Inspection on 18/04/05 for Broad Acres Residential And Nursing Home

This inspection was carried out on 18th April 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 but made no statutory requirements on the home.

Other inspections for this house

Broad Acres Residential And... 23/04/07

Broad Acres Residential And... 04/06/06

Broad Acres Residential And... 16/01/06

Broad Acres Residential And... 20/01/05

Broad Acres Residential And... 05/05/04

Broad Acres Residential And... 28/01/04

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

CARE HOMES FOR OLDER PEOPLE Broad Acres Residential & Nursing Home Leiston Road Knodishall Saxmundham Suffolk, IP17 1UQ Lead Inspector Jill Clarke Announced 18 April 2005 th 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 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. Broad Acres Residential & Nursing Home I54-I04 S24345 Broad Acres V222512 050418 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Broad Acres Residential & Nursing Home Address Leiston Road, Knodishall, Saxmundham, Suffolk, IP17 1UQ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01728 830562 01728 830417 None Mr K Kowlessur and Mrs N Knowlessur. Mrs Caroline Sandra Manders CRH 48 Category(ies) of OP - up to 48 registration, with number DE,E - up to 20 of places Maximum number of places 48 Broad Acres Residential & Nursing Home I54-I04 S24345 Broad Acres V222512 050418 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 20th January 2005 Brief Description of the Service: Broad Acres is a care home with nursing, registered to care for 48 older people. This includes 20 places for people with dementia. The home consists of a single storey building, set in large gardens. There are 34 single bedrooms and 7 shared bedrooms. All bedrooms have wash hand basin, 12 of which also have ensuite toilet. There are 4 bathrooms and a shower room, located close to the bedrooms. Communical rooms consist of 2 lounges, 1 dining room and 1 dining room/lounge. Some of the corridoors are narrow, and not suitable for wheelchair users. Broad Acres Residential & Nursing Home I54-I04 S24345 Broad Acres V222512 050418 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on a weekday from 7.35 am to 3 pm. A complaint had been made concerning the standard of care and cleanliness of the home, which was investigated as part of this inspection. Time was spent with 8 of the residents, to listen to their views on the quality of service provided. A tour of the building took in all the lounges and dining rooms, 3 toilets, 2 bathroom, and 6 bedrooms. Due to some of the most vulnerable people being unable to communicate, time was spent sitting in the main lounge, observing staff working with residents. The manager said that people living in the home, do not like being referred to as service users, but preferred to be known as residents. A group of 4 residents, said that when they came to the home they “took up residency”. This reports reflects their wishes. What the service does well: What has improved since the last inspection? Staff has continued to work on trying to keep the home clean. Resident’s towels and flannels were clean. There is more detailed information on residents care needs, in the care records. All medication is now being booked into the home. Arrangements have been made for an Occupational Therapist (OT), to visit the home, to make sure residents have the right type of armchairs and lifting equipment. Broad Acres Residential & Nursing Home I54-I04 S24345 Broad Acres V222512 050418 Stage 4.doc Version 1.30 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. Broad Acres Residential & Nursing Home I54-I04 S24345 Broad Acres V222512 050418 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Broad Acres Residential & Nursing Home I54-I04 S24345 Broad Acres V222512 050418 Stage 4.doc Version 1.30 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 standard(s) 4 Some residents care needs are met better then others, depending on their mental and physical health. EVIDENCE: Residents said that staff are a “nice crowd of people”. Further comments included “ everyone lovely”, “staff are alright” and “look after you well”. Due to the mental frailty of some of the residents, observation was used to see the reaction when staff gave care, or spoke with residents. Staff approached in a friendly manner, which reassured the resident. When passing staff would speak and say “hello” to residents and start conversations. One member of staff helped a resident with their meal. This was undertaken in a relaxed friendly manner, whilst talking to the resident who smiled back. Residents where left for long periods of time without staff approaching them. Staffing levels did not allow for carers to sit and talk to residents in the lounges. When staff did come in, they were called away to answer a call bell, or help move a resident. Broad Acres Residential & Nursing Home I54-I04 S24345 Broad Acres V222512 050418 Stage 4.doc Version 1.30 Page 9 A resident whose care records said they liked ‘looking at the television’, was located on the other side of the room, unable to view it. The residents said that they enjoyed trips out to the local shops. One resident arriving back at the home, said they had just been out to play carpet bowls, which they had enjoyed. Social activities are geared towards the more mentally alert residents. The activities co-ordinator has received no training to support them providing activities for residents with dementia. Residents who are able to undertake their own personal care, felt staff could help them more. They did not like to ring the call bell and ask for help, as they thought the bell should be used more for emergencies, and “did not want to make a fuss”. One resident said they would wait until a carer walked past their door, as they did not want to disturb the ‘busy’ staff. There is no dedicated dementia unit. Residents said that they were “not allowed to make a drink”, because of risk of some residents “scolding” themselves. There were no teapots on the table to enable residents to serve themselves. Broad Acres Residential & Nursing Home I54-I04 S24345 Broad Acres V222512 050418 Stage 4.doc Version 1.30 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 standard(s) 7 and 8 Progress continues to be made, to ensure that the health care needs of residents are identified and met. Further work is required to ensure staff is given clear guidance to support residents with dementia. Staff were not completing records accurately, which could place residents at potential risk when monitoring their care. EVIDENCE: Care records (care plan) gave information on resident’s health, nursing, personal and social care needs. Three care plans were looked at in more detail. Time was spent talking and watching residents, to find out how much care they wanted, received, and their views on the home. One care plan for a resident with dementia, gave staff no clear guidance on how to support and maintain the resident’s dignity. Where staff had recorded the resident had loss weight, there was no further writing to say if they had taken any action, or sought advice. There was no record of the resident being offered a bath or shower, where the other two care plans held completed ‘bathing records’. Broad Acres Residential & Nursing Home I54-I04 S24345 Broad Acres V222512 050418 Stage 4.doc Version 1.30 Page 11 Many residents were unable to remember if they had received personal care. They are dependant on staff keeping a record for them, offering baths and personal care. This was not always happening. A complaint made before the inspection, raised concerns that resident’s fingernails were not being cut and kept clean. While greeting residents, shaking or holding their hand, nails was discreetly checked, and found to be clean and cut short. Staff kept records for residents, who they had concerns over how much drinks and/or food they were taking/being given. One record showed that the date was wrong, and only one drink having been given at 11.15am. Information on the resident’s mobility, and any equipment needed such as a walking frame, or wheelchair, had been completed and updated. To ensure the safety of a resident, a wheelchair lap belt was being used. There was no record of permission being asked of the resident, their family or representative. Broad Acres Residential & Nursing Home I54-I04 S24345 Broad Acres V222512 050418 Stage 4.doc Version 1.30 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 standard(s) 12, 13 and 14 The set routines of the home, does not support residents to have choice and control over their lives. Not having a dedicated area of the home to support residents with dementia, impacts on all the lives of residents. The home must be able to demonstrate that they have the staffing, training and knowledge to support residents with different needs. Drinks were not always available for residents. EVIDENCE: A walk around the home at 7.35am in the morning found fourteen residents were already up in the lounges. Walking past bedrooms, nine residents were seen to be up and dressed, sitting in an armchair. Their beds had been stripped, and only one had a drink in front of them. Three residents said they did not mind getting up early. Another resident, who did not require any help with their personal care, preferred to get up early but found that they had too long “to wait for breakfast ”. Broad Acres Residential & Nursing Home I54-I04 S24345 Broad Acres V222512 050418 Stage 4.doc Version 1.30 Page 13 Five residents in the lounge were unable to understand or reply to the question, three other residents were asleep in their armchairs. One resident, was heard asking for a cup of tea, but was informed by staff that they were “too busy”. The member of staff was then heard to offer a drink of orange, and promised to make a cup of tea later. At previous inspections, both the Owner and Manager had confirmed, residents could get up when they wished. When staff were asked if residents could get up when they wanted? they replied “we wake them up and ask if they want to get up”. Night staff start to get residents up at 6am. When the day staff come on duty at 7am, they continue assisting residents, as they need “to be up by 8.30 ready for breakfast”, which is served at 8.30 – 9am. A resident said they could “get up when they wanted - as long as it was before 9”. The atmosphere in the morning was rushed, as staff helped residents get up. As residents were served breakfast in bedrooms, beds were not made, but left stripped. One resident was served breakfast in their bedroom, without their commode being emptied first. An anonymous complaint received by the CSCI, raised concerns that residents were calling out for drinks – but there were no staff around. Time was spent from 9.35am to 11.05am sitting in the lounge, by the main entrance. During this time, staff contact with residents was limited, with long periods spent without a member of staff in the lounge. Residents asked each other when the tea would come. A hot drinks trolley was brought into the lounge at 10.33am. The member of staff then left to answer a call bell. One resident complained over the “lack of staff”, and went off to find a member of staff to pour their drinks. They were informed that staff would come in “two minutes”. At 10.50am a carer came and served the drinks, leaving out two residents who required assistance. Three residents drank their drink straight down. One of the two residents, who were not served, was having their fluid intake monitored by staff. Their record showed that they were given a drink at 11.15am, which was later confirmed by the manager. Residents were observed to walk freely around the home, and enjoy a “smoke” outside, in an enclosed courtyard. Broad Acres Residential & Nursing Home I54-I04 S24345 Broad Acres V222512 050418 Stage 4.doc Version 1.30 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 standard(s) 16 The home has procedures in place to deal with complaints. EVIDENCE: The home’s complaints procedure is displayed in the entrance hall, and a copy contained in the residents information guide. Some residents said that they would raise any concerns with staff, others preferred their family do this on their behalf. Where concerns have been raised, which required police intervention, the home has been acted quickly, to protect the residents interest. The complaint investigated during the inspection found: • • • • Concerns over sticky carpets, and tabletops - Not upheld (although some carpets were found to be marked, and required cleaning). Concerns over unpleasant odours – Upheld. Concerns that staff were not around and residents were left calling out for drinks – Upheld. Concerns that resident’s fingernails were dirty and had not been cut – Not upheld. Where complaints were upheld, the home has been asked to take action to put it right. Broad Acres Residential & Nursing Home I54-I04 S24345 Broad Acres V222512 050418 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 24 and 26 The layout, manual handling equipment and furniture supplied by the home, does not meet all the service users mobility and environmental needs. Although the standard of hygiene has improved at the home, it still does not come up to an acceptable standard. With the home not being kept clean, it could potentially put residents at risk from infection. EVIDENCE: A look around the home found one carpet with black marks, another bedroom carpet had an unpleasant odour. Some of the armchairs in the lounges were dusty and found to have broken cushion zips, or which were not the right one for the seat. Not all the armchairs are suitable for each of the resident’s requirements. The Manager confirmed that this will be looked at, as part of the OT report. From the sample of 6residents bedrooms looked at, one carpet was marked and had an odour. One armchair was dirty and had a broken spring, which Broad Acres Residential & Nursing Home I54-I04 S24345 Broad Acres V222512 050418 Stage 4.doc Version 1.30 Page 16 was seen to be unsafe, and the home was asked to take immediate action to remove it. The home has been asked at a previous inspection to make sure beds where checked each day, and made up with clean linen. A sample of six beds, which had been made were checked. Out of these, five were found to have dried faeces or urine marks on the bedding. One crumpled bottom sheet still had a half dissolved tablet attached. The worst bed, with dried urine stains on the sheet was shown to the manager, who said that the resident usually made their own bed. This had been their reply at a previous inspection, for another resident. For this reason the bed had been left until the end of the inspection, before asking staff to see it. One resident, with permission of their Social Worker, Doctor and Physiotherapist, is restrained with a lap belt in an ordinary chair. During the last inspection they were trying a specialist chair, which they found more comfortable. The Manager confirmed that funding is being sought, and the chair will be purchased. Throughout the home were supplies of disposable gloves, and aprons used to prevent the spread of infection. Clean sheets were found stored in the toilet, next to a open container of dirty clothing. A toilet located close to bedrooms was found to have dried faeces marks on the light switch. The two narrow corridors do not accommodate wheelchair users. Concerns were raised over the home not having enough mobility aids, manual handling equipment and range of armchairs, suitable to the needs of the residents. The whole of the premises needed to be looked at, to ensure residents could safely move around the home. The management were asked to find an Occupational Therapist, with knowledge of older people with dementia. The Manager said that although it had been difficult to find a suitable person, they had had at last found a private OT. They were booked to visit the home on the 26th April 2005, to undertake a full survey. A resident felt that by being able to bring in their own personal possessions, had made their room feel more “homely” and “their own”. Broad Acres Residential & Nursing Home I54-I04 S24345 Broad Acres V222512 050418 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29 The home does not always have sufficient staff on duty, to meet individual residents needs and keep a clean environment. This places a potential risk for residents and staff. The home needs to look at staffing levels in the long term. If they are unable to maintain staffing levels this need to be taken into account when accepting residents with high care needs. The home has not always followed safe recruitment procedures, which could place residents at risk. EVIDENCE: The home has a history of having problems recruiting staff and keeping staffing levels up. Residents said they would like to see more staff, and felt sorry for the current staff who were always “busy”. They did not like to use the call bell unless they really had too, as they felt this put more pressure on staff. Staff said they had problems covering last minute sickness, which resulted in staff having to change their normal hours to cover. At the time of the inspection, the manager was covering for the nurse who had worked the previous night. While trying to cover as nurse, the manager was also was required to attend a meeting. Limited time was spent asking care staff for feedback on management and training, to ensure time was not taken away from the residents. Broad Acres Residential & Nursing Home I54-I04 S24345 Broad Acres V222512 050418 Stage 4.doc Version 1.30 Page 18 Domestic staff confirmed that a new cleaner had just been taken on and will be starting soon, which will give extra cleaning hours. The home now has domestic cover at weekends. Two staff records were looked at. One file only had one reference and there was no paperwork to confirm who they are. The second file had both references, but no information on where they had worked before, or paperwork to confirm who they are. Staff said that the paperwork to confirmed who they were had been seen, as Criminal Records Bureau clearance had been obtained. But no copies had been made to keep on file. The employment application form used by the home, only requested information on new staff’s work history, for the last five years. Broad Acres Residential & Nursing Home I54-I04 S24345 Broad Acres V222512 050418 Stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 The home has a safe system of recording and keeping monies held for Residents. EVIDENCE: Individual plastic pockets or envelopes are used to store each of the residents monies held for safekeeping. Individual account records, gave details on money coming in and out, which included receipts. A sample of 2 residents account records were checked against the money held, which was found to be correct. Broad Acres Residential & Nursing Home I54-I04 S24345 Broad Acres V222512 050418 Stage 4.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x 2 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 x COMPLAINTS AND PROTECTION 2 x x x x 2 x 2 STAFFING Standard No Score 27 2 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x 3 x x x Broad Acres Residential & Nursing Home I54-I04 S24345 Broad Acres V222512 050418 Stage 4.doc Version 1.30 Page 21 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. Standard 4, 12 Regulation 12, (2) 16 (2) (m) Requirement A social activity programme must be developed for residents with dementia, to supplement the activities already happening at the home. Nurses must monitor residents personal care and nutrition to ensure staff are taking appropriate action. Care records must be kept up to date and reflect actual care given. Staff must be given clear guidelines to support residents with dementia. Staff must ensure residents are offered and have access to drinks at all times, unless a Doctor has requested fluids to be restricted. Where wheelchair lap belts are used as a method of restraint for the safety of the resident, restraint forms must be completed in joint consultation with the resident, their relative or representative. Action must be taken to replace, or repair and recover the armchair in Bedroom 1. Timescale for action 30/08/05 2. 7,8 12 (1) (a)14 (2) 15 (2) 15 (1) (2) 17 (3) 15 (1) 16 (2) (i) Immediate and ongoing Immediate and ongoing Immediate Immediate and ongoing Immediate 3. 4. 5. 7, 8 8 8 6. 8 14 (2) 7. 19, 24 16 (c) 13 (4) (a) Immediate Broad Acres Residential & Nursing Home I54-I04 S24345 Broad Acres V222512 050418 Stage 4.doc Version 1.30 Page 22 8. 26 16 (2( (j) (k) 13 (3) 9. 27 18 (1) (a) 10. 29 19 (1) 2 (6) 11. 29 19 (1) (16) Schedule 2 (1-6) Staff must ensure that the home is kept clean and hygienic. · Beds made up with clean linen* · Commodes emptied · Walls/toilet roll holders kept clean from bodily fluids* · Soiled clothing not left in open linen containers · Unpleasant odours eliminated * · Furniture (armchairs, settees) and carpets cleaned (*Timescale not met from 20/1/05) The home must review their staffing rotas, to ensure they have sufficient staff on duty at all times to meet individual residents physical, mental and social care needs. The home must obtain a full employment history for all new staff. Where staff have worked with children or adults previously, the home must try to confirm the reason for them leaving. The home must ensure that staff do not commence employment until they are in receipt of all required paperwork, and steps have been taken to validate identity. (Timescale not met from 20/01/05) Immediate 30/06/05 Immediate Immediate 12. 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 13 Good Practice Recommendations To support residents with dementia, the home should seek advice from advisory groups such as The Alzheimer Association, to help develop activities and if required, access training for staff. I54-I04 S24345 Broad Acres V222512 050418 Stage 4.doc Version 1.30 Page 23 Broad Acres Residential & Nursing Home 2. 3. 4. 14 14 27 The home should review their morning routines, including serving of breakfast, to give more flexibility and choice for residents. The management, to promote a more supportive atmophere for both residents with or without dementia, should review the layout and deployment of staff. The home should look at sending staff on training such as ‘Dementia Mapping’ and ‘Validation Therapy’, to support staff in caring for, and improving the environment for residents with dementia. Broad Acres Residential & Nursing Home I54-I04 S24345 Broad Acres V222512 050418 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection CSCI 5th Floor St Vincent House 1 Cutler Street Ipswich, IP1 1UQ 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 Broad Acres Residential & Nursing Home I54-I04 S24345 Broad Acres V222512 050418 Stage 4.doc Version 1.30 Page 25 - 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. 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