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Inspection on 03/10/05 for Burlington Court Care Home

Also see our care home review for Burlington Court Care Home for more information

This inspection was carried out on 3rd October 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Residents spoken to stated that staff were very kind and pleasant. Residents seen appeared clean and well groomed.

What has improved since the last inspection?

Work has been done on the care plans in the dementia unit and the care plans for resident`s physical needs in this area are very good. Efforts are being made to make the environment more suitable for residents with Dementia in the form of new signage to enable residents to find their way around the home.

What the care home could do better:

Record keeping in the home is poor and does not demonstrate that resident`s best interests are considered. There is no evidence of resident input into their care plans, and little evidence that their individual needs are considered. Staff records are poor, making it difficult to assess if sufficient staff are provided or whether these staff have received the necessary training to meet resident`s needs. Difficulties have arisen when residents clothing becomes lost in the laundry and one lady commented that she had had no clean underwear for four days. The home has been required to address these issues.

CARE HOMES FOR OLDER PEOPLE Burlington Court Care Home Roseholme Road Abington Northampton Northants NN1 4RS Lead Inspector Linda Preen Unannounced Inspection 3rd October 2005 10:00 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 Burlington Court Care Home DS0000029409.V255251.R01.S.doc Version 5.0 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. Burlington Court Care Home DS0000029409.V255251.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Burlington Court Care Home Address Roseholme Road Abington Northampton Northants NN1 4RS 01604 250225 01604 230746 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) Burlington Care Homes PLC Vacant Care Home 102 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (76), of places Physical disability over 65 years of age (6) Burlington Court Care Home DS0000029409.V255251.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Up to 20 service users falling within the category of DE(E), Dementia over the age of 65 years, may be accommodated. Up to 6 service users falling within the category of PD(E), Physical Disability over the age of 65 years, may be accommodated. Up to 76 service users falling within the category of OP, Old Age not falling within any other category, may be accommodated. Service users falling within the category of DE(E) will be accommodated only on the first floor of `Tudor Wing`. To offer respite to a named service user as per variation application dated 11.01.05. 10th May 2005 Date of last inspection Brief Description of the Service: Burlington Court Care Home provides personal care for up to 102 service users when it is running at maximum capacity. The home currently caters for older people over the age of 65 years, including up to 20 service users with dementia. Burlington Court is located in Northampton, close to Abington Park, and is near the local shops and facilities of Wellingborough Road. Within the home there are lifts serving the first floor and the building is designed around landscaped gardens. There are three wings, namely Tudor, Saxon, and Windsor wings, each with ground and first floor accommodation, including lounge and dining areas. The first floor of Tudor wing caters for service users with dementia related needs. All bedrooms have en-suite facilities and there are only three shared bedrooms. For enhanced security there is a camera system monitoring the external areas of the home as well as electronic security gates leading to the visitors parking bays. Burlington Court Care Home DS0000029409.V255251.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two hours were spent prior to the inspection reviewing previous requirements and recommendations, comments from residents and relatives and collating information provided by the service. The inspection took place over a period of four and a half hours as part of the statutory inspection programme, and also as part of an ongoing monitoring of the home following Protection of Vulnerable Adult incidents and complaints received about the home. Four residents were chosen in order that their experience in the home could be monitored. This included looking at their records, talking to them and also to the staff concerning the care received. In addition to this staff rotas and Staff training files were seen. 5 comment cards had been received from residents, 4 comment cards from relatives and information was available from a questionnaire completed by the providers of the service. Comments from residents were varied with some being happy with the service while others made more negative comments concerning the food and activities provided. Several relatives commented on the perceived shortage of staff in the home and on problems with the laundry. A resident spoken to at the time of the inspection also commented on the problems with clothing being lost in the laundry. What the service does well: What has improved since the last inspection? Work has been done on the care plans in the dementia unit and the care plans for resident’s physical needs in this area are very good. Efforts are being made to make the environment more suitable for residents with Dementia in the form of new signage to enable residents to find their way around the home. Burlington Court Care Home DS0000029409.V255251.R01.S.doc Version 5.0 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. Burlington Court Care Home DS0000029409.V255251.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Burlington Court Care Home DS0000029409.V255251.R01.S.doc Version 5.0 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 the following standard(s): These standards were not assessed on this occasion. EVIDENCE: Burlington Court Care Home DS0000029409.V255251.R01.S.doc Version 5.0 Page 9 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 and 10 Staff have insufficient guidance to meet individual residents specialist needs. Appropriate referrals are being made to health care professionals in order for them to advise on the care of specialist needs. EVIDENCE: Care plans in Tudor Upper (dementia unit), had been updated and those care plans in place for the resident’s physical needs were very clear, precise and individualised, giving staff instruction on how to meet the needs of this group. However no care plans were in place for the mental health needs of this group of residents. Some of the care plans in place have not been dated or signed, which would obviously cause difficulties when the time came to review these documents. Care plans for residents in Saxon Upper (elderly people) were monitored, and although improvements have been made, these care plans have still not been updated to show the current situation relating to residents in some cases. For example: one resident was recorded as having been constipated for four days on the 10th of September and there was no further mention in her records concerning this problem, leading the reader to conclude that she was still constipated. On discussion with the resident it was ascertained that this was no Burlington Court Care Home DS0000029409.V255251.R01.S.doc Version 5.0 Page 10 longer the case. There was no evidence of service users or their advocates having any input into these care plans. Requirements were made concerning care planning at the previous inspection and remain outstanding. A requirement was made following the last inspection that risk assessments for nutrition and pressure area care were reviewed, updated, and that professional advice was sought where a need was identified. Evidence was available in Tudor Upper that this had happened and resident’s plans reflected the advice that had been given, but there was still contradictory information recorded. For example: One resident’s assessment sheet stated that she needed a liquidised diet but her nutrition assessment recorded ”B has no problems on nutrition. She eats and drinks very well.” In Saxon Upper, there was also evidence provided that some residents who had been identified as being at risk of developing pressure ulcers had been referred to the district nurse for advice. Burlington Court Care Home DS0000029409.V255251.R01.S.doc Version 5.0 Page 11 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 and 15. Activities are not provided to meet individual choices. Food is provided in sufficient quantities but little attention is paid to the individual requirements of residents. EVIDENCE: Residents were observed to be sitting in the communal areas in the home or in individual rooms according to preference. A programme of activities was on display on the notice board in the lounge areas of the home. Old-time music was being played for the residents in Tudor Upper and one resident was enjoying having a manicure during the inspection. Evidence of artwork completed by the residents was on display in this area. A senior carer and deputy manager informed the inspector that new games and craft supplies had recently been purchased and that plans were in the process of being formulated for Christmas activities. A weekly budget is available to provide equipment for activities within the home. Records of individual preferences concerning hobbies and interests were seen in the files monitored. A separate record is kept of resident’s participation in these activities. Lunch was observed on the day of inspection. This looked appetising and was served in good portions, however the meal provided did not correspond with what was on the menu but residents had had a choice on the previous day and this choice was seen to be acted upon. Lunch was served from a hot trolley Burlington Court Care Home DS0000029409.V255251.R01.S.doc Version 5.0 Page 12 and no choice was given to residents concerning their portion size or their preference for different vegetables etc. Those residents who required assistance with feeding were offered this in a sympathetic manner. One resident was being assisted to eat her meal by her daughter. Tables were set in an attractive way and cold drinks were available. Discussions took place concerning liquidising meals for some of the residents and advice was given that the differing components of these meals should be liquidised in order that they were still recognisable as the original foods. Three of the residents comment sheets returned to the inspection unit stated that they liked the food but one of the others recorded that he only likes the food sometimes and the other that he does not like the food. One resident spoken to in Saxon Upper stated that the standard of food was quite good and that they sometimes got a choice. However she was unaware of what was planned for lunch on the day of the inspection. Records were available of residents individual likes and dislikes in relation to food. Burlington Court Care Home DS0000029409.V255251.R01.S.doc Version 5.0 Page 13 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 and 18 Insufficient management strategies are in place to ensure that residents are protected from abuse and that action will be taken following complaints. EVIDENCE: The Commission for Social Care Inspection has received four complaints since May 2005. Three of these complaints concerned issues of resident care and one complaint raised concerns about recruitment practices within the home. The complaints concerning poor care practices were founded and requirements were made in this respect. The complaint concerning recruitment practices was partially founded. Further requirements were made concerning this. In addition to these complaints, 2 incidences have been reported to the Protection of Vulnerable Adults coordinator. Both of these incidences involved lack of care to specific residents, both of these areas were investigated and the home was required to put measures in place to correct the shortfalls identified. Staff were unaware of the correct reporting procedures or of the local Protection of Vulnerable Adults procedures. Burlington Court Care Home DS0000029409.V255251.R01.S.doc Version 5.0 Page 14 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, 23, 24, 25 and 26 Residents live in safe, the comfortable surroundings, but little attempt has been made to ensure that the environment provided is homely. EVIDENCE: A limited tour of the environment was undertaken. This showed that the home was clean and tidy. Inspectors were informed that further domestic staff have been employed and are responsible for different areas within the home. Resident’s rooms were seen to be bright and airy and showed evidence of personalisation with small items of furniture and ornaments on display. The carpet in the corridor outside bathroom 45 is badly stained and worn and is in need of replacement or repair. A requirement was made in this respect. The deputy manager has been working to provide individualised pictures to place on residents doors within the dementia unit in order to aid them in finding their way to their rooms. Burlington Court Care Home DS0000029409.V255251.R01.S.doc Version 5.0 Page 15 Lounge/dining room areas within the home are very large and do not promote a homely atmosphere. Consideration should be given to rearranging the furniture in these areas in order to make more intimate spaces. Staff hand washing facilities are provided throughout the home, and supplies of liquid soap and paper towels were freely available. In addition to this, gloves and aprons are available to staff for use when dealing with bodily fluids. In the kitchen area of Saxon Upper, a fridge contained unlabelled food with no dates of opening, and boxes of nutritional supplement with no resident’s name. The freezer compartment was in need of defrosting. Temperature recordings of this refrigerator have not been done since the 22nd of September 2005 and these temperature recordings were consistently high prior to this, with no evidence that action had been taken to correct this fault. This would cause a risk of food poisoning to residents consuming items from this fridge. A requirement was made in this respect. Several comment cards and telephone concerns had been raised concerning the losing of personal laundry. One lady spoken to reported that she had no clean underwear for 4 days despite laundry being marked with her name. A requirement is made in this respect. Burlington Court Care Home DS0000029409.V255251.R01.S.doc Version 5.0 Page 16 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, and 30 Staff records are insufficient to evidence the numbers and qualifications of staff within the home. Recruitment policies and practices are insufficient to protect the residents within the home. EVIDENCE: A staffing rota was provided as part of the pre-inspection information supplied by the home, but it was impossible to ascertain from this how many staff were on duty at any given time within the home, as there were no times stated and staff were identified by first names or nicknames only. A discussion took place with the registered person and the deputy managers, and advice was given to staff should be identified by their full names and the times of the shifts must be included on the Duty rota. Residents seen appeared clean and well groomed, and one resident stated that the staff are brilliant and on the whole are very helpful and kind. A requirement was made that evidence be provided of the staff on duty in the home. Staff training records were monitored but it was impossible to ascertain an overall picture of how many staff had received the necessary statutory training at the required intervals. The supply of this information had been made a requirement in the previous inspection and remains outstanding. The pre-inspection questionnaire provided by the registered individual states that 22 staff have qualified to National Vocational Qualification level but records within the home and discussions with staff on duty did not confirm this. A requirement was made that this training be evidenced. Burlington Court Care Home DS0000029409.V255251.R01.S.doc Version 5.0 Page 17 A senior carer in Tudor Upper stated that she was indeed qualified to National Vocational Qualification level 2 and that she was currently engaged in a course on care of dementia with Milton Keynes College. Evidence of this course and her work was seen and found to be very comprehensive. She stated that she is hoping to commence National Vocational Qualification level 3 in the near future. No other staff on duty in this unit held a National Vocational Qualification. In discussion staff were unaware who was the designated first aider on duty and the home were unable to evidence which staff members held this qualification. A list of current first aiders in the home was required. Burlington Court Care Home DS0000029409.V255251.R01.S.doc Version 5.0 Page 18 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): 31,32,33,35,37 and 38 The management of the home is insufficient to ensure that the best interests of the service uses are met. Record keeping within the home is poor and does not demonstrate that the health, safety and welfare of service users and staff are promoted and protected. EVIDENCE: There is no Registered Manager within the home at present. Management is being overseen by the responsible individual Mrs Hanspaul and by her area manager. Requirements have been made concerning this. They are being assisted by two deputy managers within the home. The high number of complaints and outstanding requirements within the home demonstrates that this current management structure is insufficient to protect resident’s needs. The acting managers have only recently become aware of the difficulties within the home and these two people are working hard to try to address the issues raised. As reported above one of the deputy managers had been working in Burlington Court Care Home DS0000029409.V255251.R01.S.doc Version 5.0 Page 19 her own time over the weekend in order to try to improve the environment to make it more suitable for residents with a diagnosis of dementia in Tudor Upper. There was no evidence that residents are involved or consulted in the formulation of plans concerning their care within the home, or in the review of these plans. A recommendation was made in this respect. Records were available of resident’s pocket money within the home but these records were insufficient to demonstrate that these monies were being handled in a safe manner. Receipts were not available for purchases listed, and no signatures were recorded for the receipt or expenditure from these accounts. A selection of balances were checked against the monies available and these matched. A Recommendation was made concerning this. New hot water boilers have been provided within the kitchenette areas of Saxon Upper and Tudor Lower units. These were freestanding boilers and presented a risk of scalding if they were to be pulled over. An immediate requirement was made that these two boilers were made secure. Records of the testing of emergency lighting and hot water temperatures were seen and found to be satisfactory, but records of the testing of fire alarms demonstrated that these tests were not being carried out at the required weekly intervals. A requirement was made concerning this. Automatic closers have been fitted to the doors of resident’s rooms where those residents have requested that the door left open. There was no evidence that qualified first aid assistance is available on each shift or that all staff have received Health and Safety training or Moving and Handling training. Requirements were made concerning these issues. Burlington Court Care Home DS0000029409.V255251.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 2 3 3 x x 3 3 3 2 STAFFING Standard No Score 27 1 28 2 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 1 2 x 2 x 2 2 Burlington Court Care Home DS0000029409.V255251.R01.S.doc Version 5.0 Page 21 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 OP7 Regulation 12()(a)(b) and 15 Requirement A care plan must be developed for all areas of resident need and identify detailed action to be taken by staff. Previous timescale of 10/7/05 not met Confirmation of the names of current staff who are qualified First Aiders must be sent to the Commission for Social Care Inspection. An activity programme must be implemented to cater for the needs and abilities of service users. Previous timescale 30th of November not yet reached Procedures and necessary equipment and facilities must be provided to ensure that the cleaning of commodes, toilets and baths, along with the disposal of clinical waste is appropriate to ensure infection control. Previous timescale not yet reached. The carpet outside bathroom 45 must be cleaned or replaced. Refrigerators in kitchenette areas must be cleaned and defrosted and unlabelled, DS0000029409.V255251.R01.S.doc Timescale for action 01/11/05 2 OP8 13(4) 01/11/05 3 OP12 16(2)n 30/11/05 4 OP26 16(2)j 30/10/05 5 6 OP26 OP26 16(2)j 16(2)j 01/11/05 20/10/05 Burlington Court Care Home Version 5.0 Page 22 7 OP21 16(2)e 8 OP27 18(1)a 9 OP28 15(1)b 10 OP28 19(5)b 11 OP29 19(4)b 12 13 OP30 OP31 19(5)b 8(1)a uncovered food removed. Temperatures in these refrigerators must be monitored and evidence of action taken when they fall outside the normal range be available. Systems for the control and return of residents laundry must be improved to reduce the amount of personal laundry lost. Clear evidence must be available to demonstrate which staff are on duty at any time, along with their hours worked. Staff must be trained to complete assessments including health care needs, for example nutrition and pressure also assessments. Confirmation of training must be submitted to the Commission for Social Care Inspection. Previous requirement, timescale not yet reached Confirmation of the staff who hold a National Vocational Qualification in care must be sent to the Commission for Social Care Inspection, in order to confirm the information provided in the pre-inspection questionnaire. Evidence must be provided that the four staff with Criminal Records Bureau checks outstanding have satisfactory checks in place Accurate records of staff statutory and other training must be available in the home. Evidence of the recruitment of a suitable Registered Manager must be sent to the Commission for Social Care Inspection. This evidence should include information concerning any publications in which this post has been advertised. DS0000029409.V255251.R01.S.doc 01/11/05 01/11/05 30/10/05 01/11/05 01/11/05 01/11/05 01/11/05 Burlington Court Care Home Version 5.0 Page 23 14 OP35 16(2)l 15 OP38 13(4)c 16 OP38 13(4)c 17 OP38 23(4)c Evidence must be available to demonstrate the proper control of resident’s pocket money accounts in the home. There must be a formal arrangement to ensure that service users in the lounge areas are able to gain staff assistance when required. Previous timescale 30th of November not yet reached. The new boilers on the kitchenette areas of Saxon Upper and Tudor Lower must be secured to prevent the risk of scalding. Fire alarms must be tested at the prescribed weekly intervals and records of these tests must be available for inspection. 01/11/05 30/11/05 04/10/05 01/11/05 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 Refer to Standard OP15 Good Practice Recommendations Residents should be offered a choice of portion sizes and individual components of their meal to allow for personal taste. Residents should be aware of the planned meal in advance of its arrival. Residents who require their meals to be liquidised should have this done so that the individual components of the meal remain recognisable. Consideration should be given to creating a more homely atmosphere in the large lounge/dining rooms in the home. A period of handover time should be incorporated in the staff rota in order that continuity of care may be provided to residents, and that all staff are aware of issues in the home. 2 3 4 OP15 OP24 OP27 Burlington Court Care Home DS0000029409.V255251.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Burlington Court Care Home DS0000029409.V255251.R01.S.doc Version 5.0 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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