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Inspection on 31/08/06 for Christopher Grange (Rhona House)

Also see our care home review for Christopher Grange (Rhona House) for more information

This inspection was carried out on 31st August 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Christopher Grange has a statement of purpose and service user guide that provide good levels of information about the home. Pastoral support is offered to residents and their visitors. Residents and visitors were complimentary about the care and support provided by staff at the home. Residents appreciated the quality and variety of food served in the home. Particular appreciation was given to the catering staff who have been working under very difficult conditions to maintain the quality of service that is expected. Maintenance procedures and staff training provide a safe environment for residents, their visitors and staff.

What has improved since the last inspection?

Improvements have continued to be made to the physical standard of the home. The redecoration programme continues and new carpets have been fitted. The lounge is bright and homely.

What the care home could do better:

Requirements have been made in respect of the storage and recording of prescribed medications. The redecoration of the corridors of the home continues but is taking considerably longer than the home previously planned.

CARE HOMES FOR OLDER PEOPLE Christopher Grange (Rhona House) Youens Way East Prescot Road Liverpool Merseyside L14 2EW Lead Inspector Jeanette Fielding Unannounced Inspection 31st August 2006 09:30 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 Christopher Grange (Rhona House) DS0000025095.V297937.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. Christopher Grange (Rhona House) DS0000025095.V297937.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Christopher Grange (Rhona House) Address Youens Way East Prescot Road Liverpool Merseyside L14 2EW 0151 220 25 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) The Catholic Blind Institute Tina Marie Clair Care Home 28 Category(ies) of Sensory impairment (23), Terminally ill (5) registration, with number of places Christopher Grange (Rhona House) DS0000025095.V297937.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 23 Sensory Impairment (SI) aged 65 years and over 5 Terminally Ill (TI) aged 50 years and over To accommodate one named person under 65 years old Date of last inspection 2nd March 2006 Brief Description of the Service: Rhona House is part of the main Christopher Grange Home, but is registered separately. Rhona House is currently registered with the National Care Standards Commission for nursing care for elderly persons. A total of 28 beds are available, with five of these being available for the care of terminal illness. The home forms part of the Christopher Grange Home that was purpose built for providing services to visually handicapped people and provides all facilities on the ground floor thereby providing full access to all areas. It is situated in Liverpool 14, close to local shops and amenities. The home is set within a residential area, close to shops and major transport routes. The home is owned by the Catholic Blind Institute and has its own chapel in which a daily mass is held. However, residents are accepted from any faith and local ministers of other religions visit to provide pastoral support. Weekly fees at the home have been identified as £524. Christopher Grange (Rhona House) DS0000025095.V297937.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection of Christopher Grange Rhona House was undertaken on Thursday 31st August 2006 over a period of 6.5hours. It involved the examination of care, staff and medication records, and discussions with some of the staff, service users and visitors to the home. Another inspector from the Commission was inspecting the services at the Christopher Grange residential care home which is managed by the same organisation, located on the same site, and sharing the same central facilities. A separate report is produced following the inspection of the residential areas of the home. The inspection was undertaken as part of the Commission’s responsibility to visit and report on all registered care homes. What the service does well: What has improved since the last inspection? What they could do better: Requirements have been made in respect of the storage and recording of prescribed medications. The redecoration of the corridors of the home continues but is taking considerably longer than the home previously planned. Christopher Grange (Rhona House) DS0000025095.V297937.R01.S.doc Version 5.2 Page 6 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. Christopher Grange (Rhona House) DS0000025095.V297937.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 Christopher Grange (Rhona House) DS0000025095.V297937.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): 1, 2, 3, 4, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are provided with a detailed and informative statement of purpose and service user guide to enable them to make an informed decision regarding their care provider. EVIDENCE: The home’s statement of purpose had been revised, prior to the CSCI inspection in March 2006 and there have been no significant changes to the home since then. The document identifies the value base for the work that is undertaken at Christopher Grange and contains information about how care will be provided. The statement of purpose encompasses the work of both Rhona House and the residential care units run by the Catholic Blind Institute that are located on the same site. All service users are issued with a contract or statement of terms and conditions on admission. Christopher Grange (Rhona House) DS0000025095.V297937.R01.S.doc Version 5.2 Page 9 The care files of six service users were inspected. Pre admission assessments are undertaken by the manager or one of the qualified nurses. The assessment involves the gathering of information from the service user, family members, GP, social worker and any other person involved in their care. The assessment enables the home to gather information regarding the service users care needs, the equipment that is necessary and any individual preferences. The assessments are detailed and informative. The initial plan of care is developed, based on the information gathered at the time of the assessment. The home is registered to accommodate five persons who require care due to their terminal illness. Some of these service users have their assessment undertaken by the District Nurse, District Nurse Liaison, Marie Curie or Macmillan nurses. The plan of care is developed to ensure that the needs of the service user can be met. The home does not offer intermediate care. Christopher Grange (Rhona House) DS0000025095.V297937.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a clear care planning system in place to adequately provide staff with the information they need to meet service users needs. The procedure for the storage and recording of medications is not adequately followed by all nurses to ensure the protection of service users. EVIDENCE: Care plans are prepared for all service users. These are detailed and informative and provide sufficient information to enable the staff to provide the appropriate level of care to each service user. Comprehensive risk assessments are prepared together with risk management strategies to reduce or remove any potential risk to the service users. The records completed by the staff give full information regarding visits to and by GP’s and other health care professionals. The services of the Tissue Viability Nurses are sought whenever necessary and all recommendations and requirements are recorded. The detailed records relating to wound care would Christopher Grange (Rhona House) DS0000025095.V297937.R01.S.doc Version 5.2 Page 11 benefit from photographic evidence to identify the healing process of wounds. The home has recently obtained a new camera for this purpose although its’ use has not been implemented. Discussion took place with nurses with regard to wound management training and it was evident that some nurses would benefit from training or updates of previous training in this area. Concerns were raised with regard to the medication procedure followed by staff. The home has produced a comprehensive medications policy and procedure but this has not been adhered to by some staff. The door to the medications room was found to be unlocked on some occasions when the room was not in use. The lock on the door requires attention as staff stated that the room is difficult to lock and unlock. This door must be maintained in the locked position when staff are not using the room. Handwritten entries on the Medication Administration Record sheets must be clearly made and witnessed by two persons to ensure the accuracy of the entry. The handwritten entries must give full administration instructions as recorded on the label produced by the pharmacist. Medications awaiting disposal should be securely held within the medications room. Some prescribed creams were found to be stored in the cupboard on the corridor which is used for the storage of toiletries. These are to be stored appropriately in the medications room or in the service users own bedroom. An oxygen container was found in one of the store cupboards on the corridor. This should be removed and either stored within the medications room or returned to the dispensing pharmacist as appropriate. A number of service users were spoken to during the inspection. All service users said that their privacy and dignity were respected at all times by the staff. Some of the nuns who live on site provide a pastoral care service to service users and their visitors. The service is an integral part of the care and support offered at Christopher Grange and is particularly valued when service users are nearing the end of their life. Staff will assist with funeral arrangements and will prepare “Order of Service” booklets if requested to do so. Service users and their families can choose to hold their funeral in the home’s chapel with ministers of their own religion officiating. Christopher Grange (Rhona House) DS0000025095.V297937.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. This judgement has been made using available evidence including a visit to this service. The quality and range of meals offered to service users is good and meets their individual choices and preferences. EVIDENCE: Although the Catholic Blind Institute manages Christopher Grange, service users of any faith are accepted into the home. A mass is held daily in the chapel and is open to all service users who wish to attend. Ministers of other religions visit individual service users and hold their own services. Service users confirmed that the routines in the home were flexible and suited their individual preferences. An activities co-ordinator provides activities and social stimulation with the service user on an individual basis as well as in small groups or with service users from other service users within the Christopher Grange complex. A list of planned activities is displayed on the notice board to give service users the opportunity to choose which activities would suit their individual preferences. Some service users spoken to during the inspection said that they did not usually wish to participate although one said that they attended whenever possible. Christopher Grange (Rhona House) DS0000025095.V297937.R01.S.doc Version 5.2 Page 13 Visitors are welcome at the home at any time and may meet with service users in the privacy of the service users bedroom or in one of the communal areas. The home provides a room where service users may meet with their visitors in private if they wish. Service users can choose the time that they go to bed and rise and this information is recorded in their plan of care. Records are held of the name that the service user wishes to be called and of the lifestyle they choose. The meals at the home are good with a wide range of choices available. A menu is provided and service users are asked to select their choice the day before. Meals were seen to be attractively presented and smelled appetising. Service users are encouraged to take their meals in the dining rooms, however arrangements are made for those who are unwell to eat in the lounge or in their bedroom. Ethnic and special diets can be provided on request or following the recommendations of the dietician and the manager liaises with the chef regarding these. Some of the crockery available for use within Rhona House was found to be chipped at the edges and requires to be replaced. Several cups were found to be extremely stained and must be cleaned or replaced as appropriate. Staff stated that the cups are cleaned with Milton to remove the stains during the night but it is evident that this process has not been undertaken for some time. There is a small kitchen within Rhona House for the provision of snack and drinks making. The solutions which directly feed the dishwasher in this kitchen should be held within a locked cupboard to prevent accidental ingestion by service users. The home’s main kitchens are in the process of refurbishment and redecoration but arrangements for the use of kitchens at the organisation’s special school nearby had worked well. . Christopher Grange (Rhona House) DS0000025095.V297937.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, 17, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Training has been given to provide them with information about abuse, how to recognise it and the action to be taken to ensure the protection of service users. EVIDENCE: The home has a comprehensive complaints procedure which is included in the statement of purpose and is displayed within the home. The procedure indicates that upon receipt of a complaint to the manager an acknowledgement of the complaint will made within 24 hours and a response within seven days. The procedure states that matters remaining unresolved may be further pursued with the home’s governing body or the Commission for Social Care Inspection. Staff spoken to, during the inspection, were able to confirm that they were aware of the procedure to be followed. Service users spoken to confirmed that they knew whom they could complain to. No complaints have been received by the home since the last inspection. The home has a policy and procedure to be followed in the event of abuse being suspected. Several staff have now completed formal training on abuse and the action to be taken and further training is planned for all staff in the near future. Christopher Grange (Rhona House) DS0000025095.V297937.R01.S.doc Version 5.2 Page 15 The home has a “whistle blowing” policy and adult protection procedures in place that are reviewed on a regular basis. They also have a copy of Liverpool City Council’s adult protection procedures. Christopher Grange (Rhona House) DS0000025095.V297937.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, 20, 23, 24, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Work continues to take place to provide service users with a comfortable and homely place in which to live. EVIDENCE: The home is on ground floor level and all areas are fully accessible to those who have mobility difficulties or require to use a wheelchair. Handrails are fitted to assist service users. The home provides a lounge and separate dining room that service users can use as they wish. Plans are in place for improvements within the dining room which will include new furniture. The lounge has been redecorated and provides service users with a homely and comfortable environment with a range of styles and sizes of chairs available. A well maintained and attractive garden area is provided for service users and is accessible to them at all times. Christopher Grange (Rhona House) DS0000025095.V297937.R01.S.doc Version 5.2 Page 17 The programme of redecoration of the corridors appears to be at a standstill with several doors still requiring to be painted. These doors have been painted with undercoat but still require the final coat of paint. This work was commenced prior to the last inspection. New flooring has been provided in the corridors and have also been redecorated since the last inspection. Bedrooms are bright and welcoming and reflect the individual lifestyles of the service users through photographs and items of memorabilia. All bedrooms are provided with en-suite facilities to further promote independence and to protect dignity. All rooms are centrally heated, have adequate lighting and are able to be ventilated safely. Locks or restricted opening devices should be fitted to sluice doors to prevent service users gaining access to these areas. The cupboard used for storing stocks of toiletries should be locked to ensure the protection of service users from accidental ingestion of these products. A small number of towels were seen to be frayed and should be removed from use. The home has a large number of good quality towels for service users use and the removal of damaged towels will not affect the overall availability. The home was found to be extremely clean throughout and no unpleasant odours were present. Appropriate arrangements are in place for waste disposal. Policies and procedures relating to the control of infection were in place and were seen to be followed by the staff. Christopher Grange (Rhona House) DS0000025095.V297937.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 good. This judgement has been made using available evidence including a visit to this service. The home provides staff in sufficient numbers to meet the needs of the service users. EVIDENCE: The home provides two qualified nurses on duty during the day supported by five or six care staff during the morning and four care staff in the afternoon. At night, one qualified nurse is supported by three care staff. A programme of recruitment has taken place and the home has not been reliant on agency staff to support the regular staff at the home, thereby providing a consistent approach to care provision. All staff have recently undertaken training on moving and handling and the home provides moving and handling equipment in accordance with service users assessed needs. All qualified nurses have recently attended training at Liverpool Marie Curie Centre to further enable them to meet the needs of service users. Additional training for staff has included Syringe Driver updates, Mentorship and NVQ. 52 of the care staff now hold NVQ qualifications. Further training has been planned which includes Diabetes Awareness, Moving and Handling and Palliative Care Awareness which will be given by the Macmillan Nurses. NVQ training continues. Christopher Grange (Rhona House) DS0000025095.V297937.R01.S.doc Version 5.2 Page 19 Discussion with staff took place with regard to Tissue Viability training, and although some of the qualified nurses have previously had this training, updates may prove beneficial. All staff are recruited in accordance with the home’s robust policy and procedure. All prospective staff are required to complete an application form prior to being called for interview. A record of the interview is made, two references are taken and checks made with the Criminal Record Bureau and the Protection of Vulnerable Adults registers. A training file is now held on each member of staff and provides evidence of competency. All staff are given supervision every two months together with annual reviews. Probationary staff are required to complete an induction programme and are reviewed at 2, 4 and six months. Evidence is held of all qualifications and nurses registration PIN numbers are checked with the Nursing and Midwifery Council. The staff records are comprehensive and provide evidence of competency of all staff. Christopher Grange (Rhona House) DS0000025095.V297937.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, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a structured management system to ensure the best interests of the service users. EVIDENCE: The Registered Manager of the home is an RGN who has extensive management experience who holds specific qualifications and has undertaken considerable training to provide a high level of care to those service users who are elderly, together with those service users who have a terminal illness. Staff meetings are held on a regular basis and specific meetings are held for nurses, daytime care staff, night staff and general assistants. Christopher Grange (Rhona House) DS0000025095.V297937.R01.S.doc Version 5.2 Page 21 Comments and suggestion leaflets are available throughout the home providing opportunities for people to comment on the facilities, care and services provided. Verbal feedback is also obtained from service users, relatives and other visitors to the home. The manager speaks with service users on a one to one basis to obtain their views and has a good rapport with all relatives. Some service users deal with their own finances and several have their finances dealt with by family members or advocates. Where the home is banking larger amounts of money detailed transactions are maintained and interest is allocated according to the level of savings for each resident. The accounts are audited on a regular basis by the finance director. The organisations annual report confirms that the home remains financially viable. All records inspected were found to be well maintained and up to date. Fire equipment checks are made on a regular basis as required and duly recorded. Records are also held of fire drills and of the staff involved. Risk assessments are undertaken on equipment, staff and service users and risk management strategies were seen to be in place as appropriate. Safety certificates are held and all were found to be up to date. Christopher Grange (Rhona House) DS0000025095.V297937.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 4 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 4 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 3 3 X X 3 3 X 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 4 X 4 X 3 X X 3 Christopher Grange (Rhona House) DS0000025095.V297937.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 OP9 Regulation 13(2) Requirement The Registered Person must ensure that the door to the medications room is kept locked when not in use. The Registered Person must ensure that handwritten entries on MAR sheets are witnessed and signed by a second person. The Registered Person must ensure that medications awaiting disposal are securely stored. The Registered Person must ensure that oxygen cylinders are appropriately stored. The Registered Person must ensure that prescribed creams and lotions are stored appropriately. The Registered Person must ensure that all stained and damaged crockery is replaced. Timescale for action 31/08/06 2 OP9 13(2) 31/08/06 3 4 5 OP9 OP9 OP9 13(2) 13(2) 13(2) 31/08/06 31/08/06 31/08/06 6 OP15 16(2)(h) 30/09/06 Christopher Grange (Rhona House) DS0000025095.V297937.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 3 4 Refer to Standard OP8 OP19 OP19 OP19 Good Practice Recommendations Consideration should be given to the provision of training in tissue viability for the qualified nurses. The programme of redecoration of corridors should be completed. Locks should be fitted to sluice and storage cupboard doors. Frayed towels should be removed from use. Christopher Grange (Rhona House) DS0000025095.V297937.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Christopher Grange (Rhona House) DS0000025095.V297937.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. 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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