Inspection on 26/04/06 for Brookview Nursing Home

This inspection was carried out on 26th April 2006.

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

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

Other inspections for this house

Brookview Nursing Home 26/09/07

Brookview Nursing Home 06/02/07

Brookview Nursing Home 18/10/06

Brookview Nursing Home 23/01/06

Brookview Nursing Home 05/09/05

Brookview Nursing Home 02/03/05

Brookview Nursing Home 20/10/04

Brookview Nursing Home 29/03/04

Brookview Nursing Home 07/10/03

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

CARE HOMES FOR OLDER PEOPLE Brookview Nursing Home Holmley Lane Dronfield Derbyshire S18 6HQ Lead Inspector Susan Richards Unannounced Inspection 26th April 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Brookview Nursing Home Address Holmley Lane Dronfield Derbyshire S18 6HQ 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) 01246 414618 01246 414657 Brookview Nursing Home Ltd Ms Sheila Bacon Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd January 2006 Brief Description of the Service: Brook view Care Home provides nursing and personal care for older persons, with the number of service users to be accommodated in accordance with the stated conditions of the homes registration. The registered provider took over ownership of the home on 17 March 2003 and has invested considerably in the substantial redevelopment and upgrading of the home and its facilities. There are 54 single bedrooms, 44 of which have en suites. There are three double bedrooms, one having and en suite facility. There is a choice of communal bathing, shower and toilet facilities suitably located. There two separate lounge areas and one combined lounge/dining room. Suitable equipment is provided to assist service users who may have physical disabilities, including an emergency call system located in all areas which service users access and a shaft lift giving access to all levels of service users areas. Level and ramped access is provided to garden areas, with seating provided. Visiting to the home is open and service users are provided with care and support from a team of nursing, care and hotel services staff. Since the previous inspection of this service, the registered manager has transferred to another home within the group and a new manager has been appointed, who has not yet submitted an application for registered manager with the Commission. Fees charged per week are in accordance with individually agreed terms and conditions between the home and individual resident detailing the local authority purchasing contracts for individual’s placement in the home or, where privately funded they are in accordance with a written contract agreed between the home and individual resident. Fees charge are as follows:Residential clients (personal care only) – As at 26.04.06 fees range from £286.80 to £356.80 per week. Fees are banded and determined in accordance with individuals assessed needs/levels of care and individual accommodation. Nursing residents per week – As at 26.04.06 fees range from £403.50 to £502.50. Fees determined as stated above. Information regarding fees was provided by the home Administrator. Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 Page 5 Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. There were 33 residents accommodated (15 receiving nursing care and 18 personal care only). Case tracking was undertaken for a total of three residents, two in receipt of nursing care and one personal care. This involved examination of the personal, social and health care records for those individuals, together with the examination of other associated records. Discussions were held with service users, a number of relatives and representatives about the care and services they received and residents’ private and communal accommodation, together with other facilities and services were inspected. Discussions were held with the manager and staff in relation to the organisation and delivery of care and support for residents in the home and the same was observed during the course of the inspection. Arrangements for staff recruitment, induction, training and support were also examined and discussed with the manager and staff. What the service does well: What has improved since the last inspection? There has been marked progress in terms of recruiting additional staff and improving the staff skill mix, which has in turn promoted measured improvements in the organisation and delivery of care and service provision to residents. Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 Page 7 The final phase of the redevelopment and upgrading of the home (refurbishment and redecoration of the original part of the building) is well underway and is to a good standard. 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. Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 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 the following standard(s): 3&4 Areas of omission in the recording of residents needs assessment information, together with identified deficits in staffs’ practise and/or knowledge undermined the home’s capacity to validate that individuals needs were being fully met. The home’s system for the organisation of care delivery, which is based on allocating staff to areas of the home, promotes a task orientated approach to care delivery rather than individualised person centred care. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. EVIDENCE: The individually recorded needs assessment information for those residents case tracked were examined and there were discussions/contacts with residents, their relatives and staff in relation to residents needs and how these were being met. Discussions were also held with the manager and staff about the arrangements for staff induction and training and the operational method Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 Page 10 used in the home for the organisation of care delivery to residents. Staff practises were also observed. (See staffing section of this report). Standardised documentation was in place to enable the recording of individual needs assessment information in accordance with a recognised model of care. However, there were significant omissions of record in some aspects of the needs assessment information of those residents case tracked. Particularly in respect of individuals psychological, cognitive and social care needs and medication usage. Omissions of recording in relation to care records is an issue, which was evident at the previous inspection for this service (January 2006) and was also included in the outcomes of two recent complaints made about the home. (See complaints section of this report). Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Residents’ written care plans did not always promote an individualised person centred or holistic approach to resident’s care and or set out individual’s social and psychological/cognitive care needs and interventions. The physical support and health care needs of residents were fairly well met and their privacy and dignity respected and upheld. However, the current arrangements for the organisation of care delivery in the home did not always promote a timely and consistent approach for residents’ access to outside health care professionals. Quality in this outcome area is adequate. The judgement has been made using available evidence including a visit to the service. EVIDENCE: The health care records (including needs assessment information, care plans and medicines administration records) were examined for those residents case tracked. The Inspector was not able to engage in meaningful discussion with residents’ case tracked about their care plans due to their individual capacities. Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 Page 12 For those residents case tracked detailed written information had been provided by their relatives/representatives in terms of their familial and social histories and lifestyle preferences by way of their written completion of a suitable document provided by the home. These provided an excellent basis to promote person centred care for each resident by way of their written care planning interventions. However, some key aspects of the information provided were not reflected in their written care plans. For example in respect of the provision of their cognitive/psychological and social care. This was raised at the previous inspection for this service in January 2006. The physical care of residents case tracked was generally well accounted for and care plans in respect of these were formulated in accordance with their risk assessed needs and detailed regularly recorded reviews. However, some aspects of individual’s care were unclear in relation to systems for ensuring that where required, referrals were made to outside health care professionals and also staffs’ responsibilities in triggering such access the monitoring of outcomes in relation to these. The Inspector discussed this with the manager in conjunction with the home’s approach to the organisation of care delivery to residents, staff deployment and skill mix and responsibilities of staff on duty for each shift. (See also Staffing section of this report). The medicines administration records of those residents case tracked were examined and were properly recorded and well maintained. The Inspector observed medicines administration being undertaken by the Registered Nurse on duty and the arrangements for the storage and administration of residents’ medicines were discussed with him and the manager. It was acknowledged that storage space for medicines is limited, with the potential to be insufficient given the capacity to significantly increase the number of residents accommodated now that the redevelopment and upgrading of the physical environment of the home is almost completed. The Inspector observed staffs practise in respect of their approaches to residents at various times throughout the inspection. Staff were observed to be respectful in their approaches to residents and mindful of their dignity and privacy needs. Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 The support for residents to maintain their contacts and relationships with families and friends was good, although, with the exception of regular and structured exercise sessions, the organisation of activities and occupation for residents was minimal. Residents are provided with sufficient nutrition and mealtimes are well organised with effectively supported and assisted from staff. It is likely that the variety, quality and choice of food available to residents will improve with the implementation of the menu reviews proposed by the home. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The previous inspection for this service – January 2006 detailed the need to ensure adequate provision for social stimulation and occupational activities for residents. The Inspector examined the arrangements to enable residents to engage in leisure and social activities of their choice, the promotion of their routines of daily living, maintenance of their personal and social relationships and lifestyle preferences. Account was taken from discussions and contacts in Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 Page 14 relation to these with residents and/or their relatives and representatives, staff working in the home and the manager and also examination of care records and associated records. The manager advised of plans to recruit an activities co-ordinator. The organisation and provision of meals was discussed with staff and residents and relatives/representatives and the Inspector observed meals being served to residents at both lunch and teatime. Meals were calm and unhurried, tables were well set and residents assisted by staff in accordance with their individual needs. Menus were also examined and discussed further with the manager and staff in relation to promoting choice. The Manager advised that menus were under review with a view to increasing choice and improving quality and also to ensure that daily menus were provided on each dining table. This had commenced with a total revision of the breakfast menu, which was a positive improvement. The nutritional requirements and special diets of residents were accounted for. The presentation of homogenised diets was also discussed, as was the provision/choice of drinks. Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 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 the following standard(s): 16 & 18 Residents and their relatives know how to complain. The registered persons have taken reasonable steps to act on formal complaints made and identify areas for further action. However, there are a number of key areas identified in this report, which if acted on will ensure a more proactive approach to care and service provision, thereby reducing the potential for omissions of care and/or further complaints. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The complaints procedure for the home is clear and openly displayed in larger print. Details of how to complain are also provided in the statement of purpose and service user guide for the home, which are provided for residents and their relatives. The Inspector looked at complaints and concerns made about the home over the previous 12 months. A formal written record is kept of complaints and concerns received by the home, together with action taken, although outcomes in terms of the complainant’s expressed satisfaction or otherwise were not always recorded. There have been a number of complaints and concerns raised with the home directly and also via Social Services and the Commission and Social Services. Four were direct complaints in respect of the care of individual residents, one of which has been investigated via Social Services under their joint agency safe guarding adults, procedures. All of the Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 Page 16 complaints were partially upheld. Action plans have been provided by the home in relation to the complaint investigated under safe guarding adult procedures and the complaint made via the Commission. During this inspection, the relevant National Minimum Standards relating to the assessment and care residents in the home, staff training and record keeping have been inspected. Outcomes are detailed under the relevant sections of this report. Concerns have also been raised by staff and relatives, both directly to the home and the Commission regarding inadequate staffing levels in the home, (see Staffing section of this report) and a lack of structured occupational activities for residents, (see Daily Life and Social Activities section of this report). Although these concerns were recorded, they have not been acted upon in a pro-active or timely manner (see previous inspection report 23/01/06). Clear policy and procedural guidance is provided for staff in the home in respect of safe guarding adults and all staff had received training in relation to this since the previous inspection in January. The arrangements for the management and handling of residents’ monies were not inspected on this occasion. These were inspected at the previous inspection for this service and were satisfactory. Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 The planned and phased total redevelopment and upgrading of the home is well on target and almost complete, resulting in a clean and well-maintained environment, which is furnished and decorated to a high standard and generally well equipped. However, safe practises in relation to infection control were not always being promoted or applied. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. EVIDENCE: A full tour of the building was undertaken. All communal areas accessed by residents were inspected, together with a number of bedrooms, including those rooms of residents’ case tracked, together with their bathing and toilet facilities and service areas. Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 Page 18 In July 2005 an application to vary the home’s registration to increase the number beds from 40 to 60 was granted in accordance with identified conditions, which have been assessed as complied with. The original part of the home has also been subject to a full programme of upgrading, repair and renewal, which is due for completion by June 2006. Part of the redevelopment also included the provision of an enclosed garden for residents, which is completed, although at the time of the inspection there was no seating provision in this area for residents. The manager advised that these would be provided. All parts of the home seen were clean and odour free, well lit and ventilated and furnished and equipped to a good standard as per the upgrading programme. The upgrading and redevelopment of the home has also created increase lounge and dining space for residents, with a choice of lounge areas and a multi purpose quiet. During the tour of the building, the Inspector observed poor practises in respect of storage and infection control. These included wheelchair storage, the handling and storage of soiled bed linen and towels, storage of waste and hand washing facilities. Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Progress with NVQ training for care staff was well established, however the inconsistent approach to the identification of staffs’ individual training and development needs and provision of the same undermines the efficacy of care and services offered by the home. Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to the service. EVIDENCE: The arrangements for staff recruitment, induction, training and supervision were examined. This included discussions with the manager and staff, examination of associated records and observation of staff practises during the inspection. Staff files were examined for four staff of different grade and skill mix, including two more recent staff starters. Records kept in relation to their recruitment were in accordance with requirements and discussions with staff were reflective of proper recruitment processes. Discussions with staff regarding the arrangements for their induction, training and supervision, observations of their practise and examination of associated records identified omissions and inconsistencies regarding the provision of the same. The manager advised that a clinical nurse lead has recently been appointed for the group with identified time to be spent in the home each week and also advised of training recently organised and undertaken by staff. Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 Page 20 At the previous inspection for this service in January 2006, serious concerns were raised with the registered provider regarding insufficient staffing levels in the home. An additional visit was made to the home following this and a further inspection of staffing arrangements undertaken. These were satisfactory and for the most part have remained so. Discussions were held with the manager regarding recruitment to vacancies and the planned increase in resident admissions over the coming weeks. The manager advised that a planned approach to increasing staffing levels and ensuring appropriate skill mix in accordance with further admissions to the home was to be applied. Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 36, 37 & 38 Arrangements to promote the health, safety and welfare of residents and staff are in the main satisfactory, although a number of deficits were identified in relation to safe working practises. Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to the service. EVIDENCE: The manager of the home has been in post since the end of February 2006 and is yet to submit her application to the Commission as registered manager for the home. Details of recognised training provided for all staff in respect of equality and diversity were provided by the manager, which the inspector discussed with staff on duty. The Manager also discussed her planned introduction of a resident satisfaction survey. Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 Page 22 Comments have been made under the staffing section of this report in respect of staff supervision, induction and training arrangements, including core training to ensure safe working practises, for which some staff identified areas they had not received training/updates. Staff records examined reflected this. Discussions were also held with the manager about these. A number of records, which are required to be kept, were examined during this inspection. These are referred to under the relevant sections of this report. Satisfactory details of the arrangements for the servicing and maintenance of equipment have been provided over recent months and are satisfactory. The systems and arrangements for the reporting and recording of accidents and untoward incidents in the home were examined, including incidents reported in writing to the Commission. Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 2 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X 3 X 1 2 2 Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14 Requirement Timescale for action 30/06/06 2. OP7 15 3. OP8 13, 17 5. OP26 13 Individual residents recorded needs assessment information must include all areas as detailed under NMS 3.3 for Older Person and in accordance with Regulation 17, Care Homes Regulations 2001. Original timescale by 28/02/06. The residents care plan must 30/06/06 detail as to how their needs are to be met in respect of their social and psychological care. Original timescale by 28/02/06. The registered person must 30/06/06 promote a consistent approach to ensure that where necessary, treatment and advice from other healthcare professionals is arranged and that a record is kept of this for each resident. Original timescale 28/02/06 The registered person must 30/06/06 make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the home. In this instance suitable provision for the storage and handling of soiled lined, provide suitable DS0000002046.V288901.R01.S.doc Version 5.1 Brookview Nursing Home Page 25 6. OP30 18 7. OP36 18 receptacles for waste disposal in bathroom and toilet areas and hand washing facilities in the identified bathroom – 1st floor extension. The registered person must 31/07/06 ensure that persons employed to work at the home receive training appropriate to the work they are to perform and that records are effectively maintained in respect of this for each staff member. The registered person must 31/07/06 ensure that all times staff is competent to meet the health and welfare needs of residents. In this instance ensure that staff are effectively supervised by way of formal individual supervision at least 6 times per year. 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. 4 5 Refer to Standard OP4 OP26 OP15 OP15 OP30 Good Practice Recommendations The registered persons/manager should seek to review the system for the organisation of care delivery to residents and introduce a named nurse and key worker system. A rollator iron should be provided in the laundry. Staff should be more pro-active in their consultation with residents in order to ensure they are offered increased opportunity for choice. Attempts should be made to make homogenised meals more appealing for residents who require them and consider the use of individual food moulds. The registered manager should undertake a staff training needs analysis and training plans for staff. Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Brookview Nursing Home DS0000002046.V288901.R01.S.doc Version 5.1 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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