Inspection on 18/07/07 for Downshaw Lodge Nursing Home

This inspection was carried out on 18th July 2007.

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

Downshaw Lodge Nursing Home 06/06/06

Downshaw Lodge Nursing Home 22/10/05

Downshaw Lodge Nursing Home 19/04/05

Downshaw Lodge Nursing Home 17/11/04

Downshaw Lodge Nursing Home 13/05/04

Similar services:

Chirnside House

Emmaus House

East Croft Grange

Craignair

Croston Park Nursing Home

Conifers Nursing Home

Cloisters

Elmsdene Care Home

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

CARE HOMES FOR OLDER PEOPLE Downshaw Lodge Nursing Home Downshaw Road Ashton-under-Lyne Tameside OL7 9QL Lead Inspector Steve Chick Unannounced Inspection 18th July 2007 11:45 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 Downshaw Lodge Nursing Home DS0000025432.V348910.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. Downshaw Lodge Nursing Home DS0000025432.V348910.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Downshaw Lodge Nursing Home Address Downshaw Road Ashton-under-Lyne Tameside OL7 9QL 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) 0161 330 7059 0161 339 4112 Exceler Health Care Group Limited Mrs Kim Beverley Langford Care Home 45 Category(ies) of Dementia (45), Dementia - over 65 years of age registration, with number (45) of places Downshaw Lodge Nursing Home DS0000025432.V348910.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 45 service users to include: *up to 45 service users in the category of DE (Dementia under 65 years of age). * up to 45 service users in the category of DE(E) (Dementia over 65 years of age). No service user under the age of 55 years to be admitted to the establishment. 2 registered nurses on duty 24 hours; The Home Manager shall be a First Level Registered Mental Nurse and be supernumerary to the stated staffing levels for 37.5 hours per week. 6th June 2006 2. 3. Date of last inspection Brief Description of the Service: Downshaw Lodge is a purpose built, two-storey building that accommodates up to 45 service users from the age of 55 years with dementia, who require nursing care. The home is owned by Exceler Health Care Group plc, which is a subsidiary company of Southern Cross Health Care, and is under the control of a general manager who is also a qualified nurse. Fees for accommodation and care at the home range from £465.35 to £475.35 per week. Additional charges are also made for hairdressing and chiropody services, newspapers and personal toiletries. Details of the facilities provided by the home are contained in the service user guide, which is displayed in the reception area of the home. Service users are accommodated in single rooms, 26 of the rooms having ensuite facilities. Rooms without en-suite facilities are provided with vanity units incorporating washbasins. Within the home there are six communal rooms offering a variety of settings for service users to socialise, entertain family or friends and participate in activities. A pleasant garden is designed to ensure that service users can enjoy being outdoors whilst maintaining their safety and security. The home has access to a mini-bus and service users who are able to, are taken for trips out to a number of local destinations. The home is located on the main Oldham Road with good access by public transport. Downshaw Lodge Nursing Home DS0000025432.V348910.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. For the purpose of this inspection two relatives of service users were interviewed in private, as was one visiting professional. Additionally discussions took place with the homes manager and an operations manager. Two staff members were also interviewed in private. The inspector also undertook a tour of the building and looked at a selection of service user and staff records as well as other documentation including staff rotas, training records and medication records. This key inspection included an unannounced site visit to the home. A subsequent visit was made, by appointment, to interview staff and look at more records. All key standards were assessed. This report also uses information gathered since the previous visit and information provided by the previous manager. Visitors spoken to were very positive about the care offered to their relatives at Downshaw Lodge. One visitor said [the home is] absolutely superb, cant fault it, the staff are friendly and helpful. What the service does well: What has improved since the last inspection? Some refurbishment to the environment within the building has been undertaken. Issues identified at the previous inspection as needing work had all been addressed, though some require further work. Downshaw Lodge Nursing Home DS0000025432.V348910.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Downshaw Lodge Nursing Home DS0000025432.V348910.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 Downshaw Lodge Nursing Home DS0000025432.V348910.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users’ needs are assessed before moving to the home to ensure that their needs can be appropriately met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A selection of service users’ files was looked at. All had documentary evidence that an assessment had been undertaken before the service user was admitted to the home. The annual quality assurance assessment (AQAA) which was provided by the home stated that every service user is assessed by the home manager or someone qualified to do so to ensure we can meet their needs. Documentary evidence of this part of the assessment process was less consistent, in one example seen the new service user admission checklist Downshaw Lodge Nursing Home DS0000025432.V348910.R01.S.doc Version 5.2 Page 9 was blank. Discussion with the manager indicated that the home would not admit people unless they believed they could meet their needs. Downshaw Lodge does not offer intermediate care. Downshaw Lodge Nursing Home DS0000025432.V348910.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Service users’ written plans of care, do not always give appropriate guidance to staff to ensure care needs are met. The homes policies and procedures in connection with the administration of medication are not always followed, which could put service users at risk. Practices in the home promote the dignity of service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A selection of service user files was looked at. All had a copy of a written care plan and there was documentary evidence that they were periodically reviewed. Downshaw Lodge Nursing Home DS0000025432.V348910.R01.S.doc Version 5.2 Page 11 The quality of the written care planning, insofar as it would offer clear guidance as to how an individuals care needs should be met, was inconsistent. Examples were seen where the care plan stated that somebody needs assistance without specifying the nature of that assistance. Examples were also seen of instructions which would be impossible to achieve in the reality of life in a care home. For example one service user was to have their whereabouts checked at all times. Another entry identified that the service user wears incontinence pads occasionally, but gave no indication as to the circumstances where this would be beneficial to the service user. Staff who were spoken to reported that they were confident that a combination of the verbal handover provided at each change of shift and evaluation sheets together with the service user files meant that staff were aware of the individual needs of each service user whenever they were offering care. There was documentary evidence that service users have access to the range of medical and paramedical services available in the community. All visitors and staff who were spoken to were confident that medical support was appropriately sought for service users at Downshaw Lodge. There was documentary evidence that service users were periodically weighed, which is good practice as a way of monitoring one aspect of health. As with other issues identified at this visit the records which were maintained were sometimes confusing. For example one service user, whose weight was increasing, had an entry on their nutritional risk assessment which recorded recent weight loss. Whilst these types of recording anomalies do not necessarily indicate poor care, they discredit the value of all the records and do not enable the home to be fully accountable for the care they provide. Downshaw Lodge uses a pre-dispensed monitor dosage system to administer service users medication. Medication was seen to be stored appropriately although no record was maintained of the temperature of the refrigerator used to store some medication. Medication administration records presented as being predominantly appropriately maintained. However, some errors in recording procedures were noted. Examples were seen where entries on the pre-printed medication administration records had been crossed through, with no written explanation as to why. Discussion with staff indicated that these had been appropriately deleted and the error was an administrative issue. Examples were also seen where differential doses were not being effectively recorded. The home does have a procedure and a system for doing this, but staff were failing to follow the procedure. The record of controlled drugs presented as being appropriately maintained. Relatives who were spoken to at this site visit reported that staff treated service users respectfully and in a way which maintained their dignity. Similarly staff who were spoken to believe that they and their colleagues Downshaw Lodge Nursing Home DS0000025432.V348910.R01.S.doc Version 5.2 Page 12 treated service users with respect and dignity. This was also borne out by observation during the visit. Relatives who were spoken to during this visit reported positively on the way in which service users’ care needs were met. Downshaw Lodge Nursing Home DS0000025432.V348910.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. An appropriate range of activities was available to service users and visitors are welcome in the home, which enhances service users fulfilment and social stimulation. The provision of food to maintain service users’ health and well-being is good and service users are able to maximise their autonomy within the context of communal living. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As with other aspects of documentation, issues relating to social and cultural needs of individuals would be improved by better recording. However a range of social activities was available for service users to participate in if they wished. A visiting professional identified that activities for service users had significantly improved. It was reported in the AQAA that close links were maintained with a local Christian church. This was confirmed as being the case by the manager and one relative who was spoken to. Downshaw Lodge Nursing Home DS0000025432.V348910.R01.S.doc Version 5.2 Page 14 There appeared to be some differentiation in the level of activity between upstairs and downstairs. The manager reported that she was aware of this and was developing strategies to ensure that service users level of social activity was not defined by which floor they spent their time on. Downshaw Lodge had a policy of encouraging friends and relatives of service users to visit at any reasonable time. Visitors who were spoken to during this visit confirmed that they could visit at any time and reported that they were made to feel welcome by the friendly and helpful staff. Staff and visiting relatives, who were asked, expressed the view that service users could exercise autonomy and choice within the context of communal living and their individual capacity. During this visit one meal was sampled. It was pleasantly presented and tasty. Relatives spoken to were positive about the provision of food. It was reported in the AQAA and by the manager that meal planning is undertaken using the nutmeg system. This is reported as being a systematic means of monitoring and analysing service users nutritional needs and intake. Downshaw Lodge Nursing Home DS0000025432.V348910.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The implementation of the homes policies and procedures worked to ensure that service users are protected from abuse or exploitation and any complaint would be dealt with appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Downshaw Lodge uses a complaints procedure which has been found to be appropriate at previous inspections and was not looked at on this occasion. All visitors who were asked, were confident that any complaint would be responded to appropriately by staff and management in the home. One visitor stated that he was confident regarding making a complaint particularly as the staff were “very nice and approachable”. The manager reported that most staff had been trained in issues relating to the identification of possible abuse of vulnerable adults. It was also reported that staff who had not benefited from this training were going to be trained in the near future. Staff who were spoken to reported that they had done abuse awareness training, including whistleblowing. All relatives and staff spoken to expressed confidence that service users were safe at Downshaw Lodge. Downshaw Lodge Nursing Home DS0000025432.V348910.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is predominantly appropriately maintained, decorated and cleaned to enable service users to live in a pleasant, safe and hygienic environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During this visit, a tour of the building was undertaken. This included communal areas and a selection of service users’ bedrooms. There are several communal areas were service users could spend their time, or they can access their rooms when they chose. The manager reported that capital money had been allocated to further improve dining furniture, some lounge chairs, and provide laminate flooring in the dining room and some new bedside drawers and cabinets. Whilst there Downshaw Lodge Nursing Home DS0000025432.V348910.R01.S.doc Version 5.2 Page 17 was evidence of improvements having been undertaken, the carpet in the upstairs dining room was looking tired and it was reported this was due for a refit. Several double glazed units had become misted up and needed replacing. The manager reported that these were on order. In one small lounge, seats were quite close together with no obvious space to, for example, place a cup or glass. The manager, who had only been in post at Downshaw Lodge for 3 weeks, appeared to be aware of all these issues and was taking steps to remedy them. Service users’ bedrooms showed a clear range of personalisation. At the time of this visit the home presented as being clean and tidy with no unpleasant smells. One visitor who was spoken to reported that there were, in their experience, occasional unpleasant smells. Other visitors reported that in their experience the home was always clean and tidy with no unpleasant smells. One visitor reported that one of the things they like about the home is that it is always clean when they visit. Service users benefit from access to a pleasant, well maintained and safe enclosed garden. Downshaw Lodge Nursing Home DS0000025432.V348910.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The numbers and skills mix of staff on duty promotes the independence and well-being of service users. Recruitment procedures are not applied with sufficient rigour to minimise the risk to service users of inappropriate staff being employed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A copy of the staff rota was looked at. This, combined with observation, verbal evidence from staff and the manager, indicated that staffing levels were maintained at an appropriate level for the number and needs of the service users resident. Information provided in the AQAA indicated that of the 20 care staff (not including qualified nurses) 8 held NVQ two or above and another eight were working towards NVQ two. It was reported that this was an improvement over the previous year. Downshaw Lodge Nursing Home DS0000025432.V348910.R01.S.doc Version 5.2 Page 19 A selection of staff files relating to the recruitment and vetting of staff who had been recently appointed was looked at. These provided evidence that most of the required vetting, including obtaining CRB (criminal record bureau) disclosures was followed. However, there was inconsistency in connection with two areas. Not all applicants had given a clear employment history where any gaps could have been identified and explored and one example was seen where a reference had not been obtained from the applicants previous employer. There was no record that could be located to indicate if there was a specific reason why these circumstances were considered to be acceptable for recruitment purposes. Another applicant had completed the application form and clearly stated they were not eligible to work in the United Kingdom. It is quite likely that this was an error in the completion of the form, however what was more concerning was that this had not been identified by anybody throughout the recruitment process. This indicates a lack of rigour in analysing information supplied by applicants to minimise the possibility of exposing vulnerable adults to inappropriate staff. One example was identified where a member of staff had reported that they had undertaken training, which was crucial to their role, with a previous employer. Downshaw Lodge did not appear to have sought documentary evidence to support this assertion. The company provides a range of training opportunities for staff. At the time of this inspection it was quite difficult to establish what training individuals had received, as the available records appeared to be out of date. For example the training matrix indicated that no staff had received training in respect of C.O.S.H.H, health and safety or infection control. The manager undertook to update these records and ensure that any staff who have not received the necessary mandatory training would be prioritised to do so. Staff who were spoken to reported that training had slipped a little over the preceding period, although they were able to confirm that new staff always received a thorough induction and a period of time with a mentor”. Relatives who were spoken to during the visit were very positive about the staff team’s attitude and competence. Downshaw Lodge Nursing Home DS0000025432.V348910.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager required further time to demonstrate that the home’s health and safety procedures are fully implemented for the benefit of service users and staff. Quality audit processes provide a framework to further improve services for the service users whose financial interests are protected by the homes policies and practices. This judgement has been made using available evidence including a visit to this service. Downshaw Lodge Nursing Home DS0000025432.V348910.R01.S.doc Version 5.2 Page 21 EVIDENCE: Since the previous inspection report was written the registered manager had left and the new manager had only been in post for three weeks prior to this visit. Understandably, this meant that areas identified by the manager as needing some input had not all been addressed. Visitors who were asked expressed a positive view of the initial impression of the new manager. It was reported that the company undertakes regular audits of the care practices in the home which are validated by one of the company’s operations managers. It was also reported that questionnaires are sent to relatives on an annual basis and an action plan is provided on the basis of the information received. The manager reported that questionnaires had been sent out in June of this year and will be collated by headquarters staff who will also identify areas for improvement if necessary. This was also reported as being standard procedure in the AQAA supplied by the previous manager. The systems in place to protect residents’ financial interests have, in the past, been found to be appropriate. A small selection of records relating to money held on behalf of service users was looked at and presented as being well maintained. Previous inspection reports have identified that the health and safety issues are appropriately dealt with at Downshaw Lodge. However, as stated elsewhere in this report, it was not absolutely clear that all staff had received appropriate mandatory training in connection with health and safety requirements. It was reported by the manager that all the necessary maintenance contracts in respect of health and safety issues remained in place. A small selection of that documentation was looked at and presented as being appropriately maintained. Staff reported that disposable gloves and aprons were provided to minimise the risk of cross infection. Downshaw Lodge Nursing Home DS0000025432.V348910.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Downshaw Lodge Nursing Home DS0000025432.V348910.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13 Requirement The medication administration records must be maintained in a way which ensures that an accurate record of the dose of medication is kept, so that the home can demonstrate that service users are receiving appropriate medication. The possibility of exposing service users to inappropriate staff must be reduced by the rigorous application of recruitment and vetting procedures. This must include obtaining the full employment history of any applicant, obtaining a reference from the previous employer and checking information given by an applicant. Timescale for action 01/09/07 2. OP29 13 01/09/07 Downshaw Lodge Nursing Home DS0000025432.V348910.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP3 Good Practice Recommendations The registered person should ensure that better records are maintained of Downshaw Lodge’s own assessment so as to better demonstrate that the needs of prospective service users can be met. The registered person should ensure that instructions in written care plans are both consistent and in sufficient detail to minimise the risk of inappropriate care being offered to individual service users. The registered person should ensure that a record is maintained of the temperature of the fridge used to store some medication, so that appropriate storage can be demonstrated. The registered person should ensure that the previous lifestyle, interests and hobbies and cultural norms of each service user is ascertained to enable the home to meet the social and cultural needs of the service user. To ensure that the home can demonstrate staff are maintaining their levels of competency accurate training records should be maintained at all times. 2 OP7 3 OP9 4 OP12 5 OP30 Downshaw Lodge Nursing Home DS0000025432.V348910.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Downshaw Lodge Nursing Home DS0000025432.V348910.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. 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!