Inspection on 04/09/06 for Cherry Trees

This inspection was carried out on 4th September 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Cherry Trees 07/10/09

Cherry Trees 01/08/07

Cherry Trees 27/02/06

Cherry Trees 05/07/05

Cherry Trees 09/11/04

Cherry Trees 25/05/04

Similar services:

Coton Hill House

Doddington Lodge

Far Croft

Churchill House Nursing and Residential Home

Field Farm House

Church Terrace Nursing & Residential Home

Fountain Court

The Forbury

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

CARE HOMES FOR OLDER PEOPLE Cherry Trees 242 Dunchurch Road Rugby Warwickshire CV22 6HS Lead Inspector Martin Brown Key Unannounced Inspection 4th September 2006 12:30 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 Cherry Trees DS0000004217.V310394.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. Cherry Trees DS0000004217.V310394.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cherry Trees Address 242 Dunchurch Road Rugby Warwickshire CV22 6HS 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) 01788 816940 01788 815049 Pinnacle Care Ltd Miss Sharon Evans Care Home 14 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (14) of places Cherry Trees DS0000004217.V310394.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may also provide care to the person named in the application for variation of registration dated 21 June 2004. 27th February 2006 Date of last inspection Brief Description of the Service: Cherry Trees care home is situated approximately 1 mile from Rugby town centre along the Dunchurch Road. The home is set back off a busy road. Local buses pass close by. Cherry Trees is a large detached domestic type dwelling converted into a care home, that can accommodate up to 14 older persons over the age of 65 years who have dementia. The home is owned by Pinnacle Care. There is one double room and twelve single rooms. Rooms have wash basins, but no en suite facilities. The home provides residential, not nursing care. Residents needing nursing care receive this from the visiting community nurses. The fees currently range from £397 to £480 per person per week. There are additional charges for hairdressing, newspapers and magazines, and for leisure transport. Cherry Trees DS0000004217.V310394.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report has been made using evidence that has been accumulated by the Commission for Social Care Inspection. This includes a number of comment cards received back from the relatives of residents. A pre-inspection questionnaire was sent to the home, in order that the home could supply basic information concerning the home, to assist the inspection. This had not yet been completed. The inspection visit was unannounced and took place from just after midday, until 7pm. All residents were seen over the course of the inspection, as were staff on both the morning and afternoon shifts, as well as several relatives who visited during that time. A tour of the premises was made, relevant documentation was looked at, and observations of the interactions between residents, staff and their environment were made. The care of a small representative sample of residents was looked at in particular detail. The manager, team leader and staff were helpful throughout, and residents and relatives were happy to talk on matters of interest and importance to them. What the service does well: The overall impression was of a warm, friendly and caring service, much appreciated by the residents and by relatives. Staff were seen to be calm, reassuring, friendly and sympathetic at all times to residents and to diffuse and ease any uncertainties and potential distress. The main meal exemplified this, with residents being assisted as needed without fuss, and people being tolerant of each other’s choices and frailties. Where individual residents showed anxiety or agitation, they were given good natured attention and support to help calm them, in a way that demonstrated staff’s understanding and awareness of their difficulties. Relatives were very appreciative of the care provided by the home, as were residents. “They do a good job here” was a typical response from one resident. Residents were supported in individual preference and activities, and were encouraged to help with individual chores, such as washing up and setting tables, where it was clear that this was safe and beneficial and fulfilling to the person concerned. Cherry Trees DS0000004217.V310394.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cherry Trees DS0000004217.V310394.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cherry Trees DS0000004217.V310394.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Residents and their relatives can be confident that the home assesses their needs and the service’s ability to meet them before they move in. EVIDENCE: Assessments for the most recent admissions to the home were looked at. These showed that the home assesses the needs of people prior to admitting them, and follows up information provided to them, whether by Social services or another home or agency, with their own assessment. Residents continue to have individual contracts; these were available in individual care folders. Information concerning the home in the form of Statements of Purpose and individual Service User Guides were seen to be available, although relatives advised that they found that a personal visit to the home was the best way to find out about it. Relatives spoken to on this matter were all pleased that this particular home had been chosen. Cherry Trees DS0000004217.V310394.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. The judgement has been made using available evidence including a visit to this service. The home is working to a fuller involvement of residents and families in the reviewing of care plans, but could usefully do more work to make those plans more ‘user friendly’. The service continues to promote individual care and attention for the people in their home in a respectful and dignified manner that takes account of all their frailties. Better scrutiny of equipment used is needed to ensure it is safe at all times. The administration and recording of medicines is much improved, although there is still room for further improvement in order that residents can be completely confident that their medication needs are being fully. Cherry Trees DS0000004217.V310394.R01.S.doc Version 5.2 Page 10 EVIDENCE: A sample of residents care plans were examined. These contain necessary information regarding individual needs and how they are to be met, and were updated on a regular basis, and greater involvement of relatives and the residents themselves, where appropriate is now being sought, in response to requirements from the previous inspection. The information is handwritten, and is not at times easy to follow to build up a clear picture of each person’s needs. The manager agreed that the needs would be better laid out in a printed format, on computer, in a way that would be more convenient to regularly update as required, and in a format that was more clearly highlighted the specific individual needs of the person. The manager expressed a keenness to rearrange these files in a more ‘user friendly’ way. Care needs are primarily related to the dementia needs of the residents. These were seen to be managed at all times in a respectful and dignified manner, and one which showed that staff had a good knowledge of individuals and their needs and of the best way to meet their needs. Residents continue to have access to GPs, nurses and other health professionals, and details of these visits are recorded. A pair of weighing scales in the toilet were not working and were an obstruction. The team leader removed these. The manager advised that they were currently sharing a set of scales with a nearby home, agreed that the home needed to have its own set of working scales so that any residents could be weighed if weight loss or gain was a concern, and promptly purchased a new set of scales for this purpose. A ‘cot side’ in use on a bed was found to be broken and potentially dangerous. It was promptly removed, and alternative safety measures put in place. It was unclear whether this had only just broken, or whether it had been like this for some while. It had not been reported. Medication storage, recording and administration was examined. The current Medication Record Administration Sheet was seen to accurately tally with medicines so far dispensed, and stock control of current medicines was seen to be accurate. The manager advised that a medication audit had just taken place that week and was satisfactory, but that she had not yet received a copy of the audit. This was forwarded to CSCI following the inspection, and was seen to be satisfactory. The previous audit, in June, had highlighted a number of errors in recording. The controlled drug registered also showed two occurrences form this period when double signatures had not been obtained. Since July, it was all correct, and stock control was correct. Cherry Trees DS0000004217.V310394.R01.S.doc Version 5.2 Page 11 Some ‘as required’ medication was recorded as ‘refused’. The team leader agreed that this was not accurate, and would be more accurately recorded as ‘not required’, in order to eliminate any possible misunderstanding. Eye drops were stored correctly in refridgerated conditions. Medications are stored in the dining area, which is in the conservatory. Most medication is kept in a low cupboard, but some, including medication that instructed ‘keep below 25C’ was in a higher cupboard. The team leader agreed that temperatures in this area may at times exceed that. The team leader was not fully aware of the exact purpose of some of the medication, and agreed that an outline of each medicine, its purpose, possible side-effects, and individual preferences would be a useful aid in administration. Cherry Trees DS0000004217.V310394.R01.S.doc Version 5.2 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 the following standard(s): 12,13,14,15 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Residents are supported in maintaining a lifestyle in line with their current wishes and needs, and are helped in continuing to make choices and decisions wherever possible. An appealing wholesome diet in pleasant surroundings helps to maintain a feeling of well-being. EVIDENCE: Discussion with residents and relatives, and observations during the inspection, showed a general satisfaction with activities and the pace of life within the home. Rather than a television being on, there was background music that was appreciated by a number of residents, who joined in a sing – song later in the day. There is a television in the smaller lounge. For most of the afternoon, this was a hairdressing parlour. Involvement of families is welcomed, and one recent arrival has been supported to maintain her gardening interests. Two residents enjoyed, at various points, helping with light chores such as laying tables and drying up in the kitchen. Cherry Trees DS0000004217.V310394.R01.S.doc Version 5.2 Page 13 The managed recounted details of recent, and planned, events, including regular in-house reminiscence sessions and ‘creative Tim’ activity sessions, as well as trips out, a recent summer fete, and a planned bonfire evening. The manager advised that residents are free to go to bed when they wish, some choosing to go relatively early. When I left at 7pm, residents in the main lounge were enjoying a sing-song with a member of staff. A midday meal was taken with residents. This was well-prepared, and enjoyed by all in a relaxed, easy-going atmosphere. Most people ate at dining tables in the conservatory, but one or two preferred to eat at their chairs in the lounge. Where assistance was required, staff provided this, in a respectful, discreet manner that helped to uphold people’s dignity. A choice was offered to all residents, all appeared to enjoy their meals, and those spoken to confirmed that they enjoyed the food provided. Cups of tea were frequently provided through the day, with the option of cold drinks also being offered. Cherry Trees DS0000004217.V310394.R01.S.doc Version 5.2 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 the following standard(s): 16,18 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Residents and relatives can be confident that those living in the home are safeguarded from abuse and that complaints and concerns will be given due regard. EVIDENCE: Only one complaint has been received over the past year. This was a current one and the complainant was spoken to and wished it to be known that the concerns were ‘minor’ ones, and within an overall satisfaction with the care and the service. The manager was aware of the concerns, some of which had been addressed, and some of which were being addressed. Appropriate policies and procedures in respect of abuse and allegations of abuse continue to be in place. There continue to be no allegations or suspicions of abuse of any form. The manager advised that the home does not have responsibility for any personal monies of residents. A policy and protocol is in place regarding personal care and male staff. Cherry Trees DS0000004217.V310394.R01.S.doc Version 5.2 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 the following standard(s): 19,20,21,23,24,25,26 Quality in this outcome area is adequate. The judgement has been made using available evidence including a visit to this service. The home has a number of shortcomings that are difficult to resolve, but the service seeks to provide a good quality and well-maintained environment. Improved, more accessible, lavatory and washing facilities would benefit residents, as will the completion of the refurbishment of bedrooms. The wide opening of conservatory windows compromises safety there. EVIDENCE: The home is not purpose-built and has been altered and extended over the years in to be a dementia care home for 14 people. Consequently, there are a number of shortcomings in the environment readily observed during an inspection that are difficult for the home to overcome. Corridors are narrow, leading to the home being unsuitable for wheelchair users within the home. Bedrooms do not have en suite facilities, the kitchen is so sited that it is a thoroughfare to the office, and the laundry. The manager advised that laundry is carried outside to the laundry during the day. Cherry Trees DS0000004217.V310394.R01.S.doc Version 5.2 Page 16 The natural slope of the land means that the conservatory, used as the dining room, is high above the large garden area, which is accessed by a ramp. The steps directly from the conservatory are not seen as suitable for residents’ use. The conservatory windows are able to be opened wide, although the garden is several feet below. Bedroom windows have small chains on them to limit their opening. The home was generally clean and hygienic. There was an unpleasant odour noticed in only two bedrooms. In both of these the manager advised that incontinence was an issue and that the carpets were due to be replaced as part of bedroom refurbishment. There are two small toilets leading from the dining room. The manager agreed that these are both too small to allow assisted use of and are rarely if ever both in use at the same time, and would be more usefully combined as one toilet of a good size. The toilet by the front bedrooms is of a much more suitable size. There is also a bathroom and further toilet downstairs. Upstairs, there are two toilets and a bathroom/toilet. There are bedrooms for ten people upstairs. Some tiles in the upstairs bathroom are cracked, which the team leader agreed may be due to some weakness in the surface area they are covering. Access upstairs is by stairs or by shaft lift, which worked appropriately and which the manager advised is regularly serviced. There is one double bedroom. The team leader advised that the two ladies currently sharing this had made a positive decision to do so, based on their wish for company. All bedroom doors are now lockable. The team leader advised that all residents were given the option of having keys, but only a small number wished to. Some bedrooms have been refurbished, all bedrooms were personalised with photographs, paintings and ornaments or individual furnishings and furniture items in some instances. The garden is accessed by a rather steep ramp and has tables and chairs and a large grassy area. The whole area slopes and dips, and a low picket fence separates one section, where there is a disused swimming pool. This is covered by a tarpaulin and, as it is on the other side of a fence, residents showed no interest in it. One lady referred to it as ‘next door’. There are risks assessments in place, the manager is aware that these would have to be revised if a resident ever showed an inclination or ability to clamber over the fence. Cherry Trees DS0000004217.V310394.R01.S.doc Version 5.2 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 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Resident’s benefit from a dedicated, consistent staff group. Unless additional recruitment is successful, there is a risk of an over reliance on existing staff to prevent staffing ratios falling to an unsafe levels. EVIDENCE: Staffing was seen to be sufficient during this unannounced inspection, but the manager acknowledged that owing to sickness and the need to recruit at least one more staff, a full staff complement was only achieved by staff working additional hours at times. This is done in preference to employing agency staffing, and is reliant on the goodwill of staff, which was much in evidence. All observed staff interactions and interventions with residents demonstrated the competence and positive nature of the staff group. The home was previously required to ensure that sufficient staff are qualified to National Vocational Qualification Level 2. The service has taken positive steps to ensure this is happening, with a number of staff achieving, or about to achieve this. On the day of the inspection, the assessor for NVQ was visiting to discuss with a number of staff their progress. She was very positive about the commitment and support provided by the service to enable staff to achieve their training goals. Cherry Trees DS0000004217.V310394.R01.S.doc Version 5.2 Page 18 Details of ongoing training showed that mandatory training was being provided and specific areas of need, such as dementia training were also covered. The one exception was infection control, for which there was no evidence of recent training, in spite of the previously highlighted concerns about the kitchen being used as a thoroughfare. A sample of recruitment files showed that safe procedures and checks are adhered to, to ensure that unsuitable or unsafe staff are not employed Cherry Trees DS0000004217.V310394.R01.S.doc Version 5.2 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): 31,33,35,38 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Residents benefit from a well-run home where their interests are parmount. EVIDENCE: The manager was able to delegate to the team leader, and was seen to be approachable and available for other staff and residents. Quality assurance surveys conducted by the home showed that the views of residents and relatives are sought in order to inform the future development of the service. Comment cards returned by relatives were positive with the exception of that raised individual concerns that are being addressed by the service. The manager advised that the home does not hold any personal monies for residents. Cherry Trees DS0000004217.V310394.R01.S.doc Version 5.2 Page 20 The accident book was seen and did not raise any concerns regarding safety in the home. Unfortunately, the Pre-inspection Questionnaire had not been completed by the manager prior to the inspection. The manager was made aware that the timely completion of a revised self assessment will, in the future, become a legal requirement. The manager advised that gas, electric, fire and other safety checks were all up to date. A copy of the most recent fire safety check was seen to be satisfactory. Staff were knowledgeable concerning fire safety. The home had on display a Gold star award following a recent Environmental Health Officer inspection. Cherry Trees DS0000004217.V310394.R01.S.doc Version 5.2 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 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 2 X 3 2 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Cherry Trees DS0000004217.V310394.R01.S.doc Version 5.2 Page 22 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. 2. Standard OP8 OP8 Regulation 12 12 Requirement A revised risk assessment is required concerning the use, or otherwise, of a cot side. The home is required to ensure that all staff are aware, and are alert for any damage or shortcomings in equipment intended to aid residents’ well being. The service must ensure that medication is stored in areas that do not exceed safe temperatures for that medication. Medication must only be recorded as refused where it is actually refused, rather than just not required. The conservatory windows must be risk-assessed, and have suitable devices to allow them to open only to safe limits. Cracked tiles must be replaced in the upstairs bathroom, and the reason for them cracking investigated. Timescale for action 15/09/06 11/10/06 3. OP9 13(2) 11/10/06 4. OP9 13(2) 11/10/06 5. OP19 23(2) 11/10/06 6. OP21 23(2) 11/10/06 Cherry Trees DS0000004217.V310394.R01.S.doc Version 5.2 Page 23 7. OP21 23 Sufficient and suitable toileting and bathing facilities must be installed which are capable of meeting the assessed needs of residents. The accessibility of these areas must be taken into consideration. Outstanding from 5 July 2005 Bedroom carpets must be replaced where they are worn and give off an unpleasant odour. Further recruitment to avoid staff working excessive hours to maintain sufficient cover. Staff training in infection control is required. 30/12/06 8. OP24 23 30/11/06 9. 10. OP27 OP30 18 18 11/11/06 11/11/06 Cherry Trees DS0000004217.V310394.R01.S.doc Version 5.2 Page 24 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 2 Refer to Standard OP7 OP9 Good Practice Recommendations It is recommended that individual care plans are formatted in a clearer and more ‘user friendly’ way. Staff knowledge of individual medications would be aided by an accessible outline guide for each medication, giving its use, possible side effects, and preferred way for individuals to take it. It is recommended that the home consider a less visible form of window restraint than the current small chains. It is recommended that the home consider less ‘institutional’ radiator covers. A ramp from the conservatory would greatly help access into the garden. 3 4 5 OP19 OP19 OP20 Cherry Trees DS0000004217.V310394.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Cherry Trees DS0000004217.V310394.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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