CARE HOMES FOR OLDER PEOPLE
Byron Court Gower Street Bootle Liverpool L20 4PY Lead Inspector
Joanne Revie Unannounced 26 August 2005
th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Byron Court F53 F03 S17267 Byron Court V247634 260805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Byron Court Address Gower Street Bootle Liverpool L20 4PY 0151 922 0398 0151 933 5687 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) Care Home 52 Category(ies) of Old Age (52) registration, with number Sensory Impairment (1) of places Byron Court F53 F03 S17267 Byron Court V247634 260805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Service users to include up to 52 (OP) and up to 1(SI) Service user category SI - Sensory Impairment relates to 1 service user only, should this service user leave, the category SI would be removed. One named female out of category service user receiving non-nursing care, should this service user leave then the condition will cease to apply. Date of last inspection 18/05/05 Brief Description of the Service: Byron Court is a purpose built care home registered for the care of a maximum of 52 service users. The Home provides care to older persons, male and female, over retirement age who require nursing care. Five beds are registered for those residents who require personal care only. Byron Court is owned by a private organisation, Byron Court Ltd. Accommodation is situated over two floors and there are three lounges and one dining room. A large foyer area is also utilised by a number of service users as a seating area. There are landscaped gardens to the front of the establishment that are easily accessed by the service users. There are 47 bedrooms comprising of 42 single rooms and 5 double rooms. None of the rooms have en-suite facilities. The Home has four bathrooms and one shower. Byron Court is situated off a main road in the Bootle area, opposite some small local shops. Public transport is easily accessible. Byron Court F53 F03 S17267 Byron Court V247634 260805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This visit was unannounced and undertaken in response to a complaint that was made to CSCI. The complainant raised four concerns as follows: Allegations were made that staff were not assisting a resident to move in the correct way. On investigation no evidence could be found to support this view. The complaint is “not upheld”. Allegations were made that the home requires more staff. Evidence was found to support this view The complaint is “upheld” Requirements have been made within this report to address this outcome. Allegations were made that staff were not giving correct care to promote healing of a pressure sore. No evidence could be found to support this view. The complaint is “not upheld” Allegations were made that staff had a poor attitude. No evidence could be found to support this view .There was evidence to support a breakdown in communication had occurred between staff and the complainant. The complaint is “unresolved” Advice has been given within this report, to address the issue of visits. Which should improve the communication situation. Discussions were held with seven residents, and seven members of staff. Their views have been reflected within the report. The service documentation was also viewed as part of the visit and this included the visitor’s book, three service users plans, Wound care documentation and off duty rotas for day and night staff. The service produced an action plan to address shortfalls identified following the inspection in May 05. A comparison was drawn between the action plan and progress made since during this inspection. The visit took place as residents were finishing their lunchtime meal. Staff were observed escorting residents out of the dining room What the service does well:
Concerns were raised via a relative to CSCI that her loved one had a pressure sore and that staff were not correctly managing the wound The conclusion was drawn that wound care is managed well within the home with senior staff writing clear instructions for all staff to follow.
Byron Court F53 F03 S17267 Byron Court V247634 260805 Stage 4.doc Version 1.40 Page 6 Wounds are mapped for size so that staff are aware of any improvement or deterioration in a wound and appropriate action is taken when this occurs. This means that staff have the skills to ensure wounds heal and that they know what action to take if they don’t heal. The complainant had expressed concerns that her loved one was not receiving support with her mobility that was appropriate to her needs. This was discussed with staff. All spoken with repeated the instructions that were written on the resident’s plan of care. The plan of care reflected the instructions that were available when the resident was assessed before moving into the home. This confirmed that the staff had a good understanding of the residents needs and all confirmed that they used the right equipment. One staff member stated” that is one area where we would never cut corners” The home is staffed by a longstanding group of carers and nurses. This means that residents receive care from staff that knows them well. Staff understand the importance of maintaining dignity, offering choice and promoting independence. Staff are supportive of each other’s role and in some cases have developed close relationships with the residents. What has improved since the last inspection? What they could do better:
When asked if there had been any improvements since the last inspection residents commented” Nothing has changed- it’s still the same” and “ still nothing to do”. Those residents spoken with were unaware of the forthcoming meeting therefore staff need to develop a better means of communication between themselves and the residents. Byron Court F53 F03 S17267 Byron Court V247634 260805 Stage 4.doc Version 1.40 Page 7 Staff commented that nothing had improved since the last inspection. Staff felt that things had deteriorated as cuts had been made to their employment conditions, which they felt had impacted on the residents care. Requirements were issued following the last unannounced inspection in May 2005 in relation to activities and staff training. Senior staff were unaware of progress in meeting these requirements. If the service is to develop, staff and residents must be kept informed of any changes, which may impact on their care or their role. The service must ensure that all residents and staff are involved in the development of the service Better communication is needed from managers. Discussions have taken place in the past regarding the replacement of the present computerised care plan system. The service only has one monitor, which means that if a staff member is inputting data other staff can’t access the computer to view the plans. This means that at times staff may find it difficult to access up to date information regarding the residents care. This needs to be addressed, if changes to a residents care are necessary improvements must be made quickly so that a further deterioration does not occur. The service must develop plans to resolve this issue and inform CSCI of their intentions. In the past it had been identified that staff morale was very low within the home. Following discussions with staff it was concluded that little has changed in this area. Comments were made such as “ we don’t even have time to laugh and joke” and when asked had things improved the response was” no, its slid down” and “ Confused residents are becoming more confused because we don’t have time to interact with them”. The comment was also made that staff feel that they are able to meet the resident’s basic needs but that staff are not able to offer quality of life to the residents that they care for. The management need to resolve this. Following the last inspection staffing hours were reduced without consultation with CSCI. This matter was discussed with the General Manager at that time Off duty rotas showed that staffing levels had been reduced further. CSCI had not been informed of this. Staff believe that this reduction has impacted on the residents care. Comments were made from residents such as` “staff are great but there are not enough of them, sometimes I have to wait a long time before they answer my bell” and “the staff are good but they’re never around so I keep myself to myself”. Staffing levels must be reviewed across the home and evidence must be forwarded to CSCI that assessments of residents needs have taken place and that staffing levels within the home reflect the outcome of these assessments. Staff particularly expressed concerns regarding assisting residents with their lunchtime meal. Their view was there were not enough staff to support eight or nine residents to eat their meal in a dignified manner.
Byron Court F53 F03 S17267 Byron Court V247634 260805 Stage 4.doc Version 1.40 Page 8 Staff stated that the number of staff that were available to help with this had been reduced which had resulted in residents being assisted with meals that had become cold or they were assisted in a rushed manner. The off duty rotas showed that most days’ six staff are available over the lunch time period. Four residents who each require assistance from two staff members were observed to be waiting for staff assistance to return to their bedroom to lie on the bed. The middle floor of the home also requires staff supervision during meal times as not all residents eat in the dining room. This is further evidence that staffing levels need to be reviewed. Staff stated that they felt guilty that they were not able to do more for the residents and that at times they were aware that residents required their hands and face washing following meals but that sometimes this was forgotten as everything was so rushed. A resident stated when asked about mealtimes that “I’m alright I can sort myself out but those who cant struggle”. A resident confirmed that it is normal for staff to try to assist a group of residents all at the same time with their meals. This practise must cease, as residents must be supported to eat their meals in a dignified manner. Staff reported they are unable to offer choices to residents such as preferred times of bathing, rising and bed times due to staffing constraints. At the request of a family one resident is having her hair washed regularly as requested on admission to the home. Initially this was not carried out as staff felt that they didn’t have time. Staff confirmed that they are now able to fulfil this request but in doing so believe they are neglecting other residents needs. When discussed further Staff stated that” we cant offer choice anymore we just have to do what we have to do to get through the day” and” We used to be able to offer choice, like when they would like a bath, but since they’ve reduced the night staff we cant do this anymore”. The service must review how choice is offered to residents. Residents are entitled to receive the care that they need at the time, and in the manner that they prefer. Systems must be developed to reflect this. Although an activities organiser has recently been employed and that this has meant some activities are offered. Fourteen hours may not be sufficient to provide both fulfilling activities outside and inside the home. Staff have fundraised to provide funds for an outing for the residents but staff and residents were unaware of when this was occurring. A resident commented that “No, there’s still nothing to do, and” No I haven’t been out anywhere”. A member of staff commented that she could take the residents out but that this would have to be done in her own time and that she wouldn’t be paid for it. It was stated,” I wish I could, but the jobs too hard and I need my time off”. This is a matter of great concern as a requirement was issued in relation to the provision of activities and how residents spend their time following the last inspection in May 2005.
Byron Court F53 F03 S17267 Byron Court V247634 260805 Stage 4.doc Version 1.40 Page 9 An action plan was received at the end of July 2005 stating, “Once the large ground floor lounge had been refurbished in two to three weeks time an activities area was to be made available”. These plans had not been implemented. It was also stated within the action plan that an outing would be taking place at the end of September but Staff and residents appeared unaware of this Also the action plan stated “if staff escort service users on outings it will leave the home with unsafe staffing levels”. This indicates that staff are not provided in sufficient numbers to meet the residents needs. The service must address these outstanding issues, as residents should be offered fulfilling activities so that they experience a quality lifestyle. This should include outings so that residents do not feel as though they are cut off from the outside world. Although the home encourages visitors to visit when they like, staff sometimes are required to give care during these times. This should be fully discussed with Key visitors when a resident is admitted to the home. The resident should be supported to decide how important these visits are, so that care can be delivered around the visit rather than during it if desired. An audit of staff qualifications within the home had been undertaken by the Manager and shortfalls had been identified. This audit was sent to CSCI. Discussions took place with staff regarding progress with staff training since the last inspection and it was revealed that staff have not received refresher training on how to move residents safely nor had they received refresher fire training. Staff confirmed that they had not received training on Abuse Awareness as required following the last inspection. A timescale of the 5th of September 2005 was given for this training to be completed Staff were unaware of any immediate plans from Senior Managers for them to receive the training before the timescale expired. The service must urgently address the outstanding requirements to avoid the possibility of enforcement action being considered by CSCI The Appointed Manager of the home has submitted an application to be registered with CSCI. An application has been received for the position of Responsible Person. It is a requirement of the Care Standards Act 2000 that these people are registered with CSCI.This process ensures that the applicants are suitable for the post. 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. Byron Court F53 F03 S17267 Byron Court V247634 260805 Stage 4.doc Version 1.40 Page 10 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 Byron Court F53 F03 S17267 Byron Court V247634 260805 Stage 4.doc Version 1.40 Page 11 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) No standards were assessed from this section on this occasion. EVIDENCE: Byron Court F53 F03 S17267 Byron Court V247634 260805 Stage 4.doc Version 1.40 Page 12 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 Staff ensure that any deterioration in residents health is assessed by an appropriate health professional. Instructions regarding the care required by residents are not as accessible as they could be. Staff have developed risk assessments to try to reduce the risk of residents having accidents. EVIDENCE: An action plan was received from the Manager of the home following the last unannounced inspection. Within the plan it was stated that relatives and representatives had been approached to ask whether they wished to be involved in the formulation of the service users plan. Unfortunately staff and residents could not confirm whether this had taken place. Greater efforts have been made to ensure risks, which could impact on residents care are documented more clearly. Staff were unaware of any plans for development or replacement of the present care plan system. Only one computer monitor is available for staff to access up to date instructions regarding the resident’s care. Byron Court F53 F03 S17267 Byron Court V247634 260805 Stage 4.doc Version 1.40 Page 13 A concern had been raised prior to the visit suggesting that the management of pressure sores was inadequate. Wound Care records were viewed in order to clarify this. Staff are recording the management of pressure sores consistently. Wound mapping is carried out so that staff are able to determine whether a wound is improving or deteriorating. A care plan was viewed which showed that staff are cross referencing wound care records and developing appropriate care to promote healing of pressure sores. Careplans showed that residents weight is recorded and that the staff of the home arrange for chiropodist and G.P’s to visit when needed. Byron Court F53 F03 S17267 Byron Court V247634 260805 Stage 4.doc Version 1.40 Page 14 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 Some activities are offered but these are not sufficient to meet the resident’s needs. Visitors are free to visit their loved ones when they choose. Staff understand the importance of offering choice to residents but feel unable to do this due to reduced staffing levels. Residents confirm this view EVIDENCE: Staff confirmed that an activities organiser has been employed since the last inspection for fourteen hours per week. During discussions residents were unaware of forthcoming activities. Staff were unaware of the proposed forthcoming trip as detailed in the action plan produced by the service following the last inspection. Staff confirmed that some activities are taking place but that these are insufficient. The large ground floor lounge was viewed. The proposed activity area had not been developed as detailed in the action plan and staff were unaware of when this was taking place. CSCI had been informed of concerns by a family member regarding visiting rights. Viewing the visitor’s book showed that this family member visited the home on a daily basis at approximately the same time. However the family member was concerned that her visit were impinged as her relative was usually in bed at this time. Staff discussions evidenced that a breakdown in communication had occurred with the family member, which had resulted in the family member feeling excluded from her relatives care.
Byron Court F53 F03 S17267 Byron Court V247634 260805 Stage 4.doc Version 1.40 Page 15 No details were recorded on the residents care plan specifying how important these visits were to the resident. Viewing three plans showed that staff had made efforts to document resident’s choice in one instance. The other two viewed lacked information on choice and preferences. However staff believe that only small choices can be offered due to reduced staffing numbers. A relative had complained that her relative required assistance with hair washing at least three times per week. This is now taking place however staff state that they can only comply with this request by neglecting other resident’s needs and at first they had been unable to comply with this request for that reason. Byron Court F53 F03 S17267 Byron Court V247634 260805 Stage 4.doc Version 1.40 Page 16 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) No standards were assessed from this section on this occasion. EVIDENCE: Byron Court F53 F03 S17267 Byron Court V247634 260805 Stage 4.doc Version 1.40 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 standard(s) EVIDENCE: No standards were assessed from this section during this visit. Byron Court F53 F03 S17267 Byron Court V247634 260805 Stage 4.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) 27,30 Staff are not provided in sufficient numbers to meet the residents needs. Staff have not received refresher training to keep the residents safe. EVIDENCE: Viewing the staffing rota showed that staffing levels had been reduced at nighttime below those agreed with the general manager in July 05.The service did employ two staff for the purpose of assisting in the dining room. This position has been made redundant. Discussions with staff showed that staff feel unable to fully meet the residents needs in a dignified manner since these cuts occurred. A resident stated when asked about mealtimes that” I’m alright I can sort myself out but those who cant struggle”. The resident confirmed that it is normal for staff to try to assist a group of residents all at the same time with their meals. Viewing the off duty rota and discussions with staff confirmed that the night time staffing level within the home has been reduced. CSCI had not been made aware of this. Staff made numerous comments, which are included in the summary, which do not reflect positively on the staffing numbers provided by the service. Resident’s also made comments, which implied that not enough staff were available within the home. Byron Court F53 F03 S17267 Byron Court V247634 260805 Stage 4.doc Version 1.40 Page 19 A member of staff in the past obtained a qualification to carry out manual handling training. This has now expired. During the last inspection in May 05 it was identified that staff required refresher training in manual handling and in fire safety and required training on Abuse awareness. However all staff spoken with confirmed that they have not received refresher Fire training or manual handling or abuse awareness training since the last inspection. The action plan, which was produced by the service and dated 29th July 2005, stated that all staff would be receiving this training in the next few weeks. Staff were unaware of when this training was taking place. Byron Court F53 F03 S17267 Byron Court V247634 260805 Stage 4.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) EVIDENCE: No standards were assessed from this section on this occasion. Byron Court F53 F03 S17267 Byron Court V247634 260805 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 x
COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 1 28 x 29 x 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x x Byron Court F53 F03 S17267 Byron Court V247634 260805 Stage 4.doc Version 1.40 Page 22 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 14.-(2)(b) Requirement The service must develop plans to ensure residents care plans are accessible to all staff at all times. CSCI must be informed of these plans with timescales. The service must ensure residents are offered fufilling actvities of their choice. This must include outings Staffing levels must be reviewed across the home. Evidence must be forwarded to CSCI that assessments of residents needs have taken place and that staffing levels match these needs. The service must review how choice is offered to residents. Residents are entitled to the care they require at the time and in the manner that they prefer. Systems must be developed to reflect this. The service must ensure that all residents are offered the opportunity and all staff are involved in the development of the service and how any future changes will impact on their care or role. The service must urgently Timescale for action 31st November 2005 31st November 2005 31st November 2005 2. OP12 16.(2)(m)(n) 18.-(1)(a) 3. OP12,OP13 ,OP27 4. OP14 12.(2),(3),(4 ) 31st November 2005 5. OP14 12.-(2) 31st November 2005 6. OP30 18.-(1)(i, 31st
Page 23 Byron Court F53 F03 S17267 Byron Court V247634 260805 Stage 4.doc Version 1.40 7. OP30 ), 12.(1)(a),23. -(4)(d) 18.-(1)(i), 13.-(5) 8. OP30 18.(1)(a),13. -(6) 7.(1)(2)(3)( 4)(5),8.(1)(2)9.(1)(2) 9. OP 31 address the outstanding requirement that all staff refresher fire training. The service must urgently address the outstanding requirement that all staff undertake refresher training on Manual Handling techniques and associated legislation. The service must urgently address the outstanding requirement that all staff recieve abuse.awareness training without further delay. Any outstanding information required for the position of registered manager or responsible individual must be forwarded to the CSCI without further delay. November 2005 31st November 2005 31st November 2005 31/10/05 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 OP13 Good Practice Recommendations The service should ensure it is clearly identified whether residents are happy to recieve staff support during visiting times or whether they wish to be undisturbed during these times. Those visitors involved should also be made aware of these preferences. Byron Court F53 F03 S17267 Byron Court V247634 260805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 2nd Floor Burlington House Crosby Road North Waterloo L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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