CARE HOMES FOR OLDER PEOPLE
Carshalton Nursing Home 28 Salisbury Road Carshalton Surrey SM5 3HD Lead Inspector
Alison Ford Key Unannounced Inspection 8th August 2006 11:00a 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 Carshalton Nursing Home DS0000019081.V307145.R01.S.doc Version 5.2 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. Carshalton Nursing Home DS0000019081.V307145.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Carshalton Nursing Home Address 28 Salisbury Road Carshalton Surrey SM5 3HD 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) 020 8669 2592 020 8669 9558 sweethomes@aol.com Sweet Homes Ltd Bhanuprasad Keihavlal Mehta Care Home 33 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0) of places Carshalton Nursing Home DS0000019081.V307145.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. A maximum of 10 service users may be in the DE(E) category. Date of last inspection 8th December 2005 Brief Description of the Service: Carshalton Nursing Home is registered to provide care for up to thirty-three older people of whom ten may have dementia however, reluctance by the local authority, to place clients in shared rooms has lead to a decrease in the number of residents in the home. As an existing care home some of the facilities would not meet the requirements of a newly registered home. A large proportion of the accommodation is provided in shared rooms, without en-suite facilities and which are smaller than would now be acceptable. There is only one lounge/dining area and this is in the form of a conservatory, which despite fans is sometimes uncomfortably hot. There is a shaft lift to ensure accessibility throughout the home and the conservatory overlooks the rear garden. There is limited off-street parking however the home is in a quiet road and close to public transport links. The home is currently being managed by Mr Mehta who has many years experience of working with this client group. At the time of this inspection fees range from £500-£550 per week. A copy of the homes Statement of Purpose, Service User Guide and the latest inspection report can be obtained from the homes Registered Providers or the latter can also be obtained from the Commission For Social Care Inspection. Carshalton Nursing Home DS0000019081.V307145.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the homes first key inspection for the year 2006/2007 and was an unannounced visit lasting three and a half hours. On the day of the visit there were 17 residents in the home. Two trained nurses were on duty in addition to the Registered Manager with 3 care staff and a cook, laundry assistant and domestic assistant supported them. A partial tour of the premises was undertaken; a sample of care plans were assessed and several of the residents were spoken to. Prior to the inspection, the Registered Manager had completed a pre – inspection questionnaire distributed by The Commission and comment cards, designed to gain the views of the people who use the service, had been distributed to a random sample of residents, care managers and others who visit the home. Since the last inspection there have been two complaints made against the home, one of which was dealt with according to local authority procedures, designed to protect vulnerable adults from abuse. Both complaints were found to be not substantiated. What the service does well:
This home seeks to provide a caring homely environment for older people several of whom have advanced stages of dementia. Staff turnover is very low which promotes a stable and familiar environment and many of the staff have received training in dementia and its associated problems, which has heightened their awareness of the healthcare needs of the residents. There is always a trained nurse on duty in the home supported by care staff, in sufficient numbers to ensure that resident’s needs are met. A key worker system is in operation to maintain continuity of care and an awareness of residents individual needs. At the time of the inspection residents, the majority of whom were sitting in the lounge, looked well cared for and comfortable and staff had the time to be able to sit and talk with them. Carshalton Nursing Home DS0000019081.V307145.R01.S.doc Version 5.2 Page 6 Residents agreed that the food served in the home was “always nice” and “they had lots to eat” They commented on “how kind the staff were” and “how well looked after they were”. Pre-admission assessments undertaken by the Registered Manager ensure that residents can be confident that their healthcare needs will be met and all of them receive a contract and Service User Guide when they move into the home. All residents have an individual plan of care, setting out the support and interventions that are needed and these are reviewed regularly to ensure that they reflect the care that is currently required. A suitable range of activities is provided and visitors are always made welcome. The home is run in accordance with current health and safety legislation and equipment and services are regularly maintained. The Registered Manager, a trained nurse with many years experience, is often in the home and is able to deal with any problems that arise promptly and complaints and concerns would always be taken seriously and acted upon. What has improved since the last inspection? What they could do better:
Previous inspections highlighted a need for a redecoration and refurbishment programme for the home, which appeared at the time to have been started, and an action plan was received by The Commission identifying a timescale for completion. It was disappointing therefore, to see that this has not been complied with. The majority of the home would benefit from redecoration, carpets are stained and worn and walls and paintwork are chipped. Notices displaying information are merely on pieces of paper all over the walls. Some bedroom furniture is broken and several curtains need rehanging. These issues mean that this home is no longer providing a pleasant environment for residents to live in. Carshalton Nursing Home DS0000019081.V307145.R01.S.doc Version 5.2 Page 7 The garden requires maintenance and piles of waste have been left by the builders. There is no garden furniture available to allow residents to take advantage of the warm weather if they would like to. The communal sitting room in this home is in the form of a conservatory, which has historically been a problem as it becomes extremely warm in the summer. In response to the increased temperatures this year, a tarpaulin type covering was placed over the roof however this is now hanging down all over the windows. Extra coolers have been installed however, residents that were spoken to still complained about the heat. Although those residents spoken with were happy living in the home, there was no evidence available to show that the Registered Providers visit the home to gain their views, which could then be used to influence the services, provided. The Registered Providers will be asked to produce an action plan to show how these issues will be addressed in order to maintain a pleasant and safe environment for residents to live in. It was noted that two doors had been wedged open, as the automatic closers were not working. The engineer was called during the inspection and a further visit will be made to check that these are working. Although all of the residents have an individual care plan, it was noted that not all current problems were documented. In order that all staff are aware of the current interventions required by residents care must be taken to ensure that this is monitored. 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. Carshalton Nursing Home DS0000019081.V307145.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Carshalton Nursing Home DS0000019081.V307145.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Residents can be confident that the pre admission assessment process ensures that the home and the services that it provides will meet their assessed needs. This home does not offer intermediate care EVIDENCE: The care plans of two residents recently admitted into the home were seen. The local authority funds all of the current residents and their care manager’s review was seen in the care plans that were assessed. In addition the homes manager undertakes their own assessment. This looks at all aspects of psychosocial and physical needs and will then form the basis of subsequent care planning. There is evidence that these needs are reviewed regularly and interventions are updated accordingly. Carshalton Nursing Home DS0000019081.V307145.R01.S.doc Version 5.2 Page 10 Carshalton Nursing Home DS0000019081.V307145.R01.S.doc Version 5.2 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Residents all have an individual care plan detailing how staff should meet their health care needs and regular review ensures that they reflect the interventions and support currently needed. Staff attitudes within the home respect the privacy of residents allowing them to retain their dignity. Medication policies and procedures, designed to protect residents and ensure their safety, are in place within the home. EVIDENCE: All residents have an individual care plan and six of theses were seen. They are based on a nursing model; ”Ropers Activities of Daily Living” and include risk assessments, assessment of skin integrity, nutritional screening and the identification of those most at risk from developing pressure sores.
Carshalton Nursing Home DS0000019081.V307145.R01.S.doc Version 5.2 Page 12 There was evidence that these are reviewed on a regular basis and updated to reflect the current situation. It was noted that not all of residents current health needs have generated a care plan showing how these will be met. In order to maintain continuity of care, it is important that all problems and the interventions that are needed are recorded. Photographic evidence is used to monitor wound healing and pressure-relieving equipment was seen in use throughout the home. Advice is sought from the Tissue Viability Nurse Specialist as needed. There is also evidence in the care plans of visits from other members of the multidisciplinary health care team. All personal care is delivered in resident’s own rooms and staff were seen interacting with them in a kind and respectful manner. During the inspection it appeared that they had sufficient time to spend with residents and were observed taking time to sit and talk with them. Medication records and storage was seen and appeared to be in order. Carshalton Nursing Home DS0000019081.V307145.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Residents can be sure that the lifestyle in this home will match their needs and that they will be encouraged to exercise as much choice over their lives as they can and maintain contact with their families and friends in order to promote their independence. The well-presented meals served in the home provide a balanced and nutritious diet, which is suited to the needs of the residents and provides variety in their daily lives. EVIDENCE: The advanced stages of dementia of many of the residents in this home can lead to restrictions on the amount of choices that they can make although their care plans illustrate that they are encouraged to do so. Recreational activities are provided in the afternoons and outside entertainers also visit. A physiotherapist attends the home weekly.
Carshalton Nursing Home DS0000019081.V307145.R01.S.doc Version 5.2 Page 14 The lunchtime meal was served during the inspection and looked appetising and well presented. All the residents were given a drink with lunch and there were sufficient staff to help those who required it. Menus were also seen which appeared varied and well balanced however it was apparent that they do not always reflect the food actually served on the day. In response to a previous requirement a book is kept outlining the meals that residents actually eat and a list is kept of individual preferences but they or their relatives would not be able to be certain what food was actually going to be served to them. The Registered Manager should have discussions with the cook so that menus accurately reflect the meals that are going to be served in the home Carshalton Nursing Home DS0000019081.V307145.R01.S.doc Version 5.2 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. A robust complaints policy, which has been made available to residents and their relatives in this home, ensures that they are aware of the procedures to be followed if necessary. Appropriate procedures to deal with abuse and discrimination ensure that residents feel safe living in this home. EVIDENCE: There is a clear complaints procedure in use in the home; it is outlined in the service user guide, a copy of which is in all the residents’ rooms. Two complaints had been made since the last inspection, one under the Vulnerable Adults Procedure. Neither was upheld. No other complaints had been made either to the home or The Commission. Previous inspections provided evidence that Criminal Records Bureau clearance had been received for all members of staff and the records of the one new staff member were also checked for this. Carshalton Nursing Home DS0000019081.V307145.R01.S.doc Version 5.2 Page 16 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. Although the home is clean, a programme of redecoration and refurbishment is required to ensure that it provides a pleasant homely environment for residents to live in. EVIDENCE: A tour of the premises was undertaken. Previous inspections highlighted a need for a redecoration and refurbishment programme for the home, which appeared at the time to have been started, and an action plan was received by The Commission identifying a timescale for completion. It was disappointing therefore, to see that this has not been complied with. The majority of the home would benefit from redecoration, carpets are stained and worn and walls and paintwork are chipped. Notices displaying information are merely on pieces of paper all over the walls. Some bedroom furniture is broken and several
Carshalton Nursing Home DS0000019081.V307145.R01.S.doc Version 5.2 Page 17 curtains need rehanging. These issues mean that this home is no longer providing a pleasant environment for residents to live in. The garden requires maintenance and piles of waste have been left by the builders. There is no garden furniture available to allow residents to take advantage of the warm weather if they would like to. The communal sitting room in this home is in the form of a conservatory, which has historically been a problem as it becomes extremely warm in the summer. In response to the increased temperatures this year, a tarpaulin type covering was placed over the roof however this is now hanging down all over the windows. Extra coolers have been installed however, residents that were spoken to still complained about the heat. It was noted that a linen trolley was stored in one resident’s room and unwanted equipment in another. Items must only be stored in rooms not currently occupied by residents. The Registered Providers will be asked to produce an action plan to show how these issues will be addressed in order to maintain a pleasant and safe environment for residents to live in. It was noted that two doors had been wedged open, as the automatic closers were not working. The engineer was called during the inspection and a further visit will be made to check that these are working. Carshalton Nursing Home DS0000019081.V307145.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29.30 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Residents can be sure that there are sufficient numbers of appropriately trained staff on duty in the home to ensure that their needs will be met and that recruitment procedures are in place to protect them. EVIDENCE: The off duty rotas were seen and showed that there were always trained nurses on duty in the home supported by care staff in adequate numbers to ensure that residents needs would be met. The registered manager is also a nurse and, in addition, laundry and domestic staff are on duty. The majority of staff have undertaking a distance-learning package in dementia care and others are undertaking training in infection control. Statutory training has been undertaken. The induction package that is undertaken, with new staff members, was seen. This is comprehensive however, needs to presented in a format that is more useful as a learning tool for the individual. This was discussed with the homes manager. Carshalton Nursing Home DS0000019081.V307145.R01.S.doc Version 5.2 Page 19 One new member of staff has been employed since the last inspection and her personnel files were seen. These were all in order however; POVA clearance that had been obtained prior to CRB clearance was not available to be seen. This record is apparently held at the organisations head office; there must be a copy of this held in the home for inspection when required. Carshalton Nursing Home DS0000019081.V307145.R01.S.doc Version 5.2 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 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): 31,33 35,36,38, Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. Residents can be sure that the home is managed by a suitably experienced person, however there is no evidence that they are able to influence the running of the home. Working practices within the home are not sufficient to ensure that resident’s health and safety are fully protected although they can be sure that safeguards are in place to protect their finances. Carshalton Nursing Home DS0000019081.V307145.R01.S.doc Version 5.2 Page 21 EVIDENCE: The registered manager has many years experience in caring for this client group and has been in post for some time. He is now undertaking supervision on all members of staff and they confirmed that this was taking place. There were however no records to support this. Supervision sessions must be recorded and available for inspection. A quality assurance survey is apparently distributed very six months however results were not available to see. In future these must be collated and distributed to residents and their relatives and made available for inspection visits. No evidence was available to show that visits are undertaken by the Registered Providers in line with Regulation 26. Written reports of these visits must be prepared in accordance with the regulation and made available for inspection. The first aid box in the kitchen was found to be totally inadequate, with out of date items in it. This must be rectified to make it a useful piece of equipment designed to treat possible injuries sustained in the kitchen. It was noted that there was an out of date tin of food in the cupboard and staff food was stored in the same refrigerator as resident’s food. The Registered Manager must ensure that this does not happen in the future. Chopping boards in the kitchen appeared worn and must be replaced. There was no evidence of any fire drills being undertaken this year. These must occur every three months and recorded evidence must be made available for inspection. Some money is held on behalf of residents and samples of the records that are kept were seen. These were all accurate and in order. Records of accidents and complaints were seen and all in order. All accidents had been minor and complaints dealt with in an appropriate and timely manner. Carshalton Nursing Home DS0000019081.V307145.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 1 Carshalton Nursing Home DS0000019081.V307145.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 OP8 Regulation 15(1) Requirement The Registered Manager must ensure that care plans accurately reflect of the problems currently experienced by residents. The Registered Manager must ensure that daily menus in the home accurately reflect the food that is to be served. The Registered Providers must submit an action plan outlining a programme of redecoration and refurbishment of the home. The Registered Providers must ensure that broken bedroom furniture is mended or replaced. The Registered Providers must ensure that all curtains that are hanging down are rehung. The Registered Providers must submit an action plan outlining how the garden will be made more attractive for residents to use. The Registered Providers must ensure that appropriate seating is provided in the garden for residents The Registered Providers must ensure that waste building
DS0000019081.V307145.R01.S.doc Timescale for action 08/11/06 2 OP15 12 (2)(3) 08/11/06 3 OP19 23(2)(b) 08/11/06 4 5 6 OP19 23(2)(b) 23(2)(b) 23(2)(b) 08/11/06 08/11/06 08/11/06 OP19 OP19 7 OP19 23(1)(a) 08/11/06 8 OP19 13(4)(c) 08/11/06 Carshalton Nursing Home Version 5.2 Page 24 9 OP19 23(2)(b) 10 11 OP19 23(2)(l ) 23(2)(a) OP19 12 OP29 18(a) 13 OP30 18(a) 14 OP33 26 15 OP33 24 16 OP36 18(2) 17 OP38 23(4)(d) 18 19 OP38 23 (2)(c) 16(2)(j) OP38 materials are removed from the garden The Registered Providers must ensure that the covering on the lounge roof is replaced or removed. The Registered Manager must ensure that equipment is not stored in resident’s bedrooms. The Registered Providers must outline how they will be undertake additional measures to control the temperature in the lounge. The Registered Providers must ensure that when a “POVA first” clearance is utilised a copy of the clearance is available in the home for inspection. The Registered Manager must develop the staff induction programme so that it becomes a more useful learning tool for new staff. The Registered Providers must ensure that there is documented evidence of visits undertaken in line with regulation 26. The Registered Providers must ensure that there is documented evidence of a quality assurance programme in place within the home. The Registered Manager must ensure that there is documented evidence that all staff are receiving regular supervision. The Registered Manager must ensure that there is documented evidence of all staff participating in a fire drill at least four times a year. The Registered Manager must ensure that the first aid box in the kitchen is replenished. The Registered Manager must ensure that out of date food is
DS0000019081.V307145.R01.S.doc 08/11/06 08/11/06 08/11/06 08/11/06 08/11/06 08/11/06 08/11/06 08/11/06 08/11/06 08/11/06 08/08/06 Carshalton Nursing Home Version 5.2 Page 25 20 OP38 16(2)(j) 21 OP38 16(2 )(j) 22 OP38 23(4)(c) not stored in the cupboard. The Registered Manager must ensure that food belonging to staff is stored separately from resident’s food. The Registered Manager must ensure that worn chopping boards in the kitchen are replaced The Registered Manager must ensure that all automatic fire doors closers are always functional. 08/08/06 08/11/06 08/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Carshalton Nursing Home DS0000019081.V307145.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Croydon 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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