Inspection on 23/01/06 for Cathedral View Nursing Home

This inspection was carried out on 23rd January 2006.

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

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

Other inspections for this house

Cathedral View Nursing Home 01/05/07

Cathedral View Nursing Home 25/08/05

Cathedral View Nursing Home 18/01/05

Cathedral View Nursing Home 11/08/04

Cathedral View Nursing Home 16/03/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Cathedral View Nursing Home Kenwyn Church Road Truro Cornwall TR1 3DR Lead Inspector Lynda Kirtland Unannounced Inspection 23rd January 2006 11:10 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 Cathedral View Nursing Home DS0000046307.V268161.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cathedral View Nursing Home DS0000046307.V268161.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cathedral View Nursing Home Address Kenwyn Church Road Truro Cornwall TR1 3DR 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) 01872 222132 01872 222132 Cathedral View Limited Mrs Lynde Gilbert Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26), Physical disability (26), Terminally ill (26) of places Cathedral View Nursing Home DS0000046307.V268161.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Service users to include up to 26 adults of old age (OP) Service users to include up to 26 adults aged over 65 with a physical disability (PD) Service users to include up to 26 adults with a terminal illness (TI) Total number of service users not to exceed a maximum of 26 Date of last inspection 25th August 2005 Brief Description of the Service: Cathedral View Limited owns two registered care homes. These are Cathedral View Residential Home and the other is Cathedral View Nursing Home. Both homes are located on the same site. Cathedral View Nursing Home is registered to accommodate 26 elderly service users in need of personal and nursing care. The home provides single bedrooms for the majority of residents although four rooms are registered for shared accommodation. Bedrooms are situated on two floors and there is a lift. There are two lounges and a large dining room for residents use. All facilities for residents are accessible for those who may have limited mobility or in need of specialist equipment such as wheelchairs. There are extensive accessible gardens for residents use. There is sufficient parking outside the home. The home is situated near to the centre of Truro city, which has good transport links into the main town and surrounding areas. Mrs Lynde Gilbert is the registered Manager for both homes and has the Registered Mental Nurse qualification. Mrs Victoria Parsons is the matron and manages the nursing home on a day-to-day basis. Cathedral View Nursing Home DS0000046307.V268161.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector visited Cathedral View Nursing Home on the 23 January 2006 and spent six hours at the home. This was an unannounced visit. The purpose of the inspection was to gain an update on the progress of compliance to the requirements that were identified in the last inspection report dated 25 August 2005. In addition the inspector focused on the following key areas of care: choice of home, care planning, health care, leisure, complaints, staffing and some management areas. On the day of inspection 26 service users were resident in the home. The methods used to undertake the inspection are to meet with a number of residents, staff, the matron, registered manager and registered provider to gain their views on the services that Cathedral View Nursing Home offer. Cathedral View records, policies and procedures were examined and the inspector toured the building. This report summarises the findings of this inspection. What the service does well: Residents commented that Cathedral View provides good quality care and accommodation. All residents said that they felt that they were consulted about their care needs which staff met. Residents commented that they have access to health care and felt that all their health needs were met to a ‘high’ standard. Documentation evidenced that access to local and specialist medical care occurs. Specialist equipment to assist in the moving and handling of residents and aids such as mattresses, grab rails, and mobility aids were in sufficient supply at the home. Residents confirmed that there was a varied and stimulating programme of activities that is provided by the home and local community. An activity coordinator visits the home four days a week and offers a programme of activities. This is displayed to promote this service and encourage others to participate. Residents are also encouraged to develop their own individual interests and evidence of this was seen throughout the inspection. Residents felt their visitors were welcomed to the home, which was confirmed in discussion with them. Residents and staff stated that if there were any issues they felt able to approach the management team directly and that their ideas would be listened to and where appropriate acted on. The home actively seeks residents’ views by holding a three monthly residents meeting. Cathedral View Nursing Home DS0000046307.V268161.R01.S.doc Version 5.0 Page 6 Residents and staff commented that there are sufficient staffing levels on duty. Residents made various comments about staff such as; they are ‘patient’, ‘kind’ and ‘caring’ and felt that the staff team were respectful. Staff confirmed attendance on training courses, which they felt, was beneficial and assisted them in their daily work. Cathedral View is a clean and attractively furnished home. Staff are aware of what measures are needed to promote infection control. Residents were positive about the level of cleanliness and the laundry provision in the home. Cathedral View has access to well-maintained gardens that are accessible for residents use. Cathedral View ensures regular maintenance of the home to ensure the health and safety of all who live, work or visit the home. What has improved since the last inspection? What they could do better: From this inspection one requirement was re notified in respect of reviewing the bathing facilities which the registered provider is actively addressing. An additional requirement to undertake a risk assessment in the storage and moving of oxygen cylinders in the home was identified. One recommendation to expand care plans to ensure that residents skills and aspirations are included was made, as was to redesign the review record to promote good practice. Cathedral View Nursing Home DS0000046307.V268161.R01.S.doc Version 5.0 Page 7 Residents and staff could not think of any further improvements that Cathedral View could make. This inspection highlighted that Cathedral View Nursing Home provides a good standard of care to residents. The inspector would like to thank the residents, staff and management team for their kind assistance during this inspection process. 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. Cathedral View Nursing Home DS0000046307.V268161.R01.S.doc Version 5.0 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 Cathedral View Nursing Home DS0000046307.V268161.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4,5 The home completes an assessment of prospective residents to make sure they are able to meet the person’s needs. Cathedral View provides a planned trial period of stay at the home. Staff are experienced and competent to meet resident’s needs. EVIDENCE: From discussion with residents they confirmed that they were consulted about their care needs prior to admission to the home. Documentation in respect of recent admissions to the home was inspected. From this it was evident that pre admission assessments occur with prospective residents and their representatives. Care needs identified by the referring professional assessments were incorporated in the assessment process and transferred to care plans. This assessment identifies the residents individual physical, emotional, social, educational and leisure needs and how the home would aim to address them. A month’s trial period is offered to all new residents after which a review is held with all parties present to consider if the placement is appropriate and if so a long-term placement will be provided. Cathedral View Nursing Home DS0000046307.V268161.R01.S.doc Version 5.0 Page 10 From records inspected and in discussion with residents they commented that they received detailed information about the home and the services it provides from the management team. They also confirmed that the preadmission and ‘moving in period’ are carried out sensitively by staff and could not see how this process could be improved. They also stated that this was undertaken with their participation and that their care needs were identified accurately. From observations of staff, plus inspection of forthcoming training programme and records it was evident that the staff team are experienced in the area of older peoples care and receive training to update their knowledge in this area. Throughout the inspection the inspector observed staff that displayed great skill in communicating and providing personal and emotional care to residents. Cathedral View Nursing Home DS0000046307.V268161.R01.S.doc Version 5.0 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Residents and their representatives are consulted in the implementation and subsequent reviews of their individual care plans. Health care needs are met to a good standard. The staff at the home builds positive relationships with residents that are based upon the residents dignity and privacy. EVIDENCE: From discussion with residents, staff and inspection of documentation it was evident that individual care needs are identified appropriately. From inspection of residents files, and in discussions it is evident that Cathedral View encourage residents to express their views in the formation of their care plans. The care plans clearly identify residents current care needs, or ‘nursing problems’ and from this specify what actions staff should take to ensure that the care need is approached in a consistent manner. The inspector recommended that the home also consider what current skills residents display, identify their aspirations and promote this in the home. As this is a recommendation to promote good practice the score system reflects this. The registered manager and matron agreed to incorporate this in the care planning process. Cathedral View Nursing Home DS0000046307.V268161.R01.S.doc Version 5.0 Page 12 The care plan is reviewed and in discussions with the management team they agreed to redesign how they record when a review has occurred, who participated and record more clearly if any changes to the care plan are needed. The inspector noted that the staff at the home, due to previous advice given to them, is duplicating some records i.e. care needs provided and a separate social record sheet. The inspector commented that the home could incorporate this into one record so that all information is located in the same place. The management team felt this would work better and will implement this with immediate effect. Therefore this will be reviewed at the next inspection. Residents commented that health needs are met by the staff at the home and by external professionals to a high standard. Detailed records of all health professional visits to individual residents further evidenced this. The home has positive relationships with local and specialist health services. Cathedral View also has access to a variety of aids and equipment to assist residents in meeting their health needs in an appropriate manner. Cathedral View Ltd have a corporate policy in the ordering, administration, storage and disposal of medication plus homely remedies policy, which was not inspected on this occasion, however staff knew of their locations. Designated staff administers medications. The controlled drugs register was completed correctly and a tablet count tallied with records kept. Medication sheets were completed correctly. Medication kept in the fridge was inspected. Monthly temperatures of the fridge are monitored which was agreed with the local pharmacist. The local pharmacist undertook an inspection in October 2005 to ensure that medications are ordered, administered, stored, disposed of correctly, and was satisfied with their practice. Due to this auditing system the inspector did not assess this further. The inspector was informed that oxygen is currently being used in the home. Appropriate signage was on display. The inspector required that risk assessments be undertaken in respect of the storage of and movement of oxygen cylinders around the home. As this was the only part of the medication standard that was not met and as the staff team agreed to address this immediately this is reflected in the final score of this standard. All residents spoken with stated that staffs display a high standard of respect in their daily interactions. Residents stated that staffs ensure that their privacy and dignity is maintained and could not see how this area of care could be improved. The inspector noted that the atmosphere of the home and residents appeared to be relaxed. Residents commented staff ’ were ‘kind’, ‘wonderful’ and ‘patient’. Cathedral View Nursing Home DS0000046307.V268161.R01.S.doc Version 5.0 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): 12,13,15 Cathedral View provides a programme of activities to promote and encourage the pursuit of residents social, educational and leisure needs. Flexible visiting arrangements are in place and visitors are welcomed at the home. Residents were ‘very satisfied’ with the provision of meals at the home. EVIDENCE: From discussions with residents they all commented that there is ‘enough to do’ during the day. The inspector noted on the day of inspection a variety of activities taking place; socialising in the lounge area, watching a film, music and receiving visitors. Cathedral View employs an activity coordinator who provides a variety of group activities on a daily basis that are advertised plus individual sessions with residents. Residents commented that they are encouraged to join in these activities and to partake in their own individual pursuits i.e. paintings, making of cards, reading. Some residents commented that they prefer to spend time in their own company and this is respected. Individual interests are recorded in residents individual files. There is a flexible visiting policy and residents determine where they meet with their guests. Resident’s felt their visitors were welcomed to the home positively, which was echoed by visitors spoken too, and neither could think of improvements in this area. Cathedral View Nursing Home DS0000046307.V268161.R01.S.doc Version 5.0 Page 14 In discussion with catering staff they confirmed that since the last inspection the menus have been reviewed with residents. Some changes to the menus were shown to the inspector. It was evident in this discussion that the catering staff are aware of and cater for individual dietary needs and that with new admissions they meet with the resident to assess their dietary likes/ dislikes and how they can be accommodated. Residents said that there is a choice of main meal. The menus inspected demonstrated that there are a variety of meals. An alternative menu is recorded for those residents who wish to have a different meal. Residents made positive comments to the inspector in the variety and quality of food provided. The cook has an intermediate certificate in catering and all staff have attended the basic food hygiene course. A cook is present in the kitchen all week plus a kitchen assistant and prepares all main meals. From discussion with the catering staff it was evident that they are aware of the importance of infection control in the kitchen area. Relevant paperwork in respect of food temperatures are kept, COSHH information was on display and all equipment was working. The inspector observed that there was no fly screens on windows and the cook stated that they are not opened due to having a fan. If these are opened a fly screen must be obtained. Cathedral View Nursing Home DS0000046307.V268161.R01.S.doc Version 5.0 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Cathedral View has an appropriate complaints and whistle blowing policy. Residents, their representatives and staff are confident to raise any concerns. The management team have an understanding of adult protection issues. EVIDENCE: Cathedral View has completed policies in respect of the complaints procedures. Cathedral View and CSCI have not received any complaints about the home. From the inspectors discussions with residents all stated that they had no concerns about the care or facilities that were provided by the home. Staff likewise commented they had no current concerns. The majority felt able to approach the management team if they had any concerns. The adult protection policy was not inspected on this occasion. However the management team and inspector discussed the area of adult protection and was reassured that the management team were able to verbalise the process that need to be taken should a allegation of abuse be brought to their attention. All staff have been nominated to attend the County’s multi disciplinary adult protection training, and the managers will attend the Investigators course when dates have been confirmed. Therefore training remains ongoing. Cathedral View Nursing Home DS0000046307.V268161.R01.S.doc Version 5.0 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): 19,21,25, The home and grounds are well maintained providing a safe environment for residents, staff and visitors. The home is clean making it a pleasant place for service users to live in. The bathroom facilities are under review to improve this facility for residents at the home. EVIDENCE: The environment section was inspected in detail at the previous inspection. Therefore only the requirements identified at that inspection was revisited on this occasion. The first was that the Registered Providers must review the current bathing facilities with a view to improving access for both residents and staff. The registered provider stated that three quotes have been gained and this work is in progress. Therefore this requirement is re notified. The second requirement was in respect of ensuring that sufficient lighting is available to residents and in the laundry area. The registered provider confirmed this has been addressed. The inspector observed that the home continues to be well maintained, clean, bright and comfortable, and overall is suitable for residents needs. Cathedral View Nursing Home DS0000046307.V268161.R01.S.doc Version 5.0 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 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 Suitable trained and experienced staffs are employed in sufficient numbers at all times to meet residents care needs. Robust recruitment procedures are put into practice to ensure that residents are protected in the home. Staff have access to appropriate training to ensure they are trained to undertake their work. EVIDENCE: On the day of inspection five care staff, a qualified nurse, matron, domestics, handyperson, kitchen staff, laundress and registered manager were on duty. In the afternoons the ratio of carers reduces to three but with the same level of qualified and management cover. At night there are two waking night staff plus a manager on call. The management team stated that the home has some care staff vacancies but they have not needed to employ agency workers as the current staff team have covered these shifts. The home employs an activity coordinator. Residents were satisfied with the level of staffing in the home and all were complimentary about the care and approach they receive from the staff team. From discussion with staff they all commented that they felt that there is sufficient staff on duty and that they ‘work as a team’. The management team stated that if care needs become more complex then they would review staffing levels and increase where needed. The inspector observed staffs that were competent in their work. Cathedral View Nursing Home DS0000046307.V268161.R01.S.doc Version 5.0 Page 18 Approximately seventy five percent of care staff has achieved a minimum of NVQ level 2 or above. The registered manager has liaised with a training company to assist in the training of the staff team. This programme was inspected and is up to date with recent legislation and in line with Skills for Care (previously known as TOPPS) and the national minimum standards. Staff felt the courses were relevant to their work. From inspection of recently recruited staff files they evidenced that appropriate employment checks have been completed. Cathedral Views Limited recruitment policies were not inspected on this occasion. Cathedral View Nursing Home DS0000046307.V268161.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,36,37 The registered manager is competent in her role to manage the home. The management approach creates an open, positive and inclusive atmosphere for residents and staff. Staff receive appropriate support to assist them in their work. Records are stored in a confidential manner. EVIDENCE: The registered manager has experience in social care setting for 20 years and has officially managed cathedral View homes for the last 3 years. She has achieved the Registered Managers Award. The matron has been in post for three years and is a registered General Nurse Level 1. They have both undertaken relevant training to update their knowledge in the area of older persons care. The staff team and residents spoke positively regarding the accessibility of the managers to voice any ideas as to how to improve/change the service. The registered providers are in regular contact to ensure that all that is needed for the home is in place. Cathedral View Nursing Home DS0000046307.V268161.R01.S.doc Version 5.0 Page 20 Staff confirmed that they meet with the management team approximately 3 monthly. Staff felt that these meetings were beneficial. Residents hold a ‘residents meeting’ that is independently chaired approximately three monthly, minutes were inspected and demonstrated comprehensive discussions in gaining their views on the service provision. The registered manager has completed a quality assurance survey with residents, and relatives, and stakeholders. The results were overall satisfaction with the care provided. The registered manager has provided a summary of the findings and will write a plan of actions that she intends to take. The matron, confirmed by records and discussion with some staff stated that all staff receives at least six supervision sessions per year. Records held by the home are stored in a confidential manner and in the main are in line with the Data protection Act. Cathedral View Nursing Home DS0000046307.V268161.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 2 X X X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 3 X Cathedral View Nursing Home DS0000046307.V268161.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP21 Regulation 23 Timescale for action The registered Provider must 30/08/06 review the current bathing facilities with a view to improving access for both service users and staff, and provide the CSCI with an action plan, including timescales. This is re notified to you. (3 rd time). A risk assessment in the storage 30/03/06 of and moving of oxygen cylinders must be undertaken. Requirement 2. OP9 13 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 OP7 Good Practice Recommendations Care plans should be expanded further to identify service users skills and actively promote these. In addition the review documentation should record more clearly when reviews of care plans and who participated occurred. Cathedral View Nursing Home DS0000046307.V268161.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 Cathedral View Nursing Home DS0000046307.V268161.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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