Inspection on 23/08/05 for Broadwater Lodge

This inspection was carried out on 23rd August 2005.

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

The inspector 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

Broadwater Lodge 26/11/07

Broadwater Lodge 02/07/07

Broadwater Lodge 09/08/06

Broadwater Lodge 08/04/05

Broadwater Lodge 16/08/04

Broadwater Lodge 20/05/04

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Broadwater Lodge, Summers Road Farncombe Surrey GU7 3BF Lead Inspector Vera Bulbeck Announced 23 August 2005 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. Broadwater Lodge, H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Broadwater Lodge, Address Broadwater Lodge, Summers Road, Farncombe, Surrey, GU7 3BF 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) 01483 414186 01483 422232 Care UK Community Partnerships Limited Miss Susan Jane Cripps Care home only (PC) 50 Category(ies) of Old age, not falling within any other category registration, with number (OP) - 6 of places Dementia - over 65 years of age DE(E) - 44 Sensory Impairment over 65 years SI(E) - 3 Physical disability over 65 years (PD(E))- 4 Broadwater Lodge, H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1: Up to 2 (two) persons may be aged 60-65 years in the categories PD or DE 2: Up to 10 persons may be admitted to the home for short stays only. Date of last inspection 8th April 2005 Brief Description of the Service: Broadwater Lodge caters for the needs of older people, providing permanent and respite care, including specialist dementia care and a day care service. The home is situated in Farncombe a short distance from the local shops. Community facilities are nearby and easily accessible to the home. Residential accommodation comprises of 5 self-contained units, each unit caters for 10 residents. All bedrooms are of single occupancy and each unit has its own bathroom, toilet, lounge, dining area and kitchenette. The gardens are nicely arranged and safe for the residents to enjoy. Broadwater Lodge has spacious communal areas and the residents are encouraged to use and enjoy the whole building. The home has a shop run by volunteers, to enable residents to purchase toiletries, drinks, books and a number of other items on sale. There is ample parking in the front of the building. Broadwater Lodge, H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second inspection to be undertaken by the Commission for Social Care Inspection for the year April 2005 to March 2006. For details of how each standard was met please refer to the main body of the report. It will be necessary to review both inspection reports for 2005-06 to obtain a full understanding of the extent to which the home meets The National Minimum Standards for Older People. The inspection was announced, which meant that visitors, staff and residents were aware of the inspection prior to it commencing. The inspectors had the opportunity to speak with a number of residents who live at the home. They were all very complimentary about the home and spoke affectionately of the registered manager and staff. Mrs V Bulbeck, Lead Inspector for the service, Mrs H Dickens Regulation Inspector and Mrs G Yates Pharmacist Inspector carried out the inspection. Miss S Cripps, Registered Manager was present. The home is registered for fifty places. There are currently forty-one residents living in the home, and eight respite residents. A full tour of the premises was undertaken. Five care plans were observed and three staff files were inspected. Four members of staff were spoken with during the inspection as well as ten residents and two relatives. Nine comment cards were received from care managers and two G.Ps the majority of comments were positive, however, some of the comments regarding communication in the home and staff awareness indicated staff need further training this was discussed at the time of the inspection. Eleven residents comments were provided mainly with the help and support of staff and the majority of comments stated they are satisfied with the home, but there was not enough activities and not stimulating. The staff were observed to be courteous and the atmosphere within the home was relaxed and friendly. The inspector wishes to thank the residents and staff for their co-operation and hospitality during the inspection. The residents living in the home wish to be called residents, therefore service users will be referred to as residents throughout the report. Broadwater Lodge, H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 Page 6 What the service does well: What has improved since the last inspection? What they could do better: On the day of the inspection a number of bedrooms contained large quantities of continence supplies, which should be stored out of sight to protect the privacy and dignity of residents. The activity organiser needs specialist training in activities for people with dementia and must continue and finish the project to have up-to-date assessments for social/leisure activities for all residents. Broadwater Lodge, H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 Page 7 The inspectors highlighted some issues regarding the catering at Broadwater Lodge and these need to be kept under review. Details are contained in the main body of the report. One resident needed to have their risk assessments up-dated to encompass challenging behaviour. The home must ensure that all visitors to the home must sign the visitors book to enable an accurate record is kept for safety precautions. 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. Broadwater Lodge, H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Broadwater Lodge, H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 4 Assessments at this home enable staff to identify and meet resident’s needs in a consistent way. EVIDENCE: Five residents files were examined during the course of the inspection. These files contained detailed information on each resident including assessment regarding their health and care needs, risk assessments and details of reviews. Night care plans were particularly informative and would ensure staff could support residents in the most appropriate way. Residents spoken to confirmed that their needs were being met though some had previously commented that the activities were not as stimulating as they might be. Social/leisure needs assessments are discussed later in this report. Broadwater Lodge, H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 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) 7,8,9 and 10 Resident’s care plans at Broadwater Lodge are sufficiently detailed to enable staff to offer appropriate support to residents. A review of medication handling was undertaken by a CSCI pharmacist inspector who concluded that whilst all but one resident was receiving their medication as prescribed there was room for improvement in the safe handling of medicines in this service. EVIDENCE: Detailed care plans identify resident’s health and personal care needs and arrangements for specialist interventions are made. The home keeps records of opticians, dentist and chiropody visits for residents. Nutritional needs have been identified and individual residents who need close monitoring in this respect are identified. One resident was seen to be eating roast potatoes at lunch however, the resident’s care plan said fatty foods such as roast potatoes should be avoided. The Registered Manager said it was this resident’s own choice to vary the special diet from time to time. Each unit kept a record for residents whose nutritional needs required monitoring and these were viewed on the day of the inspection. Medication stocks and records were sampled and showed that the majority of residents were receiving their medication as intended by their doctors. However one resident was being given medicines from an unlabelled Nomad tray and no record was being kept of the actual medicines given to this Broadwater Lodge, H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 Page 11 resident. When a variable dosage of medication was prescribed the records did not show the actual dose given and when medication was not given the records were not consistent in stating the reason why it was not given. Medication was stored securely for the protection of the residents. However, security was compromised by the practice of handing all of the medication cupboard keys to the District Nurses when they come into the home to give insulin. Two residents were holding and administering creams and ointments but there were no written risk assessments covering this activity. Residents spoken to were generally happy with their experiences at the home and they highlighted no issues regarding their privacy and dignity. The inspector noted a number of examples where staff interacted in a positive and respectful way with residents. In was noted the Registered Manager dealt very sensitively with a resident who was concerned about a relative who was very ill. A number of residents had large supplies of continence supplies in their bedrooms, which were on view. The Inspector advised if the home could investigate more suitable, and private, storage arrangements. Broadwater Lodge, H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 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) 12,13,14 and 15 The home can demonstrate how it enables residents to exercise choice in their daily lives. Recent improvements in arrangements for social and leisure activities at Broadwater Lodge have started to have a positive impact on residents. Residents generally enjoyed the food at Broadwater Lodge but some aspects need to be kept under review. EVIDENCE: It was pleasing to note one of the ways in which resident’s at Broadwater Lodge can exercise choice is through the regular residents meetings. Minutes from meetings held during the first part of this year highlighted a number of issues raised by residents including positive comments about the new activities organiser, the food, and suggestions for outings. The new Activity Organiser was interviewed and demonstrated both enthusiasm and commitment to improving the quality of life for residents through social and leisure activities. Good records were being kept of individual’s involvement, and the slow but thorough process of assessing each resident with regard to their needs, preferences and capacities had begun. It is important that this work is completed as a number of negative comments were received (both from residents and professionals) about the level of stimulation in the home. Broadwater Lodge, H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 Page 13 The home may also wish to consider the regular involvement of care staff during activity sessions. This would have the dual purpose providing for resident’s personal care needs during activity sessions, but would also benefit staff that would be able to spend some time with residents engaged in recreational pursuits. A day by day, weekly or monthly programme of activities, in a format accessible to residents, needs to be displayed in each unit in a place where residents, their relatives, visiting professionals, and the home’s staff are likely to see it. The existing programme on the main notice board was not easy to follow and not an accurate reflection of what activity had occurred on any particular day. The new activity organiser has had general training in dementia. However, specific training for activities with people who have dementia is necessary, in order to be confident that the efforts made are in line with latest best practice and sufficiently stimulating for this client group. There were examples of resident’s community involvement and the Registered Manager should be commended for her efforts to get relatives involved in the home. A standard letter inviting resident’s relatives to be involved has been drawn up by Care UK; in addition, the inspector was informed that there is an ‘open door’ policy for relatives and friends to speak with staff. The food at Broadwater Lodge received some very positive comments from residents and the Registered Manager said that the recent introduction of cooked breakfasts was proving popular. The lunch period in two of the units for more frail residents was well organised yet very relaxed. The tables had linen cloths, napkins and fresh flowers from the home’s garden. Lunchtime food is cook-chill food, which has been introduced in order to eliminate many of the difficulties and hazards in providing cooked food for vulnerable clients. The food tasted by the inspector on the day of the inspection was mainly tasty and appetising but the vegetables were very over cooked and the coconut sponge was quite dry. The food ran out in two of the units before everyone had been served. The Registered Manager said that staff are instructed to contact the day care unit if this happens, as there is usually more food than they need over there. A consultants report looked at the initial period following introduction of cook-chill food but this should be kept under review due to ongoing difficulties. One resident commented that though she liked the food, they never knew what it was until it arrived. A member of staff confirmed that the menu was in the main kitchen and residents were asked during each service what they would like from the trolley. This is really good practice for those residents who would not be able to benefit from a printed menu. It is recommended that a weekly menu, in a format accessible to most residents, be displayed Broadwater Lodge, H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 Page 14 prominently in each unit. Staff will need to continue to explain the menu at each service to those residents who would not be able to benefit from a printed version. The previous requirements made regarding the kitchen area by the Environmental Health officer had been carried out and the storage area was well organised. Hot food temperatures were carefully recorded though one week’s records were not in the file and were not made available to the inspector. Temperatures of fridges were particularly important given the nature of the food being stored and these were also carefully recorded. The inspector recommended that the jelly in one fridge, used for measuring the core temperatures more accurately, ought to be labelled as not for consumption. A very thorough policy and procedure manual covered the proper handling, heating and serving of the cook-chill food. The inspector noted that home made cakes had been prepared for resident’s afternoon tea. Broadwater Lodge, H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17 & 18 The home has a simple, clear and accessible complaints procedure, which includes timescales for the process. All required policies and procedures are in place to ensure that residents are safeguarded from harm or abuse. EVIDENCE: Relatives confirmed they know how to make a complaint and would feel happy to tell the registered manager or a member of staff if necessary of any concerns. The home has received four complaints since the last inspection. The complaints have been dealt with appropriately and records were observed, to be well documented. The majority of staff has received protection of vulnerable adults (POVA) training. Broadwater Lodge, H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 24 & 25. The location and layout of the home is suitable for it’s stated purpose. It is accessible, safe and well maintained. The home was found to meet residents’ individual and collective needs in a comfortable and homely way. EVIDENCE: The home was comfortable and homely with many nice touches including ornaments and pictures and a cosy library area for residents to enjoy. On the day of inspection it was noted relatives and friends use this area to speak with their family member. The dining rooms were nicely laid and residents obviously appreciated this, one resident commenting on the nice table linen. Furnishings were of good quality and homely. All residents spoken to said they liked their bedrooms, the majority of bedrooms were carpeted and well kept. Bedrooms still do not have lockable storage space despite this being discussed at previous inspections. Broadwater Lodge, H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 Page 17 The Handyman should be complemented for the clear and consistent records being kept on water temperatures within the home. The inspector recommended that individual outlets (rather than units within the home) should have temperatures recorded in order to show when individual thermostats may need altering. One outlet was 44-45C and needed a slight alteration. The gardener/handyman was growing flowers and vegetables in the green house and a vegetable patch. The inspectors were informed some residents are involved with the gardening and supported by the gardener. Broadwater Lodge, H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 Page 18 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, 29 & 30 The home has a comprehensive staff training programme which incorporates all areas of training to ensure, as far as reasonably possible, that residents are in safe hands at all times. EVIDENCE: Training has been ongoing and the majority of staff has attended a number of training courses. However, there is a need for staff to attend updates to training particularly first aid training, which is required every three years. A training programme is in operation, to ensure training records are kept up to date. All new staff receive induction training, which covers all mandatory training. The staffing ratio observed was adequate however; the registered manager stated staffing levels are under constant review. Including the laundry assistants and domestics. However, on the day of inspection it was noted care staff on two units were cleaning/hovering and residents were sitting in the lounge area unsupervised. This practice is not acceptable and unsafe; residents must be supervised at all times. Full recruitment procedures must be followed. All staff have been checked against the Criminal Records Bureau (CRB) before working in the home. Staff records were observed and found to be well documented, including contracts and terms and conditions. However, full details of staff must be available in the home including two references and staff application form. Broadwater Lodge, H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 Page 19 Broadwater Lodge, H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 Page 20 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) 31, 36, 37 & 38 The home has an effective quality assurance and monitoring system in place that is based on seeking the views of the residents and relatives. All policies, procedures and practices are in place to ensure, so far as is reasonably practicable, the health safety and welfare of residents and staff. EVIDENCE: The registered manager is experienced and capable of managing the home, and is in the process of commencing the Registered Managers Award and should be completed by November 2005. Staff are supervised on a regular basis and goals are set for training needs and identifying how the home can improve the care provided. All staff receive supervision on a regular basis. A number of records were observed and found to be well documented these include the accident book, fire records, training, residents and staff meetings; as well as health and safety records. However, the water temperature must be monitored and kept to the requirement of 43 Broadwater Lodge, H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 Page 21 degrees Celsius. On the day of inspection it was noted the temperature was 44 degrees Celsius. Broadwater Lodge, H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 Page 22 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 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x x 2 3 x STAFFING Standard No Score 27 2 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 x x x x 3 3 3 Broadwater Lodge, H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 Page 23 No 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 10.1 Regulation 12(4)(a) Requirement The home must review the storage of continence supplies to protect the dignity and privacy of residents. The home must continue with and complete the detailed assessments of residents needs, preferences and capacities with regard to social and leisure activities. The home must review the provision of food with regard to the issues highlighted in the detail of this report. A copy of this review should be sent to CSCI. Menus should be displayed in each unit, in a format accessible for the majority of residents. Residents who hold and administer any of their own medicines must have a written assessment of risk. Complete and accurate records must be kept of all medication administered to residents. All medication must be labelled with a dispensing label indicating to whom the medication is to be administered and at what dosage and frequency. Timescale for action 23.09.05 2. 12.3 12.4 16 23.11.05 3. 15.1 15.7 16(2)(i) 23.11.05 23.10.05 4. 9 13(4)(b) 6.9.05 5. 6. 9 9 17(1)(a) 13(2) 30.8.05 26.8.05 Broadwater Lodge, H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 Page 24 7. 9 13(2) 8. 9. 10. 24 27 29 23 18 19 11. 30 18 The keys to the medication cupboards must be kept on the person of the designated carer at all times and not handed over to health care workers not employed by the service. All bedrooms must have a lockable facility. Staffing levels must be maintained at all times including when staff are on holiday. Full recruitment details must be available in the home at all times. Including application form and references. All staff to receive up dates to training, and staff to receive training appropriate to the work they are under taking including the activity orgainser. 20.9.05 25.11.05 26.08.05 26.08.05 25.11.05 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. Refer to Standard 25 26 Good Practice Recommendations Water temperatures for individual outlets should be recorded. Sluices checked were clean and tidy. Though the home was generally clean and hygienic, on the day of the inspection one area of the home was not free from offensive odours and this needs addressing as soon as possible. The new activities organiser must have some formal\and specific training in providing activities for people with dementia. It is recommended as good practice that when it is necessary to handwrite on a medication administration record chart in the home that the member of staff writing the chart signs and dates the chart and that a second carer checks the entry for accuracy and then initials the chart. In addition the entry should include a reference to where this information was sourced, such as the H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 Page 25 3. 4. 30 9 Broadwater Lodge, 5. 12 6. 7. 15 prescriber’s name. A day by day, weekly or monthly programme of activities, in a format accessible to residents, needs to be displayed in each unit in a place where residents, their relatives, visiting professionals , and the home’s staff are likely to see it. There was insufficient food in two of the units before all residents had been served. There must be ample food on each unit to enable residents to have extra if required. Broadwater Lodge, H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 Page 26 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Broadwater Lodge, H58 - H09 s13892 Broadwater Lodge v231181 230805 Stage 2.doc Version 1.40 Page 27 - 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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