Inspection on 28/06/05 for Cole Valley Nursing Home

This inspection was carried out on 28th June 2005.

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

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

Other inspections for this house

Cole Valley Nursing Home 22/10/08

Cole Valley Nursing Home 02/10/07

Cole Valley Nursing Home 16/10/06

Cole Valley Nursing Home 16/05/06

Cole Valley Nursing Home 19/12/05

Cole Valley Nursing Home 25/11/04

Cole Valley Nursing Home 09/06/04

Cole Valley Nursing Home 27/01/04

Cole Valley Nursing Home 20/08/03

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Maple Lodge

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Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Cole Valley Nursing Home 326 Haunch Lane Kings Heath Birmingham B13 0PN Lead Inspector Jane Walton Announced 28 June and July 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cole Valley Nursing Home E54 S24835 ColeValley V227792 280605 - Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Cole Valley Nursing Home Address 326 Haunch Lane, KIngs Heath, Birmingham B13 0PN Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0121 444 8887 0121 441 1959 Cole Valley Care Limited Care Home 45 Category(ies) of Old Age, Dementia over 65 (45) registration, with number of places Cole Valley Nursing Home E54 S24835 ColeValley V227792 280605 - Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. 45 males and females over the age of 50 years for general nursing care Date of last inspection 25th November 2004 Brief Description of the Service: Cole Valley is a purpose built 45 bedded home on two levels, with a passenger lift for access to the first-floor. The home is located within the Kings Heath district of Birmingham, and is situated in a residential neighbourhood close to local amenities including shops and public transport.The home is pleasantly furnished and decorated and aims to offer a warm, homely environment for elderly people requiring nursing care.There is a small car park adjacent to the home and sheltered, private gardens for service users and their visitors. Cole Valley Nursing Home E54 S24835 ColeValley V227792 280605 - Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Announced inspection was undertaken by two inspectors over two days, who were assisted throughout the process by the Acting manager. Two formal complaints had been received by the Commission for Social Care Inspection and these were investigated during the first day of the inspection. As part of the complaint investigation, relevant care plans and other documentation were examined. There were 38 residents in the home during the inspection. The inspectors spoke with four visitors to the home, and ten residents. Information was also gathered by observing staff performing their duties, formal discussions with two, and informal discussions with three of the staff. Ongoing discussions throughout the inspection process took place with the manager. Care records were examined and a medication audit carried out. What the service does well: What has improved since the last inspection? What they could do better: Cole Valley Nursing Home E54 S24835 ColeValley V227792 280605 - Stage 4.doc Version 1.30 Page 6 Although a pre-admission assessment is carried out for prospective residents, more extensive and detailed information needs to be obtained so as to accurately determine whether the home will be able to meet their needs or not. One of the residents was seated in a bucket type chair which was no longer fit for its purpose, and the resident needs to be referred for an urgent seating assessment. The recording within the residents care plans needs to be more consistent, and the daily records for each resident must be more reflective of their life in the home. All nursing staff must receive training to develop their knowledge in the indications, adverse effects, cautions and drug interactions of medicines prescribed and administered within the home. Medication reviews must be sought on a regular basis for all residents in line with the National Service Framework for Older People. A more extensive and varied range of suitable activities need to be provided for the residents. One resident said,” I would like to have more to do, I seem to watch a lot of television.” Steps need to be taken to ensure that when training in moving and handling techniques has been undertaken by staff, that it is put into practice on a dayto-day basis. There are some areas in relation to health and safety issues that require attention, when fire drills have been carried out this must be documented, and the practice of wedging open bedroom doors must cease as this poses a fire risk. If a resident wishes to have their bedroom door open then suitable automatic closures need to be fitted. A more robust recruitment procedure needs to be followed in order to ensure the safety of the residents. 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. Cole Valley Nursing Home E54 S24835 ColeValley V227792 280605 - Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Cole Valley Nursing Home E54 S24835 ColeValley V227792 280605 - Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3,4,&5 The information gathered prior to admission of residents is insufficient to adequately assess needs thus placing residents at potential risk. EVIDENCE: A pre-admission assessment is carried out by the manager or a qualified member of staff before the resident is admitted to the home. However, the quality and quantity of information gathered prior to admission, that was seen in the care plans, was of poor quality, and insufficient to adequately identify the needs of the prospective resident. One resident had been admitted to the home and their need for close monitoring due to their confusion, had not been sufficiently identified. The home was unable to offer this level of supervision, particularly at night time, and the resident had to be found another placement. The relatives and friends of prospective residents have an opportunity to visit the home prior to admission, and all residents are offered a trial period of 12 weeks which may be cancelled by either party. Cole Valley Nursing Home E54 S24835 ColeValley V227792 280605 - Stage 4.doc Version 1.30 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 standard(s) 7,8,9,&10 The medicines had been administered and recorded accurately. The nurses did not apply sufficient clinical knowledge of the medicines they administered to ensure the residents received the most effective combination of medicines in all instances. The standard of care plans was variable so that residents personal and health care needs are not always met. EVIDENCE: Individual care plans are available for each resident and evidence was seen that in most cases the plans had been regularly reviewed. One residents care plan appeared to indicate that there had been no changes since her admission 18 months previously. A range of risk assessments had been carried out, including moving and handling, pressure sore risk assessment and a nutritional risk assessment. However, in some cases the assessments had not been signed. When the resident has been assessed as requiring a hoist it is recommended that the sling size to be used is recorded, to ensure the safety of the resident. The nutritional risk assessment that had been carried out for two residents had been recorded on a very poor quality photocopy, and was very difficult to read. One resident was seen to be seated in a “bucket” type chair that was in a poor state of repair. Cole Valley Nursing Home E54 S24835 ColeValley V227792 280605 - Stage 4.doc Version 1.30 Page 10 The manager was advised to have the chair removed from use, and to arrange to have a suitable seating assessment carried out for the resident by either a physiotherapist or occupational therapist. The daily records that were seen did not always accurately reflect the life of the resident in the home and activities undertaken by residents were not always recorded. Evidence was seen that residents have access to GPs and other health professionals as required. It was noted that a doctors book is used to record requests for residents to be seen by a GP, however, the entries were confusing and it was not always clear when a resident had been seen nor what action had been taken. Some entries had been crossed out and it was unclear as to why, and Tippex had also been used in some entries. The manager was asked to ensure that this practice ceased and that any alterations in the book were signed and dated by the person responsible. By the second day of the inspection the manager had instigated the use of a new format of doctors book. There was evidence that accidents occurring to residents that had been duly recorded in the homes accident book had not been notified to the Commission for Social Care Inspection as required. An audit of the medication management in the home was undertaken by the Pharmacist Inspector and the following are her comments... All medication audits undertaken were correct. The home has a good system for receipt and administration of medicines. Hand written Medicine Administration Record (MAR) charts were well prepared. Nursing staff need to be more aware of the clinical indications of the medicines they are administering as one service user was administered laxatives in addition to medicines to prevent diarrhoea simultaneously. Analgesics had been prescribed on a “when required” basis, but up to three different analgesics were routinely administered, compounding side effects without necessarily improving the well being of the service user. Residents were seen to be wearing clean and well ironed clothing that was appropriate for the time of year. All residents are afforded the privacy of a single bedroom, and staff were observed to address residents with respect. Cole Valley Nursing Home E54 S24835 ColeValley V227792 280605 - Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 & 15 The dietary needs of residents are satisfactorily catered for and they are provided with a balanced and varied diet that meets their nutritional requirements. Overall, the current limited range of activities offered do not fully meet the residents needs, expectations or abilities. EVIDENCE: Residents are provided with a nutritious and varied diet. Four weeks of menus were taken away and analysed and demonstrated that there are always two choices available at lunchtime including the choice of two puddings. One resident said” if you dont like whats on the menu you can ask them to change it for you”. The supper menu offers soup and assorted sandwiches every day together with an option of a hot dish of some description, for example cheese and potato pie, Cornish pasties and macaroni cheese. A limited range of activities are provided for residents to partake in if they wish to do so, however several residents stated that they would like to have more to do. The home does not have a dedicated activities organiser, and the acting manager informed the inspectors that care staff are encouraged to spend time with residents assisting them with activities. Although staff were observed to be sitting with residents in the lounges there were no obvious activities taking place. Relatives and friends are welcome to visit residents at any reasonable time, and are welcomed to the home. One resident was waiting in a wheelchair near the front door, in anticipation of a visit from a relative who was taking her out for the afternoon. Cole Valley Nursing Home E54 S24835 ColeValley V227792 280605 - Stage 4.doc Version 1.30 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,&18 The home has a satisfactory complaints policy and procedure that is accessible to the residents and the visitors so that they are aware of how to complain should the need arise. Staff demonstrated a good understanding of adult protection issues that provides a safe environment and protects service users from abuse. EVIDENCE: There is a complaints policy and procedure available in the home that meets the required standard. Two formal complaints received by the Commission for Social Care Inspection were investigated during this inspection. The following elements relating to one of the complaints were upheld-issues relating to moving and handling, insufficient pre-admission information, and the inappropriate wedging open of fire doors. The issue relating to the care plan was partly upheld because although there was a care plan in place it was insufficiently comprehensive and did not fully identify the residents needs. With relation to the second formal complaint, the element relating to medication, with some residents being given” as prescribed” medication on a routine basis, has been upheld. The remaining elements of both complaints were either not upheld or inconclusive. The adult protection policy and procedure available in the home incorporates the Birmingham Multi-agency Guidelines for Adult Protection. The staff interviewed demonstrated a good understanding of abuse, and responded appropriately as to how they would act in any suspected case of abuse. Cole Valley Nursing Home E54 S24835 ColeValley V227792 280605 - Stage 4.doc Version 1.30 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,21, &26 The overall quality of the furnishings and fittings in the home is of good standard and provides residents with a comfortable home to live in. EVIDENCE: Cole Valley nursing home is purpose-built and provides accommodation on two floors with a passenger lift for access to the first-floor. Evidence was seen that the lift is regularly maintained. The home is fully accessible by wheelchair. There are three separate lounge areas and a dining room, however, the dining room does not provide sufficient space to accommodate all residents if they wished to use it at the same time. There are ample assisted bathing and toilet facilities in the home to meet the needs of the residents, some of which are within easy reach of the communal sitting and dining rooms. The areas of the home seen at this inspection were clean and odour control was good. It was noted however, that the carpet in the reception area required cleaning. Cole Valley Nursing Home E54 S24835 ColeValley V227792 280605 - Stage 4.doc Version 1.30 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 &30 The processes for the recruitment of staff were not robust potentially placing residents at risk. The shortfalls in the permanent staff complement and resulting need to use agency staff disrupts the consistency of care to residents. Not all staff were adequately trained to undertake all aspects of their work and this does not provide the required safeguards for residents. EVIDENCE: At the time of the inspection there were sufficient staff on duty to meet the needs of the current residents in the home. Four weeks of staff rotas were taken away and analysed, these demonstrated that on many occasions there are shortfalls in the required numbers. Evidence was seen that the shortfalls are covered by the employment of agency staff. Several residents and visitors commented that agency staff are often present in the home. Of the permanent staff complement, a high percentage are qualified to NVQ level 2 or equivalent and this is commended. A sample of staff files was examined, and evidence was seen that the PIN number of one of the trained members of staff had not been confirmed with the Nursing and Midwifery Council, and another file contained no proof of identity. There was evidence that a range of training courses are available for staff however, it was noted that some staff required updates in statutory training areas such as moving and handling. The training requirements for staff were discussed with the manager who informed the Inspector that individual needs had been identified. One member of staff was seen to use inappropriate moving and handling techniques with a resident, despite having undertaken recent update training. Cole Valley Nursing Home E54 S24835 ColeValley V227792 280605 - Stage 4.doc Version 1.30 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,35,&38 A robust system for the management of residents personal allowances is in place and their financial interests are safeguarded. The health, safety and welfare of residents are not always fully protected and they are potentially placed at risk. EVIDENCE: The acting manager is an experienced qualified nurse and manager and has worked in the care home environment for several years. She is currently undertaking the Care Managers Award, and must submit an application to the Commission for Social Care Inspection to be the registered manager for the home. A questionnaire is sent to a percentage of residents relatives each month in order to obtain feedback about the service that the home provides. This must be further developed to include an annual report about the findings. Currently, residents meetings are not held, however, the manager stated that she does a” walk around” the home twice a week to ensure that she speaks to all residents and hears their views. Cole Valley Nursing Home E54 S24835 ColeValley V227792 280605 - Stage 4.doc Version 1.30 Page 16 A sample of residents personal allowance records were examined and all balances were found to be correct. Receipts are retained although it was recommended that those from the hairdresser are more easily identifiable. The fire records were examined and all the regular checks and training are carried out and documented, however records for fire drills could not be produced for inspection. An up-to-date copy of the gas safety certificate was also not available for inspection. All other maintenance records were found to be up-to-date and current. The manager must ensure that all accidents and incidents that occur in the home that affect the health and well-being of residents are notified to the Commission for Social Care Inspection without delay. The bedroom doors of several residents were seen to be propped open and this poses a fire risk. The manager must make sure that this practice ceases or that an automatic door closure is fitted to the door that will close upon the fire alarm sounding. Cole Valley Nursing Home E54 S24835 ColeValley V227792 280605 - Stage 4.doc Version 1.30 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x 3 x x x x 3 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 x 2 x 3 x x 2 Cole Valley Nursing Home E54 S24835 ColeValley V227792 280605 - Stage 4.doc Version 1.30 Page 18 yes 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 OP3 OP4 Regulation 14(1)(b,d ) &(2) 12(1)(b) Requirement The acting manager must ensure a full assessment is carried out for all prospective service users. The manager must ensure that the home is able to meet all the needs of a prospective and a resident prior to admission. The acting manager must ensure that there is consistency with the recording of information in care plans. The acting manager must ensure that the identified resident who was seated in a bucket type chair is referred for an urgent seating assessment. The acting manager must ensure that all the information recorded in the residents daily records is complete and accurate. The acting manager must ensure that any corrections or alterations made to entries in the doctors visit request book are initialled. The use of Tippex must cease immediately. All nursing staff must receive training to develop their knowledge in the indications, adverse effects, cautions and drug interactions of medicines Timescale for action 18/7/05 18/7/05 3. OP7 15 18/7/05 4. OP7 15 19/7/05 5. OP7 12(1)(a) 19/7/05 6. OP8 12(1)(a) 18/7/05 7. OP9.4 OP9.9 13(2) 18/8/05 Cole Valley Nursing Home E54 S24835 ColeValley V227792 280605 - Stage 4.doc Version 1.30 Page 19 8. OP9.10 9. OP12 10. OP29 11. OP30 OP38 12. 13. OP30 OP30 14. OP31 15. OP33 16. OP38 prescribed and administered within the home. 13(2) Medication reviews must be sought on a regular basis for all service users in line with the National Service Framework for Older People 16(2)(n) The acting manager must ensure that a varied range of suitable activities are provided for all residents. 19 The acting manager must ensure Schedule that all new staff have the 2 appropriate checks as detailed in schedule 2 of the Care Homes Regulations 2001. 18(1)(a) The acting manager must ensure that the member of staff who was observed to be using inappropriate moving and handling techniques with residents , undertakes immediate appropriate update training. The manager must take steps to ensure that training undertaken by staff is used in day-to-day practice. 18(1)(c)(i The acting manager must ensure ) that all staff undertake regular updates in statutory training. 12(1) The acting manager must 18(1)(a,c) introduce a formal training (i) programme for all staff to TOPSS and NTO guidelines. (Outstanding since 25/11/05) 9(1) The acting manager must submit her application to the Commission for Social Care Inspection to be the registered manager of the home. 24(1)(a,b) The acting manager must further develop the existing quality assurance program in order to produce an annual report. 37 The acting manager must ensure that all accidents and incidents that occur that affect the health E54 S24835 ColeValley V227792 280605 - Stage 4.doc 18/8/05 18/9/05 18/7/05 19/7/05 18/8/05 18/10/05 10/8/05 18/10/05 19/7/05 Cole Valley Nursing Home Version 1.30 Page 20 17. OP38 12(1) 18. OP38 23(4)(a)( e) 19. 20. OP38 OP38 12(1)(a) 12(1)(a) 21. 22. OP38 12(1)(a) and well-being of residents are notified to the Commission for Social Care Inspection without delay. A copy of the current gas safety certificate must be forwarded to the Commission for Social Care Inspection. The acting manager must ensure that all fire drills that are carried out are documented and the documentation is available for inspection. The bucket chair identified as being unfit for purpose is to be removed from use immediately. The practice of wedging open residents bedroom doors must cease immediately. Where a resident wishes to have their bedroom door open, the door must be fitted with an appropriate automatic closure in the event of a fire. All new staff must receive fire awareness training within one day of employment. 25/7/05 18/7/05 18/7/05 18/7/05 18/8/05 18/7/05 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 It is recommended that when a resident has been assessed as requiring the use of a hoist for moving and handling purposes, the appropriate size sling is recorded on the care plan. Cole Valley Nursing Home E54 S24835 ColeValley V227792 280605 - Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Birmingham & Solihull Local Office 1st Floor, Ladywood House, 45-46 Stephenson Street Birmingham B2 4UZ 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 Cole Valley Nursing Home E54 S24835 ColeValley V227792 280605 - Stage 4.doc Version 1.30 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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