CARE HOMES FOR OLDER PEOPLE
Country View Nursing Home Warkton Kettering Northants NN169XQ Lead Inspector
Stephanie Vaughan Unannounced Inspection 16th January 2006 10:00 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 Country View Nursing Home DS0000012609.V277793.R01.S.doc Version 5.1 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. Country View Nursing Home DS0000012609.V277793.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Country View Nursing Home Address Warkton Kettering Northants NN169XQ 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) (01536) 484692 (01536) 518376 brian_webb@btconnect.com Country View (Warkton) Limited Mrs Margaret Jean Webb Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29), Physical disability (4) of places Country View Nursing Home DS0000012609.V277793.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. No one falling within the category of OP may be admitted to the home where there are 29 persons of category OP already accommodated within the home. No one falling within category PD may be admitted into the home where there are 4 persons of category PD already accommodated within the home The total number of service users accommodated in the home must not exceed 29. 10th October 2005 Date of last inspection Brief Description of the Service: Country View Nursing Home is owned privately and managed by the owners. The nursing home is a large converted country house, with a large ground floor extension. It comprises double and single rooms with day spaces. The home has a large garden which is maintained to a high standard, and is accessible to service users. The home also has views over open countryside. Country View Nursing Home DS0000012609.V277793.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission of Social Care Inspection is upon the outcomes for residents and their views of the service provided. The methodology of case tracking is used to find out if the care being provided to the residents is of an acceptable standard and meets their individual needs. ‘Case tracking’ involves the review of resident’s records, meeting with them and talking with the care staff that provides the personal care to the selected residents. The inspection also includes a review of the homes’ procedures and processes to ensure that all practices carried out by the staff protect the residents. A monitoring visit was conducted on the 2nd of November 2005 to monitor compliance with the five immediate requirements issued at the inspection dated 10th October 2005. Four of these had been met and one pertaining to the management of risk associated with residents who do not wish or are unable to use wheel chair footplates continues to remain outstanding. This inspection was the second statutory inspection and carried out on an unannounced basis, over a period of four hours. One hour was spent in preparation for this inspection, which comprised a review of previous inspection reports with associated requirements and recommendations, a review of the service history and five comment cards from residents or their representatives, all of these contained positive responses. The Commission for Social Care Inspection have received no new complaints since the last inspection. What the service does well:
Residents spoken to stated that the care provided at the home was very good, and all appeared well groomed and appropriately dressed. Interaction between staff and residents was observed and seen to be friendly and relaxed. The home has recently had an audit of medication systems conducted by a community pharmacist. Evidence was presented to demonstrate that the systems were found to be in order. One recommendation had been made pertaining to the replacement of the fridge thermometer and this had been obtained. Country View Nursing Home DS0000012609.V277793.R01.S.doc Version 5.1 Page 6 Residents confirmed satisfaction with the meals provided by the home, stating that the food was excellent and that you could have as much as you liked and there were always alternatives available if you did not like what was available on the day. What has improved since the last inspection?
The home have now introduced a consent form which is to be used to establish and evidence whether a resident consents to share a double room, which is in the process of being implemented. Residents now have adequate records to demonstrate appropriate management Percutaneous Endoscopic Gastrostomy Feeding and associated fluid balance charts. In addition there was evidence that residents have greater access to specialist nurses, with the involvement of the continence nurse in their assessment.and residents consent for the use of bedrails is now sought and documented. Existing residents have been surveyed regarding their wishes to have privacy locks and lockable facilities installed within their private accommodation. However all residents have declined this facility Mealtimes are now better managed with individual assistance being provided to residents who require support. Improvements have been made to the individual plans of care, in that there was is evidence that residents preferences regarding routines are now being recorded, with reference to preferred times of rising and retiring to bed. The management have introduced a regular newsletter for residents and their representatives, which inform residents on a range of issues and also ask for feed back about the services provided. One example included a request for residents’ views about the festive arrangements that the home had made for the Christmas period. A limited tour of the premises was conducted and inspectors noted that vacant rooms were currently being redecorated and refurbished, consistent with the homes refurbishment and redecoration programme Rooms now contain new commodes that are fitted with appropriate covers and the trip hazard previously identified in room 7 had been made safe. Rooms viewed evidenced individual personalisation including small items of furniture. The review of the function of sash windows is due for completion in the near future; and the sash windows have been repaired and made safe. A senior
Country View Nursing Home DS0000012609.V277793.R01.S.doc Version 5.1 Page 7 staff member confirmed that the water temperature gauge on the additional Jacuzzi adaptation for one bath had now been repaired Trailing wires that had been identified at the previous inspection have now been secured. One resident who is wheelchair dependant, and needs a hoist for all transfers has now been moved to a more appropriate room, in which her needs may be more successfully met. Systems within the home have been improved to ensure that residents and their representatives are informed about the outcome of fund raising activities and in addition collections for staff gifts are no longer conducted. What they could do better:
Although the home has an admission process that includes the completion of an assessment form this format limits the amount of fundamental information that is sought and recorded prior to any admission. In the absence of this essential information there is no assurance that the potential resident’s individual care needs can be met Further work is needed to ensure that the Individual plans of care consistently provide staff with adequate detailed information about the health, personal and social care that is required for residents. Individual plans of care are reviewed on a regular monthly basis, however there was little evidence that residents or their representatives are involved in either the development or review of the individual plans of care. Individual plans of care indicated that some improvements have been made to establish individual past lifestyles and interests, however having obtained this information there is no evidence that these specific interests are catered for. The layout of the main sitting room and the number of residents using the room could have potential implications for the safety of residents in the event of fire. Currently the home does not have a risk assessment in place to address this potential hazard. Discussion with management confirmed that residents’ access to the garden area is limited. The Registered Manager confirmed that she considered it unsafe to allow residents access to the garden without staff supervision. However there was no evidence that this judgement had been based upon individual, formal documented risk assessments, to demonstrate that residents’ freedom of movement is not unnecessarily inhibited. Country View Nursing Home DS0000012609.V277793.R01.S.doc Version 5.1 Page 8 A number of radiators were noted to have unprotected high surface temperatures; the home has a general risk assessment in place to address the collective issues. However this must reviewed to ensure that the risks to individual residents are assessed and be included in the individual plan of care. Further improvements must be made to the record keeping within the home to ensure that records are accurate, signed and dated, consistent and clear to avoid confusion, which has the potential to cause harm to 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. Country View Nursing Home DS0000012609.V277793.R01.S.doc Version 5.1 Page 9 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 Country View Nursing Home DS0000012609.V277793.R01.S.doc Version 5.1 Page 10 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, Standard 6 does not apply to this home There is no assurance that the potential resident’s individual care needs can be met. EVIDENCE: Case tracking of two of the most recently admitted residents identified that the home continues to use a dependency assessment tool. This has a tick box format and is used to assess residents prior to their admission as to whether the home is able to meet their needs. The format captures minimal information about the residents’ health needs and fails to take into account issues such as the location and type of the room to be offered, individual personal needs and preferences. The format also fails to identify whether the resident would get on with the existing residents and was neither signed nor dated. One of the care plans evidenced that the home have now introduced a consent from which is to be used to establish and record whether a resident consents to share a double room and is currently being implemented.
Country View Nursing Home DS0000012609.V277793.R01.S.doc Version 5.1 Page 11 Country View Nursing Home DS0000012609.V277793.R01.S.doc Version 5.1 Page 12 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 Individual plans of care continue to have some shortfalls and have the potential to place residents at risk. Medication systems are sound. EVIDENCE: Residents now have adequate records to demonstrate appropriate management of fluid balance charts and Percutaneous Endoscopic Gastrostomy Feeding. In addition there was evidence that residents have greater access to specialist nurses, with the involvement of the continence nurse in the assessment of residents. Residents consent for the use of bedrails is now sought and documented Some work has been undertaken to improve the content of Individual plans of care, however this work needs to continue to ensure that staff are provided with adequate detailed information about the health, personal and social care that is required for individual residents. For example: • Absence of a care plan for a resident’s personal and oral hygiene.
Country View Nursing Home DS0000012609.V277793.R01.S.doc Version 5.1 Page 13 • • No assessment for the risk of pressure for two residents, even though one resident was underweight and had been recorded as having had areas of broken skin. Inadequate information regarding the management of a supra pubic catheter e.g. the type, size and frequency of change and associated cleansing routines and dressings Individual plans of care are reviewed on a regular monthly basis, however there was little evidence that residents or their representatives are involved in either the development or review of these plans. There was no evidence that advice was sought from relevant health professionals when problems were identified for example: - nutritional risk. The home has recently had an audit of medication systems conducted by a community pharmacist. Evidence was presented to demonstrate that the systems were found to be in order. One recommendation had been made pertaining to the replacement of the fridge thermometer and this had been obtained Privacy and dignity is generally managed well. The management confirmed that the existing residents have been surveyed to offer privacy locks and lockable storage facilities, however all residents have declined and this facility is included as being available within the Service Users Guide. Country View Nursing Home DS0000012609.V277793.R01.S.doc Version 5.1 Page 14 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 The available activities do not always meet the assessed needs of individuals. The layout of the main lounge continues to compromise the privacy and dignity of residents. EVIDENCE: Individual plans of care indicated that some improvements have been made to establish individual past lifestyles and interests, however having obtained this information there is little evidence that these specific interests are catered for. For example one resident was seen to have had a very varied and stimulating lifestyle recorded and was only listed as requiring to be pushed in his wheel chair into the garden. In most cases the activities that are provided are recorded within the daily records. However a more detailed account of the activities provided for the youngest and more dependent resident are currently recorded within a separate record This provides evidence that the home are meeting the specific needs of this resident. The privacy of residents is compromised by the close proximity to one another in the main lounge and their ability to enjoy television programmes may be affected by four televisions being used in the same room.
Country View Nursing Home DS0000012609.V277793.R01.S.doc Version 5.1 Page 15 Residents confirmed satisfaction with the meals provided by the home, stating that the food was excellent and that you could have as much as you liked and there were always alternatives available if you did not like what was available on the day. Lunchtime service was observed and residents who required assistance with eating were appropriately and sensitively supported. The management have introduced a regular newsletter for residents and their representatives, which inform residents on a range of issues and also ask for feed back about the services provided. One example included a request for residents’ views about the festive arrangements that the home had made for the Christmas period. A limited tour of the premises was conducted, residents’ rooms indicated that residents are able to personalise their private accommodation with their own possessions and small items of furniture. Country View Nursing Home DS0000012609.V277793.R01.S.doc Version 5.1 Page 16 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 The home has an appropriate complaints policy, which is accessible to residents within the Service Users Guide. Residents are protected from abuse, however residents’ rights are not always protected. EVIDENCE: The Commission have received no new complaints about the home since the last inspection. Discussion with management confirmed that residents’ access to the garden area is limited. The Registered Manager confirmed that she considered it unsafe to allow residents access to the garden without staff supervision. However there was no evidence that this judgement had been based upon individual, formal documented risk assessments, to demonstrate that residents’ freedom of movement is not unnecessarily inhibited. The Registered Persons confirmed that they continue to liaise with appropriate Authorities regarding specific issues relating to the Protection Of Vulnerable Adults. They ensure that the recommended actions are carried out on a continuous basis and that appropriate records are maintained. Country View Nursing Home DS0000012609.V277793.R01.S.doc Version 5.1 Page 17 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 The standard of the environment has been improved and is comfortable, clean and hygienic. The safety of residents is not always protected. . EVIDENCE: A limited tour of the premises was conducted and inspectors noted that vacant rooms were currently being redecorated and refurbished, consistent with the homes refurbishment and redecoration programme. Rooms now contain new commodes that are fitted with a appropriate covers and the trip hazard previously identified in room 7 had been made safe The review of the function of sash windows is due for completion in the near future; and the sash windows have been repaired and made safe. A senior staff member confirmed that the water temperature gauge on the additional Jacuzzi adaptation for one bath had now been repaired.
Country View Nursing Home DS0000012609.V277793.R01.S.doc Version 5.1 Page 18 Rooms viewed evidenced individual personalisation including small items of furniture. One resident who is wheelchair dependant, and needs a hoist for all transfers has now been moved to a more appropriate room, in which her needs may be more successfully met. Country View Nursing Home DS0000012609.V277793.R01.S.doc Version 5.1 Page 19 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): 29 & 30 Staff recruitment and training are managed well to ensure that residents are protected and appropriately cared for. EVIDENCE: A selection of staff files were viewed and seen to contain evidence of a thorough recruitment procedure, staff supervision and training. Staff files indicated that staff have access to appropriate mandatory training and training specific to some of the needs of the existing residents. However there was no evidence that staff had had the training previously recommended in relation to communication skills, sensory impairment and care of the elderly Country View Nursing Home DS0000012609.V277793.R01.S.doc Version 5.1 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): 34, 35, 37 & 38 Financial procedures are in place to protect residents. Record keeping within the home does not always promote residents rights and best interests. Health and Safety issues are not always addressed within the home EVIDENCE: Following a requirement made at the last inspection the management have reviewed their policies and procedures to protect residents when financial transactions take place. Record keeping within the home continues to be inconsistent which has the potential to cause confusion and associated harm to residents. Examples include the following: • • • Forms that are completed are not consistently signed and or dated. On occasion incorrect dates have been entered e.g. 01/11/06. The blank Waterlow assessment documents appeared to have been photocopied from a form that had been previously used. Although some
DS0000012609.V277793.R01.S.doc Version 5.1 Page 21 Country View Nursing Home of the previous markings had been erased some of the original scores were still visible and had the potential to cause confusion and incorrect scoring. This same format appeared to have been consistently used since at least 2003. Safe working practices were observed in most cases however the following shortfalls were identified: • Two residents were noted to be using wheelchairs without footplates. On enquiry inspectors were informed that these residents did not have the use of footplates due to medical reasons. However this was not evident from the individual plan of care and no risk assessments were in place to evidence that the risks involved in this practice were being reduced or managed. One resident required the use of oxygen however there was no appropriate signage in place to warn of the associated hazards and in addition there was no reference to the risks associated with the use of oxygen included in the care plan for oxygen therapy. Individual plans of care identify whether a resident requires the use of bedrails, in all cases the assessment states that protectors were not required. Advice was given regarding research based practice concerning the use if these restraints. A number of radiators were noted to have unprotected high surface temperatures; the home has a general risk assessment in place to address the collective issues. However this must reviewed to ensure that the risks to the individual residents are assessed and be included in the individual plan. The layout and the number of residents using the main sitting room could have potential implications for the safety of residents in the event of fire. Currently the home does not have a risk assessment in place to address this potential hazard. • • • • Trailing wires that had been identified at the previous inspection have now been secured. Country View Nursing Home DS0000012609.V277793.R01.S.doc Version 5.1 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 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 2 18 3 3 2 3 3 3 3 2 3 STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X 3 3 3 2 2 Country View Nursing Home DS0000012609.V277793.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation Reg 14 Requirement The pre-admission assessment must be further developed to ensure that all relevant information is sought prior to any new admission. Requirement unmet, timescale extended to 01/03/06 The care plan must contain sufficient instruction and guidance for all staff to aid the provision of care. Requirement unmet, timescale extended to 01/03/06 Individual plans of care must evidence that they are developed and reviewed with the resident or their representative Resident’s freedom of movement must not be restricted unless this is in their best interests and is supported by a detailed risk assessment The Registered Persons must conduct a detailed risk assessment regarding the risks associated with the number of residents and associated
DS0000012609.V277793.R01.S.doc Timescale for action 30/12/05 2. OP7 Reg 15 30/12/05 3 OP7 Reg15 01/03/06 4 OP17 Reg13 01/03/06 5 OP20OP38 Reg23 01/03/06 Country View Nursing Home Version 5.1 Page 24 6 OP20OP38 Reg 23 7 OP25OP38 Reg 13 8 OP37 Reg 17 9. OP38 Reg 13 10 11 OP38 OP38 Reg 13 Reg 13 furniture within the main lounge The Registered Persons must seek guidance from the fire officer regarding the layout of the main sitting room and submit the response to the Commission for Social Care Inspection Residents who have radiators with unprotected high surface temperatures in their rooms must have individual risk assessments conducted to reduce and manage the risk, included within their individual plans of care The standard of record keeping must be reviewed and action taken to ensure that records are maintained, up to date, accurate and compliant with the data Protection Act All wheelchairs must have the footplates in place, unless individual specific requirements are evidenced in a detailed risk assessment and retained in the individual’s plan of care. Requirement unmet, 11/10/05 & 12/10/05 Timescale extended to 01/02/06 Appropriate signage must be provided where oxygen is in use to warn of the hazards Residents, who require the use of bedrails must have appropriate risk assessments, based on current guidance, conducted and associated equipment provided to prevent the risk of injury and entrapment. 01/03/06 01/03/06 01/03/06 11/10/05 01/02/06 01/02/06 Country View Nursing Home DS0000012609.V277793.R01.S.doc Version 5.1 Page 25 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 OP12OP13 OP13 Good Practice Recommendations Individualised activities that reflect the resident’s interests and lifestyle should be planned, provided and recorded within the individual plan of care. The registered persons should be actively consulting and involving the residents in the development of any activities programme to ensure that individual expectations, preferences and choices have been identified and considered. Staff files should evidence that povafirst checks have been obtained The residents should be encouraged to access the gardens freely 3 4. OP1818 OP20 Country View Nursing Home DS0000012609.V277793.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Country View Nursing Home DS0000012609.V277793.R01.S.doc Version 5.1 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
