Inspection on 27/06/06 for Derby House Nursing Home

This inspection was carried out on 27th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Derby House Nursing Home 23/05/07

Derby House Nursing Home 01/11/05

Derby House Nursing Home 04/07/05

Derby House Nursing Home 28/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Derby House Nursing Home 12 Broad Walk Buxton Derbyshire SK17 6JS Lead Inspector Susan Richards Key Unannounced Inspection 27th June 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Derby House Nursing Home DS0000002052.V300439.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. Derby House Nursing Home DS0000002052.V300439.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Derby House Nursing Home Address 12 Broad Walk Buxton Derbyshire SK17 6JS 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) 01298 23414 01298 23334 Derby House Nursing Home Limited Mr Derek Andre Brindley Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Derby House Nursing Home DS0000002052.V300439.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registration includes the accommodation of two younger adults with physical disabilities as named in the notice of proposal. Date of last inspection 1st November 2005 Brief Description of the Service: Derby House is located in the heart of Buxton, overlooking a park within a pleasant residential area. The home is an old Victorian building, initially registered many years ago under the Registered Homes Act 1984, transferring under the Care Standards Act in 2002. Accommodation is over three floors and is suitably adapted to meet the needs of residents with mobility problems, with a range of mobility aids provided. There is a shaft lift and emergency call system provided throughout. There is one communal lounge/dining room available on the first floor, although floor space and facilities here are limited in terms of the number of residents that use this room at any one time. However, due to the size of many individual bedrooms, most residents prefer to use these as bed sits. There is a choice of bathrooms and toilet facilities and a central kitchen and laundry. Staff facilities are also provided. Residents receive care and support from a team of registered nurses, care and hotel services staff, together with the registered manager, who is also a registered nurse in both mental and general nursing. Ownership of the home is a family concern and the registered providers are on site daily. Fees charged range from £466.00 to £591.00 per week. Information regarding fees is as detailed by the registered provider in the pre-inspection questionnaire dated 04 May 2006. Derby House Nursing Home DS0000002052.V300439.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. There were 28 residents accommodated the time of the inspection. Methodology used included case tracking. This involved the random sampling of three residents accommodated. Discussions were held with them about their care and the services they received in accordance with their given capacities. Their individual care and associated records were also examined and discussions were also held with staff about their care. What the service does well: What has improved since the last inspection? What they could do better: Develop existing mechanisms for the ongoing monitoring and review of working practises and approaches in the home, with the aim of further empowering residents in terms of their daily living arrangements, ensuring that, with this aim in mind, the registered persons and staff are truly conversant with and effectively promote not only the safety needs of residents, but also their rights and best interests. Derby House Nursing Home DS0000002052.V300439.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Derby House Nursing Home DS0000002052.V300439.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 Derby House Nursing Home DS0000002052.V300439.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 Residents are provided with the appropriate information they need about the home. They do not move into the home without their individual needs being properly assessed in consultation with them (or where necessary, their representative) and there are suitable arrangements to enable them to visit/trial the home before a decision to live there in a permanent basis is made. Quality outcome in this area is good. This judgement has been made using evidence available, including a site visit to the home. EVIDENCE: Discussions were held with residents’ case tracked and also a relative about the arrangements for admissions to the home. Feedback from residents (or their representative indicated that most had been given written information about the home by way of the service user guide and had individual written terms and conditions/contracts, although one resident was unable to recall due to short-term memory difficulties. Discussions with the provider and staff verified that this had been provided to their relative acting on their behalf. Derby House Nursing Home DS0000002052.V300439.R01.S.doc Version 5.2 Page 9 Individuals recorded needs assessment information was examined, including pre-admission assessment information collated by the home and single assessment information provided by way of care management arrangements for those who were funded via local authorities. Information recorded was comprehensive and detailed and accorded with areas as discussed with residents in respect of their daily living arrangements and lifestyle preferences. An established format for the recording of individuals’ wishes and preferences in relation to death and dying had been introduced since the previous inspection. Overall residents (and relatives spoken with) felt that their needs were largely well met. Derby House Nursing Home DS0000002052.V300439.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 There are suitable arrangements and systems in place to ensure that residents health care needs are met and overall they are treated with respect and their individual dignity and privacy promoted, although a review of staff practises in terms of accessing the private accommodation of some residents, whose bedrooms are also fire escape routes will ensure that the latter is more effectively upheld. Quality outcome in this area is good. This judgement has been made using evidence available, including a site visit to the home. EVIDENCE: The written care plans for each service user were examined. These were formulated in accordance with their risk-assessed needs, were regularly reviewed and overall were reflective of recognised guidance concerned with the care of older persons. Discussions were held with residents’ case tracked about their care and daily living arrangements and also with staff about the arrangement and organisation of care delivery in the home. Individuals’ lifestyle preferences, including their preferred routines was reasonably well Derby House Nursing Home DS0000002052.V300439.R01.S.doc Version 5.2 Page 11 accounted for, although for one resident, these were not recorded in their individual care file. This was discussed with the nurse in charge and provider. Arrangements for access to outside health care professionals, including that relating to routine health care screening was also discussed with residents and the nurse in charge and records were examined in relation to these, which were appropriately maintained. The arrangements for the management and administration of the medicines in the home were examined, with particular focus on those residents case tracked. These were generally satisfactory, although one residents’ medicines administration record (MAR) sheet examined had a hand written instruction, which was not detailed in accordance with recognised guidance. The need to ensure that a list of staff full signatures be provided for those staff responsible for the administration of residents medicines was also discussed with the provider and nurse in charge. Discussions were held with residents about their personal care and staff approaches to this. Residents expressed satisfaction in this respect, with the exception of one area, which seemed to have become routine practise as staff regularly accessed specific residents bedrooms via the fire escape route through another residents room rather than use the proper route. This was discussed with the provider and nurse in charge. Derby House Nursing Home DS0000002052.V300439.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Residents were well supported to maintain contacts with their families and friends and the local community in accordance with their individual choices. Although arrangements for the regular review of activities provision on an individual basis, and where possible, in consultation with each resident, may better inform the planning and organisation of activities and ensure that residents are satisfied and are in agreement with these. The cook’s review of menu provision with residents is a positive approach towards ensuring they are provided with meals, which they like and are in accordance with their individual choices, although a review of staff practises in respect of the serving of and assistance with meals would also benefit their enjoyment. Quality outcome in this area is adequate. This judgement has been made using evidence available, including a site visit to the home. EVIDENCE: Discussions were held with residents regarding their social contacts, leisure and activities and also with a staff member who had dedicated time allocated to the organisation and provision of activities. Records of a variety of activities Derby House Nursing Home DS0000002052.V300439.R01.S.doc Version 5.2 Page 13 engaged in by residents were kept within individual care files and also detailed on the pre-inspection questionnaire completed by the registered provider. Feedback from residents was variable regarding the provision of activities. Some was satisfied with their arrangements whilst others felt that there these could be improved. All residents spoken with said they could see their visitors at any time they chose. A number of relatives visited the home during the inspection. The location of the home directly overlooking the park, which could easily be accessed by residents, was seen as a positive aspect of the home. Many residents, due to their frailty and individual choices enjoyed the views of the park, but did not access it. Staff spoken with said they did encourage residents to go out with their support, either into the park or into town, although uptake was infrequent. A monthly church service is organised to take place in the home, which residents had the option to attend. A small group of residents (6 in total) ate their lunch in the first floor lounge during the inspection. Food provided was sufficient and appropriately presented and residents said they generally enjoyed the meals offered. However, whilst residents were still eating their main course, their puddings were brought in and put on the table with their dinner. There was no consultation with them about this. These had been brought upstairs on an open trolley with no plate covers. Some residents spoken with said that the puddings were often cold by the time they ate them. One of the residents, with confusion began to eat their pudding with their knife, whilst still eating their lunch. There was no staff supervision for a significant period of time, with one staff member occupied who was assisting another resident to eat and drink. Feedback obtained from residents regarding the quality of food provided was variable. Some were satisfied, some felt that the main meal was very good but that more variety was needed at teatime. Menus were discussed with the cook, who was relatively new into post and had commenced a review of this. Examples of changes already made by here were discussed. The cook advised the changes were being undertaken in consultation with residents. Derby House Nursing Home DS0000002052.V300439.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Suitable information is provided for residents and their representatives to enable them to complain and there are satisfactory systems and arrangements in place to promote the protection of residents from abuse, although further monitoring of the situation in respect of the three same complaints made would establish a clear measure as to residents satisfaction with the outcome. Quality outcome in this area is adequate. This judgement has been made using evidence available, including a site visit to the home. EVIDENCE: Feedback from residents established that they knew how to complain and/or raise concerns they may have, although some felt that matters raised, although usually dealt with were sometimes initially responded to in an overly defensive manner. There is a complaints procedure in place for the home, which is displayed and also provided in the service user guide/brochure. This was discussed with the registered provider and nurse in charge, together with details of complaints received by the home over the previous 12 months and the complaints record kept in the home was examined. There had been four complaints made and recorded. All were upheld, with three relating to the same issue. However, discussions with residents indicated that the latter were perhaps not fully resolved. Derby House Nursing Home DS0000002052.V300439.R01.S.doc Version 5.2 Page 15 Discussions were held with staff regarding the procedures to follow in the event of any suspicion or actual witnessing of the abuse of any resident. All staff was conversant with the home’s policy/procedural guidance, which had been updated since the previous inspection and had undertaken training in respect of adult protection. Derby House Nursing Home DS0000002052.V300439.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 & 26 Residents live in a clean and comfortable environment and their own rooms for the most part suit their needs. However, residents’ safety was not always promoted in terms of the storage of hazardous substances and aspects of infection control and residents are not routinely provided with a lock to their bedroom door or lockable storage space unless they request these. Quality outcome in this area is adequate. This judgement has been made using evidence available, including a site visit to the home. EVIDENCE: A full tour of the premises was not undertaken on this occasion. The private and communal facilities of those residents case tracked was inspected and also the laundry area. Residents spoken with were satisfied with their rooms, which they had chosen and which were well decorated, furnished and equipped, although not all rooms have at least 2 double electric sockets. The provision of these is included in the home’s written programme of maintenance, upgrading and renewal. Two of the bedrooms seen had en Derby House Nursing Home DS0000002052.V300439.R01.S.doc Version 5.2 Page 17 suites and one provided a wash hand basin. All rooms were personalised accommodating residents’ own furniture, which they had chosen to bring with them. Records were kept for each resident in respect of their own furniture. One resident had a lock fitted to their bedroom door at their request. However, the lock was a chain type fitted on the inside of the door. A risk assessment was not seen in respect of this, including staff access in the event of an emergency, although the Inspector is since advised that staff are able to gain access in the event of an emergency and that there has been consultation with the fire officer in respect of this lock. Since the previous inspection the registered provider had written to residents nearest relative/representative asking them to determine which residents would choose to have a lock fitted to their bedroom door and requesting they sign a declaration to this effect indicating the choice made. However, some residents spoken with and one relative on behalf of a resident said they would like a lock if easy to use and safe. These comments raised also relate to a recent complaint made by three residents, one of who now has the chain type lock fitted. All areas seen were clean. However, bars of soap were observed at some communal washbasins and not all waste bins had lids provided. Cleaning materials and other substances potentially hazardous to health were left out in some bathroom areas and also in sluice areas. Derby House Nursing Home DS0000002052.V300439.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Residents’ needs are generally well met by staff who is properly recruited and also supported by the registered provider to attend a variety of training. Although a recorded individual skills analysis for existing staff who have not had the benefit of the recently introduced skills based induction programme, would further benefit in providing a clear baseline skills assessment record for all staff employed, thereby determining any gaps. Quality outcome in this area is good. This judgement has been made using evidence available, including a site visit to the home. EVIDENCE: Details of staff employed/turnover and staff recruitment, induction, training and deployment were provided by way of the pre-inspection questionnaire completed by the registered provider. These were discussed with the registered provider and staff and records were examined in relation to these, which were generally well maintained. A skill based induction package for care staff had been introduced since the previous inspection. Certificates of the completion of these were kept in individual staff files for those newer staff starters whose induction was in accordance with this recently introduced format. The personal files of four of the most recent staff starters were examined. With the exception of one, these contained satisfactory information in respect of their recruitment, including checks obtained. However, one staff member had commenced their employment with Derby House Nursing Home DS0000002052.V300439.R01.S.doc Version 5.2 Page 19 only one written reference obtained where two are required. This was discussed with the registered provider who had obtained one written reference and an initial telephone reference, but felt an oversight had occurred in monitoring the receipt of the second written reference and advised that this would be pursued immediately. Seventy five percent of care staff had either achieved at least or were in the process of working towards NVQ level. Two staff has achieved NVQ level 3 with 4 due to commence in September. Staff said they were encouraged and well supported to attend a wide range of training in relation to the care needs of residents accommodated, including wound care, diabetes, dementia care, oral health, palliative care, pressure ulcer care and pain management, via local health providers. Derby House Nursing Home DS0000002052.V300439.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 37 & 38 The home is reasonably well managed and run and in the main there are suitable systems and arrangements in place to protect and promote the health, safety and welfare of residents and staff in consultation with them, although some areas in respect of staff working practises were not always fully promoted or upheld in residents best interests. Quality outcome in this area is adequate. This judgement has been made using evidence available, including a site visit to the home. EVIDENCE: The Inspector did not see the registered manager on the day of the inspection. He is a registered nurse both general and mental and is also one of the registered providers operating the home since its initial registration. He does not hold a formal management qualification. Derby House Nursing Home DS0000002052.V300439.R01.S.doc Version 5.2 Page 21 There is a formal quality assurance system in operation, which includes an annual audit of all national minimum standards for the care of older persons and also includes satisfaction questionnaires surveyed to residents and relatives and also other stakeholders on a periodic basis. Details of the last audit were provided, including quality assurance action planning for 2006, which includes action in respect of requirements made at the previous inspection. Discussions were held with residents as to how they were consulted and other feedback was also received by way of resident comment cards. The arrangements for the management and handling residents monies (those case tracked) were examined and discussed and are satisfactory. Methods of staff supervision employed were discussed with staff and also the registered provider and records were examined in respect of these for the four most recent staff starters whose personal files were examined. These were satisfactory. A number of records, which are required to be kept in the home, were examined. These are referred to under the relevant sections of this report, for example care records, complaints records and staff records. They are appropriately maintained and safely stored. Details of the arrangements for staff training in respect of safe working practises were discussed with the registered provider and staff and were also provided on the pre-inspection questionnaire. Discussions confirmed that there were some gaps for some staff in respect of first aid instruction and policy statement, infection control and food hygiene and handling. Fire drills were not routinely practised or recorded. Details of the up to date maintenance of equipment in the home were provided by way of the pre-inspection questionnaire. Records of accidents and incidents were examined for those residents case tracked and written notifications made to the Commission were also noted and discussed. These were in accordance with required practise. As detailed under the environment section of this report, some substances, which may be hazardous to health, including cleaning materials were left out around the home, although there was a lockable facility provided for the storage of these and bars of soap were left out in communal areas and some waste bins did not have lids provided. Derby House Nursing Home DS0000002052.V300439.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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X 2 X 2 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 3 X 3 3 3 2 Derby House Nursing Home DS0000002052.V300439.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. NMS OP9 Regulation 13, 17 Requirement Where a medicines instructions are hand written on a residents medicines administration record (MAR) sheet, this instruction must be signed and dated by the person writing it and countersigned and dated by a witnessing staff member. A list of staffs’ full signatures must be kept for those staff responsible for the administration of medicines to residents. Substances which are potentially hazardous to health must be stored safely at all times - all parts of the home to which residents have access to must be as far as reasonably practicable free from hazards to their safety. Suitable arrangements must be made and upheld by staff in respect of the prevention of infection in the home. In this instance, bars of soap must not be used in communal hand washing areas and waste bins must be fully occlusive. Safe working practises must be DS0000002052.V300439.R01.S.doc Timescale for action 01/08/06 2. OP9 13, 17 01/08/06 3. OP19 13 01/08/06 4. OP26 13 27/08/06 5. OP38 13, 23 & 31/08/06 Page 24 Derby House Nursing Home Version 5.2 18 ensured (see main body of report under management section). RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP10 Good Practice Recommendations A review of staff practises should be undertaken in respect of staffs chosen method of accessing the private accommodation of residents whose bedrooms are also fire escapes to ensure that their privacy and dignity is upheld in a respectful manner. Residents care plans regarding their daily living preferences in respect of their individual occupational, leisure and social activities should be regularly reviewed with them and record of those reviews maintained. It should be ensured that mealtimes are unhurried with residents being given sufficient time to eat each course, before the next is brought to them. The registered manager should ensure that residents are satisfied with the outcome of their complaint. All residents should be routinely provide with suitable locks to their bedrooms doors, (which may be easily accessed by staff in the event of any emergency) and also lockable storage space, thereby promoting residents own choice as to whether or not to used them. An individual skills analysis should be undertaken for each care staff member who has not undertaken the recently introduced skills based induction programme and a record kept in respect of this in their personal file. The registered manager should achieve a level 4 in management or equivalent. 2. OP12 3. 4. 5. OP15 OP16 OP24 6. OP30 7. OP31 Derby House Nursing Home DS0000002052.V300439.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Derby House Nursing Home DS0000002052.V300439.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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