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Inspection on 22/09/05 for Cameron House Nursing Home

Also see our care home review for Cameron House Nursing Home for more information

This inspection was carried out on 22nd September 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

There was generally a positive picture about the care provided. Several residents and a visitor said the home was "very nice", that you were "well looked after" and that most staff were "very good". However, some problems were also talked about (see below). Residents could choose to join in a range of regular, organised social activities. Residents said the food was "good". Residents lived in an attractive, clean and comfortable home. The home had a group of staff that were keen to raise standards.

What has improved since the last inspection?

New curtains had been fitted in the small conservatory and new dining room tables and chairs provided.

What the care home could do better:

A concern from this inspection was care staff said sometimes, some residents had a meal in wet clothes/continence pads, and that sometimes, some residents were taken to bed very early after tea (for the convenience of night staff). The home needs to act on this and put things right. The home needs to make sure all residents always get the proper care and help they need, as soon as possible and that routines should not be for the benefit of staff.Staff need to have more training to make sure they understand what to do if they have concerns about how residents are treated and to also make sure they know how good quality care should be provided. Generally, staff also need more training to better look after residents with special needs (such as dementia and diabetes). Written information about the help residents need should be more personal (and kept up to date), so staff know what to do for each resident. To keep residents safe, written information about any medication they take must be kept up to date. To make sure residents receive the food they need, how information about special diets is passed to kitchen staff should be looked at. The design of the home`s entrance should be looked at, with a view to making improvements so it better suits residents with confusion. The strong, bad smell in one bedroom needs to be sorted out. Ways of making sure that individual meetings happen regularly with staff need to be looked at (so staff have the chance to discuss their work and matters that are important to them).

CARE HOMES FOR OLDER PEOPLE Cameron House Nursing Home Cameron Street Bury Lancashire BL8 2QH Lead Inspector Sarah Tomlinson Unannounced 22 September 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cameron House Nursing Home F56 F06 S17340 Cameron House V236585 220905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Cameron House Nursing Home Address Cameron Street Bury Lancashire BL8 2QH 0161 764 8571 0161 763 6395 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) Ringdane Ltd (wholly owned subsidiary of Four Seasons Healthcare) Beverley Josephine Unsworth CRH Care Home N Care Home with Nursing 40 Category(ies) of OP Old Age : 39 Places registration, with number TI Terminally Ill (18 years - 59 years) : 1 Place of places Cameron House Nursing Home F56 F06 S17340 Cameron House V236585 220905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The home is registered for a maximum of 40 service users, to include: Up to 39 service users in the category of OP (Older People); Up to 1 service user in the category of TI (Terminally Ill under 65 years of age) Date of last inspection 27 January 2005 Brief Description of the Service: Cameron House Nursing Home provides nursing and personal (‘residential’) care for older people. Both permanent and respite places are available. The home is owned by Four Seasons Healthcare (a large national company). It is a modern, detached building on two floors (with a lift). All the bedrooms are singles. There is a small, enclosed garden to the rear and car parking to the front and side. The home is in a residential area, with a main road and public transport nearby. Bury town centre is approximately one mile away. Cameron House Nursing Home F56 F06 S17340 Cameron House V236585 220905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over nine and quarter hours. Time was spent talking with residents (3), visitors (1) and staff (manager, administrator, nurse, carers (6), chef, handyman, domestic and laundry assistant). Time was also spent looking at paperwork and around the building (including bedrooms, bathrooms and toilets on both floors). A complaint had been made about the home several days before this inspection. Consequently, a complaint investigation was also carried out during the visit. The findings from this are in a separate report. What the service does well: What has improved since the last inspection? What they could do better: A concern from this inspection was care staff said sometimes, some residents had a meal in wet clothes/continence pads, and that sometimes, some residents were taken to bed very early after tea (for the convenience of night staff). The home needs to act on this and put things right. The home needs to make sure all residents always get the proper care and help they need, as soon as possible and that routines should not be for the benefit of staff. Cameron House Nursing Home F56 F06 S17340 Cameron House V236585 220905 Stage 4.doc Version 1.40 Page 6 Staff need to have more training to make sure they understand what to do if they have concerns about how residents are treated and to also make sure they know how good quality care should be provided. Generally, staff also need more training to better look after residents with special needs (such as dementia and diabetes). Written information about the help residents need should be more personal (and kept up to date), so staff know what to do for each resident. To keep residents safe, written information about any medication they take must be kept up to date. To make sure residents receive the food they need, how information about special diets is passed to kitchen staff should be looked at. The design of the home’s entrance should be looked at, with a view to making improvements so it better suits residents with confusion. The strong, bad smell in one bedroom needs to be sorted out. Ways of making sure that individual meetings happen regularly with staff need to be looked at (so staff have the chance to discuss their work and matters that are important to them). 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. Cameron House Nursing Home F56 F06 S17340 Cameron House V236585 220905 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Cameron House Nursing Home F56 F06 S17340 Cameron House V236585 220905 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 4 There was a mixed picture regarding how well residents’ needs were being met. Generally, a good standard of care was received. However, at times, the personal support needs of some residents were not being met, with routines being for the benefit of staff. Also, the specialised and complex needs of some residents were at risk of not being met, as relevant training had not been provided to most care staff. EVIDENCE: Pre-admission assessments were generally in place. The manager carried these out, or in her absence, the deputy. From talking with residents, a visitor and staff, and observing how staff worked, residents’ needs appeared to be generally met, with comments that the home was “very nice” and that you were “well looked after”. However, The home was caring for people with specialised and complex needs that most care staff had not received training about (e.g. dementia, diabetes, cerebral palsy). The inspector observed poor practice, when one carer move a confused resident without talking to or interacting with them. Cameron House Nursing Home F56 F06 S17340 Cameron House V236585 220905 Stage 4.doc Version 1.40 Page 9 In addition, staff said that at times, some residents were taken to the dining room for meals without being changed (and consequently left in wet clothes/continence pads). Also at times, some residents were put to bed very early after tea (for the convenience of some night staff). Cameron House Nursing Home F56 F06 S17340 Cameron House V236585 220905 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 The personal care needs of some residents could be better met if the care planning system provided staff with more personalised information. Medication was generally well managed. However, some procedures for ensuring correct administration potentially put residents’ health at risk. Although most staff provided personal support respectfully, at times, some staff did not (resulting in residents’ privacy and dignity not being upheld). EVIDENCE: Three care files were examined. Care plans and risk assessments were in place. However, these were not being updated (either monthly or after external reviews, where changes to care practices had been agreed). Preprinted, general (‘core’) care plans were in use. These contained very little personal information (of which staff, when questioned, were knowledgeable of). Also, care plans did not reflect any resident or family involvement regarding individual care preferences. It was suggested that the ‘monthly review’ could be used as one opportunity to add in such information. Cameron House Nursing Home F56 F06 S17340 Cameron House V236585 220905 Stage 4.doc Version 1.40 Page 11 With regard to regular health care checks, there was evidence of doctors’ visits being recorded. However, monthly weight and chiropody records in the care files were not being completed (although information was being recorded elsewhere). It was agreed advice would be sought from the continence advisor with regard to reviewing one resident’s specialist needs. Regarding medication, nursing staff were responsible for administering medication to ‘nursing residents’ and senior care staff to ‘residential’ residents. Two drugs trolleys were kept. When not in use, these were kept in a locked room on the first floor. Stock levels of four controlled drugs were checked and found to be correct. Clear records were kept regarding the entry of medicines into the home and any returns. A contract was being agreed for a new authorised waste contractor (in the meantime, the community pharmacist had agreed to continue accepting any returns). Some administration records did not provide accurate information about current medicines (e.g. one contained six medicines that had been discontinued; another showed iron tablets were still being given, even though these were discontinued the previous month). However, good practice was noted, as one resident was supported to look after their own medicines. A risk assessment had been carried out, although information about any practical arrangements, including any monitoring or prompting, should also be recorded. Further good practice was noted, as each resident had a ‘homely remedy’ sheet that had been authorised by their GP. Residents said that most staff were “very good”. Residents said staff knocked on doors and that most staff treated them with dignity, for example keeping them covered when helping to bathe or go the toilet. However, some staff were not so respectful and residents said they had had to “harden up”. Cameron House Nursing Home F56 F06 S17340 Cameron House V236585 220905 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14 and 15 Links with the community were good, which combined with in house activities, ensured the social and recreational needs of residents were satisfactorily met. At times, staff did not allow some residents to make choices, resulting in them being unable to have control over their lives. Meals were good, offering both choice and variety. Special dietary needs were generally well catered for, although this was at risk when the required information was not made available to catering staff. EVIDENCE: The activities co-ordinator organised a range of social activities. These included baking, quizzes, carpet bowls and reminiscence activities with pictures and objects (with residents’ involvement individually documented). Visitors to the home were also organised, including monthly entertainers, visits from local school children and a choir. A weekly activities list was displayed in the entrance. Trips away from the home had been extremely limited as the company minibus had been out of action (with only one trip taking place in August). Good practice was noted, as the home planned to provide raised sensory garden beds. Further good practice was noted, as a clinical nurse specialist had been appointed within the company to focus on developing Cameron House Nursing Home F56 F06 S17340 Cameron House V236585 220905 Stage 4.doc Version 1.40 Page 13 activities for residents with confusion and dementia. Cameron House was due to receive input from this nurse specialist in the coming months. As noted previously, at times, some residents were taken to bed very early after tea, for the convenience of some night staff. Staff said this occurred even when some of these residents preferred to stay up. Such poor practice would also impact on these residents’ diets, as the interval between their last meal and breakfast would be unacceptably long (more than 12 hours). Residents said the food was “good” and “quite nice” and that they got offered a choice at each meal (choices and any changes to the 4-week menu were recorded daily). Good practice was noted, as the chef confirmed that food for soft diets was presented separately (and not mixed together), to preserve appearance and flavour. A special diet was currently needed for a resident with ‘irritable bowel syndrome’. However, this information had not been passed to the kitchen (previously, the chef had researched and provided a special diet for a resident on a gluten free diet). Cameron House Nursing Home F56 F06 S17340 Cameron House V236585 220905 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Arrangements for protecting residents were not satisfactory, placing them at risk of harm and abuse. EVIDENCE: A serious complaint had been made to CSCI several days before this inspection. Consequently, a complaint investigation was also carried out during the inspection visit (details of the complaint had also been brought to the manager’s attention, who had taken prompt and appropriate action in response). The investigation found the complaint to be upheld. The findings are detailed in a separate complaint report. As noted previously, staff reported poor care practices with regard to some residents, at times, being brought to the dining room and having their meals sat in wet clothes/continence pads. Also at times, some residents were taken to bed very early after tea (despite maybe preferring to stay up), to suit the convenience of some night staff. Cameron House Nursing Home F56 F06 S17340 Cameron House V236585 220905 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 22 and 26 The home provided residents with an attractive, comfortable and homely place to live. A review of the design of the entrance area could create a more pleasant, safe and appropriate place for some residents with special needs. EVIDENCE: Cameron House was bright and welcoming. There was a high standard of décor and furnishings, which were domestic in style. Good practice was noted, as wallpaper was used in the entrance hall and lounge/dining areas, helping the building appear homely and comfortable. Since the last inspection, new curtains had been provided in the small conservatory. New dining room tables and chairs (with armrests and glide bars) were just in the process of being delivered. The dining room carpet was also due to be replaced with non-slip, laminate flooring, to enable cleanliness to be better maintained. The building was originally designed as a hotel. Many of the current residents had confusion or dementia. The design of the building, in particular the Cameron House Nursing Home F56 F06 S17340 Cameron House V236585 220905 Stage 4.doc Version 1.40 Page 16 entrance that leads straight into the main corridor and lounge areas, could better reflect their needs (as such a visible entrance/exit sometimes caused distress and confrontations). Each bedroom door had a printed nameplate. Although appropriate for staff, a larger font size, on lower signs would make them easier for residents to read. A good standard of hygiene was found, with residents also saying their rooms were kept “clean and tidy”. A housekeeper, two laundry assistants and two domestics were employed, with two domestics and a laundry assistant on duty each day. Some staining from general wear and tear was beginning to show on the ground floor (bedroom) corridor carpet. Ways of deep cleaning this whilst causing minimum disruption to residents (and staff) were discussed. A very strong malodour was noted in bedroom 2. Although repairs had recently been carried out in the en-suite bathroom, the malodour persisted and was unacceptable. Cameron House Nursing Home F56 F06 S17340 Cameron House V236585 220905 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 30 At times, both general and specialist needs of some residents were not being met. This resulted in a poorer quality of care being experienced. EVIDENCE: As previously noted, most care staff had not received training to work with residents with specialist and complex needs (e.g. dementia, including how to understand and support residents on both a practical and emotional level; diabetes; irritable bowel syndrome). As also noted, poor care practice was observed with regard to moving confused residents. Different ways of meeting these needs were discussed, e.g. through teaching sessions given during extended handovers; using the clinical nurse specialist recently appointed within the company; one to one guidance and shadowing. As previously noted, staff and residents reported some occasional poor care practices (with regard to respecting residents’ dignity; encouraging and supporting residents to make choices; promoting continence and skin integrity). Cameron House Nursing Home F56 F06 S17340 Cameron House V236585 220905 Stage 4.doc Version 1.40 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 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) 32, 33, 36 and 38 There was some tension and dissatisfaction within the staff team. The manager needs to investigate and then implement strategies to improve both care practices and staff morale. Regular maintenance checks were carried out on fire safety equipment, promoting the health and safety of both residents and staff. EVIDENCE: Staff said they were not receiving formal, one to one supervision. With regard to the poor care practices reported by care staff, carers felt it was difficult to challenge or change the situation due to the staff involved. Staff also said that whilst some staff worked together well as a team, others did not. Cameron House Nursing Home F56 F06 S17340 Cameron House V236585 220905 Stage 4.doc Version 1.40 Page 19 With regard to the required internal unannounced quality monitoring visits (‘Regulation 26 visits’), CSCI had not received copies of the accompanying reports since April 2005. The inspector understood that changes in the area management team had produced this gap. However, in light of the reports of poor care practices identified during this inspection, it is particularly important these immediately re-start (with regard to supporting the home manager in instigating change). Records showed that safety checks had been carried out on fire extinguishers, emergency lighting and the fire alarm. The fire alarm was sounded weekly, with different points activated in rotation. It was suggested that a different staff member was asked to assist each week (rather than the same small group of three people). This would enable as many staff as possible to feel confident with the fire alarm system and procedures. The handyman had recently taken over responsibility for fire safety training (which day staff were to receive twice a year and night staff three times a year). The inspector was impressed with his commitment and enthusiasm. Cameron House Nursing Home F56 F06 S17340 Cameron House V236585 220905 Stage 4.doc Version 1.40 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 2 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 2 15 2 COMPLAINTS AND PROTECTION 3 x x 2 x x x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 x 2 2 x x 1 x 3 Cameron House Nursing Home F56 F06 S17340 Cameron House V236585 220905 Stage 4.doc Version 1.40 Page 21 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 4, 10, 14, 18 Regulation 12, 13 Requirement Timescale for action 6 October 2005 2. 4, 10, 14, 18, 30 12, 13, 18, 19, 21, 24 3. 4, 10, 30 12, 14, a) Staff must provide care in a manner that respects the privacy and dignity of residents. b) Staff must provide personal care in a prompt and appropriate manner. c) Staff must allow residents to make decisions about the care and support they receive, and as far as possible, act on these wishes. The reports of poor care practices must be investigated and acted upon (a) at times, residents are left in wet clothes/incontinence pads when brought to the dining room for meals and (b) at times, residents are taken to bed very early (for the convenience of some night staff). A report of the action taken (and subsequent monitoring arrangements) must be sent to CSCI. 18 Additional training must be provided to care staff working with residents with specialised needs (e.g. dementia; diabetes). Prospective residents must not be offered a service unless the 31 October 2005 31 March 2006 Cameron House Nursing Home F56 F06 S17340 Cameron House V236585 220905 Stage 4.doc Version 1.40 Page 22 home can meet their needs. 4. 7, 8 12, 14, 15 Care plans and risk assessments must be reviewed at regular intervals and kept up to date. Care plans must reflect residents individual health and welfare needs. Residents (and/or their representatives) must be involved in developing their care plans. 13 Medication administration records must be clear and kept up to date. 12, 13, 18 All staff must receive refresher training about (a) whistle blowing; (b) abuse awareness; (c) respecting residents dignity; (d) residents right to make choices; (e) basic care practices, regarding promoting continence and skin integrity. 16 The malodour in bedroom 2 must be fully resolved. 18, 21 All care and nursing staff must receive regular, formal, one to one supervision. 21, 24, 26 Unannounced quality monitoring visits must be carried out at least once a month (and include regular interviews with care staff), with a report of each visit sent to CSCI. 31 December 2005 5. 6. 9 4, 7, 8, 14, 18, 30 31 October 2005 31 December 2005 7. 8. 9. 26 32, 33, 36 32, 33 6 October 2005 31 December 2005 31 October 2005 10. 11. 12. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 7, 8 Good Practice Recommendations How health care checks (e.g. chiropody appointments, weights) are recorded should be reviewed, with a view to F56 F06 S17340 Cameron House V236585 220905 Stage 4.doc Version 1.40 Page 23 Cameron House Nursing Home 2. 3. 12 4, 7, 8, 15 4. 19, 22 5. 27 reducing duplication and incomplete records. Four Seasons Healthcare should ensure the minibus is kept in good working order, particularly through the summer months. How information about special diets is passed to the chef should be reviewed. As part of the investigation into poor care practices, a review of the length of time between meals, overnight, should be carried out. A review of the design and layout of the entrance area should be carried out, with regard to better meeting the needs of mobile residents with confusion/dementia. The design of bedroom door nameplates should be reviewed. As part of investigation into poor care practices, the adequacy of staffing levels and shift patterns should be reviewed (at meal times and at night). Cameron House Nursing Home F56 F06 S17340 Cameron House V236585 220905 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Turton Suite, Paragon Business Park Chorley New Road Horwich Bolton BL6 6HG 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 Cameron House Nursing Home F56 F06 S17340 Cameron House V236585 220905 Stage 4.doc Version 1.40 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!