. Date of last inspection Brief Description of the Service: Brightbow Lodge and Court are located in Bedminster, close to the city centre, within walking distance of local shops and amenities. They are separate premises on the same grounds and have different staffing and managerial structures. Main bus routes and bus stops are close by. The homes offer 24 hour social and nursing care, and are able to meet a range of needs providing active rehabilitation, low level rehabilitation and continuing care. The home has an activities organiser to work with individuals, develop activity programmes which have an emphasis towards social, recreational, educational or employment skills training. Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over two days, totalling 12 hours. The main purpose of this visit was to examine care plans and other associated records and to inspect staff recruitment procedures. In addition to this a full inspection of the premises took place. Evidence was collated from examining records, discussion with staff and residents and a tour of the premises. During the inspection it came to light that the home had not received their last inspection report, which was due to an administrative error by the CSCI. As a consequence of this any unmet requirements made at the last visit will be carried forward with extended timescales. Not all standards were inspected and this report should be read in conjunction with others so a fuller picture of the home can be gained. What the service does well: What has improved since the last inspection? Staff have been offered more opportunities to train so residents can be reassured that a skilled team will meet their needs. The majority have received abuse training so they are more able to protect vulnerable adults. A conservatory has been built which has provided additional communal space for residents and a protected area where they can smoke. Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 Page 6 Plans have been put forward to provide additional facilities in Brightbow Lodge and which will involve an increase of staffing levels. Once achieved this will improve the rehabilitative services received by residents. 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. Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 5 There are clear agreements in place so residents know what is expected of them if they take a place at the home. EVIDENCE: The majority of these standards were not inspected and will be a focus of the next visit. The manager was asked to send an updated copy of the home’s Statement of Purpose and service user guide. These should be reviewed on an annual basis to ensure their accuracy. It was noted that residents have an accommodation agreement which details the terms and conditions of living within the home. These were signed by both the resident and homes’ representative. This meets with requirements of the legislation. Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 9, 10 Some improvements need to be made to care plans and risk assessments so that residents know they will be encouraged to retain their independence safely. They can be re-assured that information about them will remain confidential. EVIDENCE: Opportunity was taken to view care plans for both Brightbow Lodge and the Court. Brightbow Court has made some positive developments in reviewing and improving care plans. The three plans selected at random, however, varied in content and quality, depending on who had written them. An example of a good one was seen that evidenced that the home takes into account individual needs and preferences. Others lacked sufficient detail and discussion took place about how these could be improved. This was the subject of a requirement at the last inspection and will continue to be so. Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 Page 10 In addition to the above it was noted that one care plan contained personalised language. This was discussed with staff and it is recommended that the use of such language be reviewed. The care plans seen in Brightbow Lodge continue to be generally well written and they contained good detail of needs and what support was to be given by staff. These included residents’ signatures and were being evaluated monthly. This is good practice. The homes have a missing persons policy and this has been used appropriately in the past. It was apparent, through discussion with staff and observation, that residents are supported to take risks as part of independent lifestyles. Some self medicate, take more control over their finances and access community facilities independently. Each resident has a risk assessment which highlights potential risks in different areas of their lives, including their mental health needs. Those seen in Brightbow Lodge were up to date. Some could have benefited from more detail and this will be discussed in more depth with the manager. In Brightbow Court it was noted that there was a potential suicide risk highlighted for a resident who has recently moved there. The home was advised that the risk assessment in place for this should be more detailed – this should include potential triggers and actions to try and reduce the risks. The homes have a policy in relation to confidentiality, which is discussed during the induction period. This was confirmed through discussion with staff and minutes of a recent staff meeting evidenced that all have been reminded of their responsibilities in this respect. Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17 Action needs to be taken to improve procedures in the kitchen so that residents’ health and safety can more appropriately maintained. EVIDENCE: Opportunity was taken to view the kitchen. It was noted that some areas were in need of a deeper clean and that the small fridge required defrosting. In addition to this there was a used ashtray on the side and some of the tile grouting was dirty. Also the cook had not been testing fridge and freezer temperatures or probing food at the regular intervals. The cook was not wearing white overalls. As a result of these findings the Environmental Health Officer was asked to visit, which has subsequently been achieved. This has resulted in a number of recommendations and contraventions being reported. A requirement is made regarding these – with a timescale by which these should be actioned. An additional visit has been arranged to the home to check on progress. Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 Page 12 There was a limited amount of food stock on the premises – the cook said that they used a major food store close to the home daily so that they could ensure freshness. This is good practice. Opportunity was taken to join residents with their lunchtime meal in Brightbow Lodge. This was well presented and tasty. It was very evident that the cook is flexible and was providing a number of alternatives for residents who did not want the main alternative. Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Residents can be re-assured that their personal and health care needs will be met sensitively and promptly. The medication system is safe but, for added protection, tablets administered on an and as and when basis need further monitoring. EVIDENCE: Care plans seen in Brightbow Lodge contained good detail of the personal care needs of residents. Dependency levels in this respect vary considerably and are influenced both by physical disabilities and mental health needs. Discussion with the manager indicated that staff have made strenuous efforts to support some residents to dress more appropriately and to improve their hygiene. She was pleased with the positive developments made in this respect. Staff were observed sensitively assisting residents with their personal care needs. Records provided evidence that residents are supported to see the relevant health professionals and specialists, particularly in relation to their mental health needs. All visits and developments are fully recorded. Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 Page 14 The chiropodist visits the home regularly and records confirmed that residents are supported to have annual check ups. Opportunity was taken to inspect the medication system in Brightbow Court. They operate a monitored dosage system for the administration of medication that is supplied at regular intervals by the local pharmacist. Generally records held in relation to this were found to meet the requirements of the legislation. Some residents have medication which is prescribed on an as and when basis which is related to their mental health needs. The home was advised that they should develop medication profiles which also include guidelines for when PRN medication is needed and who can authorise their use. This is particularly important when mood-altering tablets are used. Any use of prn medication should be reviewed regularly. Stock records are held for household remedies, such as painkillers. A spot check of these was found to be accurate. The assistant manager said that he is going to organise re-fresher medication training for all staff – this will be a focus of forthcoming inspections. Some residents self medicate, risk assessments in relation to this were not viewed during this visit. It is good practice that individuals are able to retain their independence in this respect if it is safe to do so. Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Residents can be confident that they will be listened to and protected from abuse. EVIDENCE: The homes have a complaints procedure, which sets out timescales for action and the contact number of the CSCI to whom concerns can also be raised. This meets with requirements of the legislation. Opportunity was taken to view the complaints logbook. There has been one complaint received by a resident since the last inspection, which has been resolved. There have been no complaints received by the CSCI. It was noted that there was a residents meeting in October during which time a number of issues were discussed, including menu planning and the level of alcohol consumption. These provide an important, more formal forum, through which residents can air their views. The home has responded well to a series of requirements made resulting from an incident within the home involving potential abuse. Evidence was seen that the majority of staff have now received abuse awareness training. This was delivered by the manager who is qualified to provide this training. In addition to this the homes have re-written their protection of vulnerable adults policy. This should help them to respond more appropriately if another incident were to occur. In addition to the above the majority of staff have received managing aggression training. Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,30 Some areas of the home are in urgent need of re-decoration and standards of cleanliness must be improved – residents would then benefit from a more homely and comfortable environment. EVIDENCE: Brightbow Lodge and Brightbow Court are located in the heart of Bedminster and are close to local facilities and amenities. Since the last inspection a conservatory has been built, which is now the designated smoking area for residents living in Brightbow Lodge. This is a positive development. There are plans, which have been given the go-ahead by the CSCI, to make some changes to Brightbow Lodge. This will involve each of the three floors having a more specific use. For example, the ground floor will be for the use of frailer residents, the middle floor for those who are more independent and the third floor for those who require more support. These plans include the provision of extra communal space and kitchen facilities. Once achieved, this will represent a considerable improvement. It will also lead to a reduction in registered beds on this side from 38 to 33. Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 Page 17 On the first day of the visit there were a number of bits of furniture in the back yard – this was unsightly and could represent a health and safety risk. By the second day of the inspection this had been cleared. Opportunity was taken to inspect both Brightbow Lodge and Brightbow Court. The following was noted for Brightbow Lodge: • • • Residents bedrooms were personalised and reflected personal tastes – some rooms were barer that others and the décor also reflects individual mental health needs Residents confirmed they had bedroom door keys – which provides them with a means to keep their personal possessions secure and to maintain their privacy. The corridors, communal areas and bedrooms were cleaned to an adequate standard. The following was noted for Brightbow Court: • • • • The flooring in the dining area\lounge was stained and worn in areas. This was in need of replacing. The corridors were dark, had stained paintwork and were in need of redecorating. In addition to this the carpets in these areas were worn and stained The bathrooms seen were institutional in appearance, and had dated decor. It is recommended that these be refurbished. Many of the bedrooms were in need of redecoration and had stained and chipped paintwork. After discussion it was noted that these had not been redecorated for a number of years. The home should begin a planned programme of re-decoration of these. A number of bedrooms and communal areas of the home were not cleaned to an adequate standard. For example shelves and mirrors were dusty and some carpets needed hovering. These were pointed out to staff. Discussion took place about the need to balance promoting independence in this respect whilst also fulfilling the “duty of care”. The home needs to review work practice in this respect and to improve standards of cleanliness. An additional visit will be made to the home to follow up on this. • The proprietor has now submitted a plan for the refurbishment. Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35,36 Staff are well trained and supervised so residents receive a service from a confident and competent team. There is a robust recruitment procedure in place which serves to protect vulnerable adults. EVIDENCE: Rotas provided for inspection indicated that there are three staff on duty throughout the day in Brightbow Lodge and two staff on duty at Brightbow Court. This does not include management or ancillary staff, such as the cook and housekeepers. Staffing levels are at a minimum and whilst they do allow for the basic needs of residents to be met – they do not give much scope for rehabilitation. The new prospals for Brightbow Lodge, however, include an increase in staffing levels. This would be a positive development. Opportunity was taken to view three staff files. These were found to contain a contract of employment, proof of identity, criminal records checks and references. They were well maintained and indicated that the homes operate robust recruitment procedures. Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 Page 19 One member of staff said there had been an improvement in the level of training provided in the home and records indicated that this has included topics such as schizophrenia, learning disabilities and dementia. The achievement of Level 2 NVQ has been linked to the organisations’ pay scale, which has provided an additional incentive for staff to train. The proprietor said that 6 staff are working towards their NVQ and a further three have just registered to commence it. This is good practice. The home should ensure that certificates relating to units achieved are held on file. Discussion took place with the manager about her annual budget for training and whether she felt this was sufficient. It is recommended that she develop a more structured annual training programme. The homes operate a formal supervision system and records evidenced that they take place at the appropriate intervals. This is good practice and provides an important, more formal forum, through which staff can discuss developmental issues and concerns. In addition to the above staff meetings are held at regular intervals and fully recorded. Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 Residents’ benefit from living in a well run home. EVIDENCE: The manager displayed a clear awareness of her responsibilities under the Care Standards Act and has acted promptly to resolve any issues arising. She also has a good understanding of areas of development for the home and is working towards addressing these. She is well qualified and is a registered nurse. The manager does not have a deputy – it has been recognised by her and the organisation that she would benefit from this or a more senior staffing structure. It is hoped that this will be achieved soon. Health and safety was not a major focus of this inspection. It was noted, however, that the homes do not have a workplace fire risk assessment. The manager was directed to a web site from which she could gain further information about this. Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 Page 21 In addition to the above some staff require updated first aid training. The portable electrical appliances were being tested on the second day of the inspection. There was an up to date insurance certificate. Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 x 3 x 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 1 25 3 26 1 27 2 28 3 29 x 30 1 STAFFING Standard No Score 31 x 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 x x 2 3 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 1 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x x x x x x Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 Page 23 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. 4. Standard YA6 YA9 YA17 YA20 Regulation 15(2)(b) 13(4)( c ) 16(2)(j) 13(2) Requirement The care documentation in Brightbow Court needs to be reviewed and updated. Risk assessments need to include more detail Ensure that the advice of the environmental health officer is followed Develop medication profiles which include guidelines for the use of tablets given on an as and when basis. Replace flooring in the dining area of Brightbow Court Begin a planned programme of refurbishing bedrooms in Brightbow Court Begin planned programme of redecorating hallways in Brightbow Court Improve standards of cleanliness in Brightbow Court Ensure that certificates of achievement are held on training files. Develop a workplace fire risk assessment Ensure all staff have first aid training Timescale for action 30/03/06 28/02/06 30/01/06 28/02/06 5. 6. 7. 8. 9. 10. 11. YA24 YA26 YA28 YA30 YA32 YA42 YA42 23(2)(d) 16(2)(c) 23(2)(d) 16(2)(j) Schedule 4(6)(f) 23(4)(a) 12(1)(b) 28/02/06 28/02/06 28/02/06 28/12/05 30/03/06 28/02/06 30/06/06 Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 Page 24 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. 2. 3. Refer to Standard YA6 YA27 YA35 Good Practice Recommendations Review the use of language in care plans Refurbish bathrooms Develop an annual training programme. Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Brightbow Lodge & Brightbow Court DS0000020271.V279151.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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