Inspection on 26/09/07 for Coombe Hill And Blenheim Lodge Nursing Home

This inspection was carried out on 26th September 2007.

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 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

Coombe Hill And Blenheim Lodge... 17/10/06

Coombe Hill And Blenheim Lodge... 31/01/06

Coombe Hill And Blenheim Lodge... 16/02/05

Coombe Hill And Blenheim Lodge... 07/09/04

Coombe Hill And Blenheim Lodge... 28/01/04

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The Infirmary

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

CARE HOMES FOR OLDER PEOPLE Coombe Hill And Blenheim Lodge Nursing Home 1-3 Adelaide Road Surbiton Surrey KT6 4TA Lead Inspector Jon Fry Key Unannounced Inspection 10:15a 26 September & 11th October 2007 th 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 Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.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. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Coombe Hill And Blenheim Lodge Nursing Home Address 1-3 Adelaide Road Surbiton Surrey KT6 4TA 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) 0208 399 3388 0208 399 8771 info@titleworth.com Titleworth Ltd Care Home 40 Category(ies) of Dementia - over 65 years of age (31), Learning registration, with number disability (9), Old age, not falling within any of places other category (31), Physical disability (9), Sensory impairment (40), Terminally ill (40) Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th October 2006 Brief Description of the Service: Coombe Hill and Blenheim Lodge Nursing Home is situated close to Surbiton town centre. There are good bus and train links to surrounding areas and central London. Coombe Hill provides residential and nursing care for up to 31 older people, some of whom may have dementia. The other part of the home known as Blenheim Lodge provides care for up to 9 people who have physical disabilities aged eighteen and upwards. The Registered Persons have produced a Statement of Purpose and User Guide, which includes information on the aims and objectives of the service. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We spent ten hours in the home over two separate visits. This visit mainly focussed on the care being provided for the older people living in the Coombe Hill part of the service. We used a formal way to observe people in this inspection called the ‘Short Observational Framework for Inspection’ (SOFI). This involved us observing 4 people who have dementia who use this service for 2 hours and recording their experiences at regular intervals. We looked at their state of well-being, and how they interacted with staff members, other people who use services, and the environment. We also spoke to twelve people who live at the home, two relatives or friends of individuals, the Director of Operations, the manager and five staff members. We looked at records and documents, including three people’s care plans and the home’s User Guide. A completed survey was received from one relative or friend of an individual. The home completed an Annual Quality Assurance Assessment (AQAA) to tell us about the service provided, how it makes sure of good outcomes for the people using it and any future developments being planned. What the service does well: People living at the home feel well cared for. Typical comments from people who use the service were positive and included “I’m taken care of”, “the care is very good”, “so far so good”, “not bad at all” and “if you’ve got to be somewhere, this is a good one”. We saw that staff generally responded well when individuals needed assistance and looked after peoples’ physical needs. Individuals enjoy the food they are served. Comments included “pretty good”, “very good” and “the lunches are particularly good”. Recruitment checks are carried out and the records of these are very well maintained. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.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. The summary of this inspection report can be made available in other formats on request. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.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 Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 4. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good information is available to prospective users of the service. Satisfactory assessments are completed before people move in but these could be improved to capture better quality information. EVIDENCE: We saw that a guide is available which tells people about the home and the service it offers. This is available in normal type and can be produced in large print on request. We have recommended that it be made available in other formats such as pictures and audiotape. Assessments are completed before someone moves into the home. One person said “they came to see me at the hospital” before they came to live there. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.R01.S.doc Version 5.2 Page 9 We looked at the assessments completed for three people. These contained basic information about the individual but mainly centred on health and physical needs. Only limited information had been obtained about the person’s life and their interests. We have recommended that the home look at the assessment format in use to capture better more person centred information about the person. Relatives, friends or advocates could be asked for information if the person is unable to volunteer this themselves. Once an assessment is completed then care staff need to sign and date it. This was not being done consistently which makes it difficult to know how up to date the information is, and when it needs to be reviewed. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are well meaning in what they do but the care provided needs to be more person centred and less task based. Action is being taken to make sure that care plans better address individual needs and look at the whole person. Arrangements for administering medication need improvement. EVIDENCE: The majority of people we spoke to said that staff treated them with dignity and respect. Comments included “on the whole they’re pretty good”, “the care is very helpful” and “the staff work very hard”. One person felt that the quality of care “varies from person to person” referring to the staff and another said “sometimes they hurry me”. We thought that staff were well meaning in their practice but were too focussed on tasks and missed opportunities to spend time with people. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.R01.S.doc Version 5.2 Page 11 A good example was where one staff member was putting out cutlery and other items in preparation for lunch when it was actually served thirty minutes later. We thought that this time could have been better used just to sit and talk with people. One person kept calling out “nurse” as they wanted to know when they were going home. This calling went on for about 10 minutes with some staff walking by but not acknowledging the persons request. A staff member then spent a long time sitting with and talking to them about their past and how this was now their home. We thought that this was good practice and the person stopped calling out for a long period. When they did start to ask again when they were going home, a different staff member responded very quickly but said “you go home at 8 o’clock”. This does not show a person centred approach or appreciation about how the individual may feel. We saw one instance where the dignity of a person living there was not upheld. This person was allowed to go into the communal lounge wearing clothing that was inappropriate and looking dishevelled. This was addressed by the home at the time of our visit. Staff must also make sure they knock on people’s doors before entering as we saw two instances where staff just walked in on individuals. Procedures for the administration of medication need improving. We found four instances where medication had not been given to people as prescribed. Other issues found included one persons prescribed medication being used for another individual and records kept not being detailed enough to allow proper auditing. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The range of activities on offer for older people could be improved. Good support is already available for younger adults living in the Blenheim Lodge part of the home. Improvements need to be made to make sure that mealtimes are a positive occasion for everybody involved. EVIDENCE: One person living there said to us that “something is missing” and that “they need to make it more interesting” and “more individual”. Another individual said “I read a lot” as there is “not enough to do”. Other people said “they could talk more”, “they have activities twice a week” and “there are occasional trips and entertainment”. Younger adults living in the Blenheim Lodge part of the home were positive about the support provided. Their comments included “we have activity evenings” and “support workers are on in the afternoons”. Other comments included “we don’t get a lot of outings” and “would like more theatre trips”. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.R01.S.doc Version 5.2 Page 13 Activities take place twice weekly in the Coombe Hill part of the service and entertainers also visit approximately every two months. A farm came to the home recently and people living there also went on a boat trip. The service is planning to buy a suitable vehicle and said in their AQAA that this will allow them to plan more outside activities. The activities programme is currently being reviewed. We saw that some good work around activities and occupation is being done by the home’s Occupational Therapist. This work needs to be fully supported and this person’s role should be reviewed as they also have other important responsibilities. We have recommended that the home look at how care staff could be more actively involved in the provision of activities. This may involve reviewing individual roles, shift patterns and established routines but this may be crucial in developing care that is person centred rather than task based. It is recommended that life story books be developed with people living there and these could then be shared with others in the home. This may also help staff to relate to people as individuals and encourage more interaction. Most people spoken with said that they enjoyed the food offered with comments including “pretty good”, “not bad”, “very good” and “the lunches are particularly good”. One person said that the “the main meal is good” and another individual said “better than hospital food”. People spoken to said they were given a choice of meals and could eat in their rooms if they wanted to. A number of people we spoke to did not know what was being served for lunch on the first day we visited. The manager said that she was already working on developing more user-friendly picture menus. We looked at lunch being served and think that the service needs to look at how mealtimes can be made a more positive social occasion for everybody involved. Individuals were supported to eat lunch by care staff and this was done in an unhurried manner but it was too task orientated with the main aim being to make sure that people ate and drank properly. Some people were helped with their meal with little or no interaction and were passive and silent throughout the meal. One person received help from four different staff during the course of their meal. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are protected from abuse. Concerns about the care provided are listened to and acted on. EVIDENCE: Comments from people who live at the home included “I see the manager if I have any complaints”,“ no complaints” and “so far so good”. Individuals spoken to said they felt able to speak to staff or managers about any issues they may have. There have been no recorded complaints since the October 2006 inspection. The complaints policy and procedure is displayed in the home and is part of the guide for the people living there. The home should look at making sure that the complaints procedure is available in different formats as appropriate. The organisation is reviewing its training programme and Safeguarding Adults will be part of the mandatory training provided to all staff working at the home. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.R01.S.doc Version 5.2 Page 15 There have been two Safeguarding issues since the last inspection. We saw that the home had worked positively with the Local Authority to investigate these and make sure that people using the service are kept safe. The home keeps a compliments file. Letters received in 2007 included comments such as ‘your home is a caring one’ and ‘we have appreciated all the care and kindness you have shown’. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 24 and 26. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home enjoy a clean, comfortable and safe living environment. There is currently extensive re-decoration work going on at the home that makes it difficult to properly assess these Standards. EVIDENCE: People spoken to were generally happy with the environment. Comments from individuals included “we are very lucky”, “attractive decor” and “ok”. Re-decoration work was ongoing at the time of this inspection. Areas of the home are being painted and improved. Scheduled improvements include new flooring and furniture in the main lounge / dining room and a more accessible garden. The manager said that the layout of the lounge and dining area was Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.R01.S.doc Version 5.2 Page 17 also being looked at. The current arrangement of chairs around the edge of the room is not homely. The home needs to make sure that all toilets and bathrooms have locks fitted. One toilet on the ground floor had no lock at the time of our inspection. Areas of the home are also being developed to be even more friendly and interactive for the people living there. Good ideas such as pictures on doors to help people know where they are going should continue to be put into practice. The home was clean and hygienic on both days we visited. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are protected well by the recruitment procedures. The staff training and development programme needs improvement. EVIDENCE: Feedback about the way the staff carried out their duties was generally positive. Comments included “nice bunch of carers”, “reliable”, “polite”, “they work very hard” and “they never overlook anything”. Relatives or friends of individuals said “staff work hard” but they “don’t have the training” and “all the staff very pleasant and helpful”. As stated previously, there is scope to look at the role of carers and make sure that social and emotional care is seen as an important part of their job. We have recommended that the home looks at individual roles, shift patterns and established routines to help support person centred care. It is recommended that staff teams also look at the routines in place to see if there are areas where they could move away from task based care to a more person led approach. Changes in culture may require further training and support ‘out on the floor’ from the organisation and making sure that there are people role modelling good practice for others to follow. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.R01.S.doc Version 5.2 Page 19 We saw that staff generally responded well when individuals needed assistance and looked after peoples’ physical needs. Whilst the staff were all well meaning, two individuals were much more person centred than others in the way they worked. They spent time with people chatting and explaining things when people were confused or needing reassurance. When we spoke to staff, only one of them could tell us about person centred care and how it was important for people with dementia. We think that all care staff working in the home need to have full training in dementia care and how to be person centred. This is being planned by the organisation. As stated previously, the home is making improvements to its training programme to make sure that staff have the training they need to do their jobs. This will cover induction, mandatory training such as manual handling and then specialist training in variety of subjects. We saw that the necessary recruitment checks are carried out by the home for new staff and good records are kept of these. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. New management arrangements are in place and this should now benefit the people living there. There are satisfactory arrangements to make sure that the health and welfare of people using the service is protected. EVIDENCE: The home has a new Director of Operations and Manager. Both have lots of experience and clearly have good ideas about developing the service. We could see that improvements are already being made under their leadership. The manager stated that she is applying to be registered with the CSCI. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.R01.S.doc Version 5.2 Page 21 The Quality Assurance system is being reviewed. Much of the process for getting feedback from people living there and their representatives is informal and the managers have an ‘open door’ policy. A meeting is held with people living in the Blenheim Lodge part of the home every month and this includes a few older people from Coombe Hill. The manager said that they were planning a monthly meeting with everybody living in the service and also regular meetings with relatives and friends. Health and Safety checks take place to make sure people are kept safe and generally good records are kept of these. It is strongly recommended that the hot water temperatures of baths and showers be recorded each week rather than on a monthly basis. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.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 3 3 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 2 X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X 3 Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.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 Medication must be administered as prescribed with full records kept. This is to ensure the health and welfare of people living at the home. In order to make sure that the dignity of people is maintained, care staff must provide care and support individuals in a manner suitable to their age and experience. This includes appropriate care and support to wash and dress which upholds the individual’s personhood. In order to preserve the dignity and privacy of people living at the home, all toilets and bathrooms must have locks on the door. Staff must knock before they enter people’s rooms. 4. OP31 8 (1) (a) & CSA 2000 The Manager must make application to be registered with the CSCI. 01/12/07 Timescale for action 01/11/07 2. OP10 12 (4) (a) 01/11/07 3. OP10 OP21 12 (4) (a) 01/11/07 Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.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 OP1 OP3 Good Practice Recommendations The user guide to the home should be made available in a variety of formats such as audiotape or pictures. The assessment format should be reviewed to make sure that good quality person centred information is captured. This can then be used to inform the care plan from when the individual moves in. Relatives, friends or advocates could be asked to contribute information if the person cannot give this himself or herself. Care staff need to sign and date assessments consistently. 3. OP7 The home should look at ways to make the care plans more person centred and better reflect the individual’s life and preferences. The plan in place should direct the care to be person orientated and less task based. Care plans need to give specific information about how the person likes the care and support to be delivered. Better background information about the person and their life should be recorded. Life story books should be developed with the individual and their family or friends. These books should be used to help communication and engagement. Staff need to look at the routines in place and how they can be more flexible in their practice. Time spent with people and increasing wellbeing should be priorities of the service. The work of the Occupational Therapist needs to be fully supported by the service. A new programme of activities needs to be drawn up for Coombe Hill and care staff encouraged to be actively involved with this provision. More use of rummage boxes, sensory items and soft toys / dolls should be considered. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.R01.S.doc Version 5.2 Page 25 4. 5. OP7 OP12 6. OP12 7. 8. OP12 OP14 9. OP14 Staff providing activities should have training in this area. It is strongly recommended that the home have its own minibus or similar vehicle available. Care staff should look at how people could be more involved in the daily life of the home. This could be helping with preparation of meals, serving food and drink, helping with laundry or cleaning. Pictures, photographs and memory boxes should be used to make the environment more user friendly. Painting door surrounds in different colours should be considered to help identify different areas. Mealtimes need to be reviewed to make sure they are a positive occasion for all concerned. Practices such as protected mealtimes, staff eating with people who live there and varying times / numbers of mealtimes should be considered. Picture menus should be displayed to help people know what is being served that day. Individuals should receive support with eating from one member of staff who stays with them throughout the meal. 10. OP15 11. 12. OP19 OP33 The layout of the lounge should be looked at to make it more homely. It is recommended that the home look at developing systems for consultation with people living at the home. These may include regular meetings, a user committee or representation at management meetings. Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Coombe Hill And Blenheim Lodge Nursing Home DS0000026251.V343075.R01.S.doc Version 5.2 Page 27 - 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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