Inspection on 20/04/05 for Cravenside

This inspection was carried out on 20th April 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 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

Cravenside 04/06/08

Cravenside 11/07/07

Cravenside 02/05/06

Cravenside 22/09/05

Cravenside 07/10/04

Cravenside 05/04/04

Cravenside 09/09/03

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

CARE HOMES FOR OLDER PEOPLE Cravenside Lower North Avenue Barnoldswick Lancs BB18 6DP Lead Inspector Keren Nicholls Unannounced 20 April 2005 9.55 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. Cravenside F57 F07 S35008 Cravenside V223155 200405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Cravenside Address Lower North Avenue Barnoldswick Lancs BB18 6DP 01282 816790 01282 853620 karen.mason@careservices.lancscc.gov.uk Lancashire County Care Services 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) Care Home 44 7 15 20 3 6 Category(ies) of Physical Disability PD registration, with number Dementia DE(E) of places Old Age OP Mental Disorder MD(E) Physical Disability PD(E) Cravenside F57 F07 S35008 Cravenside V223155 200405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service should at all times employ a suitably qualified manager who is registered with the Commission for Social Care Inspection 2. Within the overall total of 44, a maximum of 20 service users requiring personal care who fall into the category of OP (either sex) 3. Within the overall total of 44, a maximum of 15 service users requiring personal care who fall into the category of DE(E) (either sex) 4. Within the overall total of 44, a maximum of 3 (named) service users requiring personal care who fall into the category of MD(E) (female) 5. Within the overall total of 44, a maximum of 6 service users requiring personal care who fall into the category of PD(E) for intermediate care only (either sex) 6. Within the overall total of 44, a maximum of 6 service users requiring personal care who fall into the category of PD for intermediate care only (either sex) 7. Within the overall total of 44, a maximum of 1 (one) named service user requiring personal care in the category of PD (male) Date of last inspection 7th October 2004 Cravenside F57 F07 S35008 Cravenside V223155 200405 Stage 4.doc Version 1.30 Page 5 Brief Description of the Service: Cravendside is a home providing 24-hour accommodation and care to residents identified in the categories above. The home is owned and managed by Lancashire County Care Services, which is a Lancashire County Council direct services organisation. The home is located near to Barnoldswick town centre, and has footpath access to the town centre shops and other amenities. The home looks out onto a green and has an enclosed protected garden at the front and sitting areas and car park by the front entrance. The home is purpose-built and comprises two ground floor and three first floor residential units (accommodating between 6 to 8 service users per unit) and a first floor day care lounge. There is a passenger lift. Two of the ground floor Units provide dedicated space for older service users who also have dementia. These Units have free access to the protected garden. In an adjoining, but separate ground floor unit, Cravenside provides residential care for up to 6 older people, or younger adults who need help with rehabilitation (intermediate care). The home also offers day care in a separate lounge/activity centre. Each Unit has single bedrooms, a bathroom, toilets and a communal lounge/dining area with integral kitchen. The day care space may be used by all residents and comprises a large activites/dining room and hairdressing salon. The home has separate smoking rooms on the ground and first floors. A small room with a pay telephone is located on the ground floor. The home provides limited car and mini-bus transport (booked in advance). Cravenside F57 F07 S35008 Cravenside V223155 200405 Stage 4.doc Version 1.30 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place between 9:55am and 5:25pm (7.20 hours). This was a statutory unannounced inspection. A partial tour of the premises took place of communal rooms (living/dining areas, bathrooms and toilets) and the laundry and kitchen. The intermediate care (rehabilitation unit) was not inspected. Six staff (covering 5 Units), the acting manager, a ‘bank’ manager and fourteen service users were spoken to. Care was observed for some service users who had dementia, but were unable to verbally express their views. What the service does well: What has improved since the last inspection? Sixteen staff had attended a course about caring for people with dementia, which has helped them to understand the special needs of people who have dementia. The care staff and the domestic staff have continued to work hard to achieve NVQ level 2 and level 3 qualifications in care. Care staff hours have been increased since the last inspection. This has meant that at least one member of staff is available on every Unit to ensure the safety and comfort of service users. Cravenside F57 F07 S35008 Cravenside V223155 200405 Stage 4.doc Version 1.30 Page 7 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. Cravenside F57 F07 S35008 Cravenside V223155 200405 Stage 4.doc Version 1.30 Page 8 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 Cravenside F57 F07 S35008 Cravenside V223155 200405 Stage 4.doc Version 1.30 Page 9 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) 1, 3 , 4 and 5. Service users and their representatives were consulted about service user’s needs and wishes prior to admission. Trained people had assessed these needs, to ensure that they could be met by the home. Service users had been given appropriate information about the home, which had enabled them to make an informed decision about whether Cravenside was the right place for them to live. EVIDENCE: Service user’s files showed that pre-admission assessments had been conducted by social workers and these had been discussed with the manager of the home. Service user’s care plans had needs assessments, which had been carried out by the person’s keyworker and had been checked by the manager. Services users spoken with said that the home and the staff met their needs for accommodation, health, social and personal care. There was a file by the front door, with information about the home. A Service User’s Guide (giving information about living at the home and about the complaints procedure) was on the notice boards of each Unit. The Guide was written in large print so that older service users found it easy to read. Service users said that they knew what the home had to offer and several people had Cravenside F57 F07 S35008 Cravenside V223155 200405 Stage 4.doc Version 1.30 Page 10 visited the home prior to their admission. A service user explained that her relative had visited several homes on her behalf prior to her admission and she was satisfied that she had had sufficient information to make a choice about living at Cravenside. The manager explained that she was in the process of putting together an information pack to give to service users at admission time. The manager was advised that she must ensure that she confirms in writing to the service user that the home can meet the needs of service users (see Regulation 14 (d)). Cravenside F57 F07 S35008 Cravenside V223155 200405 Stage 4.doc Version 1.30 Page 11 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 and 9 In general the health, personal and social needs of service users were met. Good progress had been made in ensuring that current best practice was used to meet the needs of service users who also had dementia. However, care plan and diary recording needed to improve. Shortfalls were identified in medication practices, which had the potential to place service users at risk. EVIDENCE: Individual plans of care were available and keyworker staff had reviewed these regularly. A separate section identified the daily care of service users, which took into account needs, wishes and desires. However, goals and aims were generalised. These need to be more specific regarding how outcomes for service users are to be met, and who is responsible. The daily diary care records should reflect the care that has been given, as identified in the agreed care plan. The benefit of keeping all the records together was discussed with the manager. Because records for each service user were kept in three different places, there was a lack of continuity of recording, with the potential for confusion and lack of continuity of care for service users. This was reflected in contradictory care plan and diary records. Since the last inspection, service user’s weight had been monitored more closely, although staff said that the scales often broke down. Weight had not Cravenside F57 F07 S35008 Cravenside V223155 200405 Stage 4.doc Version 1.30 Page 12 been monitored in the last month for people with dementia. It was recommended that the or – weight change should be clearly recorded in the comments section of the plan. Poor practice was observed in respect of medicines recording and administration. Medicines were left unattended when administering to service users on a different unit. Staff recorded medicines as being refused by service users, when they had not been offered; as necessary (PRN) and other medicines were not offered or administered as per the prescriber’s details; medicines had not been detailed as discontinued. Recommendations were made in respect of medicines keeping, administration and recording. Advice from the specialist pharmacy inspector was given to the manager in respect of one service user and ‘covert’ administration. Cravenside F57 F07 S35008 Cravenside V223155 200405 Stage 4.doc Version 1.30 Page 13 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, and 15 Social activities within and outside the home were individually appropriate for the people who lived at Cravenside and provided daily variety and interest. Staff positively enabled residents’ contact with family and the local community. Meals were of good nutritious quality and offered choice and variety, although food intakes for people with dementia were not monitored sufficiently carefully to ensure maintenance of the service user’s health and well-being. EVIDENCE: Several service users said that they appreciated the social activities on offer at the home. A ‘pie and peas’ activity evening had been arranged for the evening of the inspection. One member of staff took responsibility for organising activities in the home and trips out. Records of service user’s meetings showed that resident’s requests were honoured and trips to Blackpool, a local pantomime and to a butterfly farm had been organised. Service users commented that they very much enjoyed attending the day care activities. There was a full programme of activities on offer every day to suit different tastes and abilities. Several service users said that they particularly enjoyed singing, quizzes and the ‘keep-fit’ classes. In addition, staff working on the dementia care units had arranged activities, such as a coffee afternoon, videos, baking and making fruit salads for people who did not usually attend day care activities. Details of activities were displayed on the notice boards in each Unit. Cravenside F57 F07 S35008 Cravenside V223155 200405 Stage 4.doc Version 1.30 Page 14 Service users said that they were able to receive visitors in the privacy of their own room and chose whom they do and do not wish to see. There were many visitors throughout the inspection day and the record of visitors showed this was normal for Cravenside. Staff were friendly and welcoming. There were no restrictions on the times of visiting and service users said their visitors were made welcome and offered refreshment. Clergy of various denominations visit the home to hold services and see individual service users. Cravenside was fortunate in having the day care room available for group meetings and community events, which meant choice for service users and did not impinge on service user’s private communal accommodation. The lunch-time meal observed was nicely presented, well cooked and there was a choice of two dishes or alternative. Service users comments included “the meals are excellent”, “I enjoyed what I had” and “no complaints about the food”. Likes and dislikes were taken into account in care plans and meals were varied. Service users said that staff asked them for their meal choice the day before and informed them of the day’s menu so any alternatives could be provided. Menus, provided by the trained and experienced cook staff, were balanced and catered for health needs (such as diabetic and soft diets). Weight records of service users who had dementia noted that some service users had low body weight (under 7 stones). It was recommended that attention should be paid to monitoring weight loss/gain and the body mass index of service users. Care plans should include a clear plan for weight maintenance. Recommendation was also made in respect of ensuring that the dining environment in the dementia care units meets current best practice guidance (such as plain, rather than fruit designed place-mats). Cravenside F57 F07 S35008 Cravenside V223155 200405 Stage 4.doc Version 1.30 Page 15 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 Complaints were taken seriously and Cravenside had a robust complaints procedure, which was followed. This ensured that complaints were acted upon within reasonable timescales and service users can be confident that their concerns, no matter how ‘minor’ will be listened to and properly investigated. EVIDENCE: Service users said that they knew to whom to complain if they had a problem. They commented that they thought their concerns were taken seriously. The home’s complaints procedure was easy to understand and was widely available in the home, both on each Unit and in the foyer. Service users had also received copies of the complaints procedure in their Service User’s Guide. Detailed records of the nature of complaints and concerns, investigations and the action taken in response were kept by the home. External management oversaw complaints. The Commission had not received any complaints since the last inspection. Cravenside F57 F07 S35008 Cravenside V223155 200405 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21 and 26 The home had an excellent standard of cleanliness in service user’s accommodation and the communal areas inspected were odour-free. There were no obvious hazards to safety and the building and grounds were maintained in good order, providing a safe, comfortable and ‘homely’ environment. Problems with baths on the dementia care units were identified and recommendations to address these were made. EVIDENCE: The décor, furnishings and the majority of furniture was domestic in character and conveyed a “homely” feel in the Units. Several service users said that they were very satisfied with the standards of accommodation both within and outside the home. Service users said they enjoyed sitting out and were happy with outside space. The front garden looked pleasant and colourful with Spring flowers. Cravenside F57 F07 S35008 Cravenside V223155 200405 Stage 4.doc Version 1.30 Page 17 Evidence from items seen around the home (e.g. fire extinguishers) showed that equipment was routinely checked and maintained to ensure the safety of service users. Problems were being experienced in respect of the bathrooms on the dementia care units. Bathrooms were too small to accommodate service users who needed to use a wheelchair and to have staff assistance. Consequently, some service users were being denied the opportunity and choice of having a bath, although their personal hygiene needs were being met through ‘bed baths’. Problems with the laundry service were noted to be ongoing since the withdrawal of the dedicated laundry assistant. Care staff reported that they were finding it difficult to find time for this task. Whilst the majority of service users said that they found the laundry service satisfactory, concerns about missing clothes have been raised with the home and addressed under the complaints procedure. The conditions in the laundry could be improved and the laundry room generally was untidy with fluff, washing powder, rubbish and piles of bedding spilling onto the floor and one drier was broken. Discussion with staff and the manager elicited that laundry work was ‘everybody’s but nobody’s’ task and the manager should find an appropriate and acceptable solution. Cravenside F57 F07 S35008 Cravenside V223155 200405 Stage 4.doc Version 1.30 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 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 and 29 A dedicated and stable staff team who were actively pursuing NVQ qualification and in-service training satisfactorily and safely met service user’s needs. A robust and thorough staff recruitment process also helped to ensure protection for service users. EVIDENCE: Service users had good relationships with the staff team. Service users commented that staff members were “very good”, “co-operative”, and that the staff “gave a good service”. Service users told of many small kindnesses of individual staff, which made them feel cared-for and special. Two service users said that the staff were “very nice” but always busy. Sometimes they had to wait for attention and staff did not always have time to talk with them. 22 out of the 32 (70 ) of the care staff had achieved NVQ level 2. Nine staff had nearly completed NVQ level 3 and 3 domestic staff were completing their level 2 courses. 16 care staff had attended a certificated dementia care course. The majority of staff had attended training in health and safety and moving and handling. Since the last inspection care staff hours had been increased and this had enabled a member of staff to always be present on each Unit to meet the needs of individuals and promote safety. Cravenside F57 F07 S35008 Cravenside V223155 200405 Stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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 and 35 The acting manager was not registered with the Commission for Social Care Inspection (as required by the conditions of registration). However, the acting manager provided appropriate leadership and supervised and directed the staff team in a way that promoted the wellbeing of service users. Robust internal and externally audited financial procedures protected service users financial interests. EVIDENCE: Since the last inspection the registered manager had left. An acting manager was in post and intends to seek registration with the Commission. The acting manager was very experienced and had achieved formal NVQ level 4 qualification in management and care. Additionally, she had attended several training courses to update her knowledge and skills. Staff said that they had a good relationship with the acting manager and respected her judgement. The acting manager had some ideas that she intends to put into practice in respect of additional information for service Cravenside F57 F07 S35008 Cravenside V223155 200405 Stage 4.doc Version 1.30 Page 20 users at their time of admission and in care planning. Throughout the inspection, service users, staff and visitors were encouraged to talk to the manager through an ‘open door’ policy in the office. The home had renewed their ‘Investors in People’ award and used this as a basis for staff training and development. Annual ‘customer satisfaction’ surveys were conducted, although it was not clear how changes were effected as a result of the feedback. There were regular residents meeting and the minutes of these were displayed in large print on the notice boards in the Units. Financial and other policies and procedures were adhered to. Service users signed their own pension/benefit books and took charge of their own personal allowances and savings. Service users said they made their own decisions about how and on what to spend their money and had opportunities to go out to town to buy personal items. Service users explained that staff ran errands for them. Cravenside operated a temporary savings system for service users, whereby they may keep a maximum of two weeks personal allowances in secure safekeeping at the home. Other savings may be banked using the Lancashire County Care Services banking system (which allows for individual non-interest bearing accounts) or have their own banking accounts if they prefer. Case tracking showed that records of all transactions were kept (with receipts) and monies were correct. These were audited by the management team at the home and from time to time by external auditors. The area manager also inspected financial and other records. Some recommendations from the previous inspection remain: - that the commitment to lifelong learning and development for each service user is identified in their care plan and that the home implements a recognised quality monitoring and feedback programme to assess the quality of life of service users with dementia. It was also noted that a fire drill had not been carried out since 27/9/04 and the acting manager was advised that a drill must be carried out as soon as possible. Cravenside F57 F07 S35008 Cravenside V223155 200405 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 2 3 2 x x x x 2 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 1 x 3 x 4 x x x Cravenside F57 F07 S35008 Cravenside V223155 200405 Stage 4.doc Version 1.30 Page 22 NO 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. Standard 9 Regulation 13(2) Timescale for action All staff must adhere to the Immediate policies and procedures for safely and administering medicines. In ongoing particular, medicines must not be left unattended and Medicines Administration Charts (MAR) must be completed using the correct codes. Suitable bathing facilities must 31/7/05 be provided in the two dementia care Units The appointed manager must 20/5/05 seek registration with the Commission Fire drills and practices must be 30/4/05 held at suitable intervals and and at regular that staff and (as far as intervals practicable) service users are aware of the procedure to be thereafter followed in the event of a fire, including the procedure for saving life. Requirement 2. 3. 4. 21 31 38 23(j) 8(1) 23(4)(e) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Cravenside Refer to Good Practice Recommendations F57 F07 S35008 Cravenside V223155 200405 Stage 4.doc Version 1.30 Page 23 1. Standard 7 2. 3. 4. 5. 6. 7. 8. 8 17 18 26 33 33 37 That care plans should set out in detail the action that needs to be taken to ensure that fully assessed needs of service users are met. The generalised goals in care plans should be specific and clearly identify how outcomes for service users are to be met, either by staff action or other means. That weight gain or loss is monitored and recorded, within a plan of care That the staff team considers how best to meet the rights of service users who have dementia to participate in political and civic processes. That staff are given information about the Protection of Vulnerable Adults register That the problems of laundry cleanliness and service are addressed by the manager That commitment to life-long learning and development for each service user is identified in their care plan. That the management team make explicit how changes were effected as a result of feedback from the customer satisfaction questionnaire That the manager considers ways in which people with dementia (and those acting on their behalf) are enabled to access and contribute to service users personal records and care plans. Cravenside F57 F07 S35008 Cravenside V223155 200405 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Unit 4 Petre Road Clayton-le-Moors Accrington BB5 5JB 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 Cravenside F57 F07 S35008 Cravenside V223155 200405 Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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