Inspection on 07/12/05 for Dunollie Care Home

This inspection was carried out on 7th December 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Dunollie Care Home 27/04/10

Dunollie Care Home 15/01/10

Dunollie Care Home 26/09/09

Dunollie Care Home 31/03/09

Dunollie Care Home 11/08/08

Dunollie Care Home 05/11/07

Dunollie Care Home 21/05/07

Dunollie Care Home 27/11/06

Dunollie Care Home 11/05/06

Dunollie Care Home 19/05/05

Dunollie Care Home 02/11/04

Dunollie Care Home 13/07/04

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Hawkhills

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The Grove Waltham

Staveley Birk Leas Nursing Home

Carentan House

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

CARE HOMES FOR OLDER PEOPLE Dunollie Nursing Home Dunollie Nursing Home 31 Filey Road Scarborough North Yorkshire YO11 2TP Lead Inspector Mary Slattery Unannounced Inspection 7th December 2005 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 Dunollie Nursing Home DS0000043116.V280473.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Dunollie Nursing Home DS0000043116.V280473.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Dunollie Nursing Home Address Dunollie Nursing Home 31 Filey Road Scarborough North Yorkshire YO11 2TP 01723 372836 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) dneuropeancare@aol.com European Care (SW) Ltd *** Post Vacant *** Care Home 49 Category(ies) of Old age, not falling within any other category registration, with number (49), Physical disability (49), Terminally ill (5) of places Dunollie Nursing Home DS0000043116.V280473.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service Users to include 49 OP, 49 PD and 5 TI up to a maximum of 49 service users. Service Users in the category PD to be aged 40 years plus. Date of last inspection 19th May 2005 Brief Description of the Service: Dunollie Care Home provides nursing care and accommodation for up to 49 service users. Service users over the age of 65 years who need general nursing care, service users who are terminally ill and service users over the age of 40 who have a physical disability and need nursing care. The home is owned by European Care (SW) Limited and was registered with the Commission in August 2003. The home is located close to the centre of Scarborough its amenities and facilities. The home is set in large ground and the accommodation provided is in both single and double rooms. There is a variety of communal space a passenger lift to all floors and ample parking for visitors and staff. Dunollie Nursing Home DS0000043116.V280473.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report related to an unannounced inspection on the 7th December 2005. The inspection was carried out by two Regulatory Inspectors and took nine and a half hours including two hours preparation time. A full inspection of the premises and facilities was carried out including the service users private accommodation. A cross sections of the homes records were looked at which included service users assessments, care plans, staff rotas and employment records, safety certificates and menus. The focus of the inspection was on a number of key standards, inspecting the case records of a number of service users to establish if they corresponded with their experiences of life in the home. Time was spent talking to service users and staff and relatives, observing the activity in the home and the interaction between service users and the staff. The appointed manager was available throughout the inspection and the findings were discussed and agreed at the close of the inspection. What the service does well: What has improved since the last inspection? Dunollie Nursing Home DS0000043116.V280473.R01.S.doc Version 5.1 Page 6 The changes made to the daily routines have improved the daily lives of the service users. There is greater flexibility around meal times and a wider choice of food. The changes in the staff rota and the increase in the staffing levels allow more time for the delivery of personal and nursing care and time to chat and have some fun. More contact has been made with external health care professionals to seek advice and guidance about the service users care. The staff said that the communication systems have improved. The care staff have responsibility for keeping care records and for reporting on changes in the service users conditions. 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. Dunollie Nursing Home DS0000043116.V280473.R01.S.doc Version 5.1 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 Dunollie Nursing Home DS0000043116.V280473.R01.S.doc Version 5.1 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, 3, 4 and 5 People are able to visit the home to look at and discuss what the home provides but more information needs to be gathered about peoples needs before moving in to make sure that their needs can be met in a safe manner. EVIDENCE: There is a statement of purpose and a service user guide but these were not readily available in the home and there was no evidence that service users are given copies of these documents for them to refer to. The policy of the home is that prospective service users will have an assessment and there was an assessment document in place. A selection of assessment record were looked at they had limited information about the needs of the service users. A small number had information about the service users condition and the reasons why they needed to be admitted to a nursing home others did not. Dunollie Nursing Home DS0000043116.V280473.R01.S.doc Version 5.1 Page 9 Some of the assessments had been signed and dated others and there was no evidence to show that he assessments had been discussed and agreed with the service users or their representative. Sections of the assessment forms had not been completed and there was no information available as to why. There is no consistent approach to doing pre admission assessments and to completing the assessment forms to make sure that sufficient and appropriate information is gathered. The information available was not considered sufficient for staff to establish if the service users needed any specialist equipment prior to admission. People are invited to visit the home to look at the facilities and to discuss the services offered by the home before a decision is made for them to move in. Dunollie Nursing Home DS0000043116.V280473.R01.S.doc Version 5.1 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 and 11 Further improvements need to be made to the service users care plans to make sure there is a yardstick for judging whether appropriate care is delivered and that they are safe. EVIDENCE: The service users appeared well cared for, well groomed and a number of the service users made very positive comments about the care and attention they received from the staff. The appointed manager and some of the nursing staff have done a review of the care plans and all the staff have had opportunities to become familiar with the care plan documents. They have also been informed as to what is expected of them in referring to the service users plan of care and in keeping records of the care delivered and the outcomes of that care. The care plans looked at were in general of poor quality and did not give enough information about the personal care and nursing care needs of the individuals. Dunollie Nursing Home DS0000043116.V280473.R01.S.doc Version 5.1 Page 11 The information that had been gathered at the assessment was not always accurately transposed into a plan of care and there was little guidance for staff as to how each individual care should be delivered. Where the care plans stated that people need help with personal care with regard to washing, dressing and bathing there were no details about what exactly they needed, how this was to be carried out and who was going to do it. A service user who had been discharged from hospital was at risk from pressure ulcers and it had been advised on discharge that a nimbus mattress should be provided, this however was not provided. The staff reported that the condition of the service user had improved but there was no information in the care plan to evidence this and reasons given as to why a nimbus mattress had not been provided. The accident records showed that a service user had suffered a number of falls and that bed safety rails had been put in place. There was information to show that the service user did not like the bed safety and would hit out at the rails and climb out of the end of the bed, thus falling and causing injury and bruising to the skin. There was no written risk assessment in place to assist staff in managing the situation. The bed safety rails were still in position and no alternative safety measure had been considered. One of the care plans looked at showed that a service user had lost a substantial amount of weight, the nutritional assessment did not indicate that the service user was a t risk but there was no information as to the reason for the weight loss or of what action had been taken. A number of the service users are very frail and by nature of their conditions are not always able to tell staff what they need. There was a lack of information about how service users are able to make their needs know to the staff. The daily records that are kept by the staff were looked at and an entry was made that one of the service user was very agitated but there was no information in the care plan to explain to staff how to manage this and what action had been taken to investigate the cause of the agitation. The qualified nursing staff are responsible for the medication procedure. The system and facilities were inspected and gaps were found in the administration records. One of the service users had not received their prescribed medication on a number of occasions as the staff had failed to make sure that a further supply had been ordered and provided. Where service users need regular applications of creams for skin care, the creams are kept in their bedrooms and are applied as required by the staff that attends to their personal care. There was no recording system in place for those staff to use to confirm that the creams have been applied. There is no formal system in place for the medication to be audited to make sure that all medication is available as required by the service user and that action is taken where gaps in records are found. The home is registered to accommodate service users who are terminally ill and who need specialist care. There are currently no service users living in the home within this category. It is important that no service user who need this Dunollie Nursing Home DS0000043116.V280473.R01.S.doc Version 5.1 Page 12 specialist care is admitted as there are no staff currently working in the home with the skills and training need to meet their needs. Some of the service user accommodated have physically disabilities and require nursing care. Specific staff are allocated to care for these service users but they have not had any training in relation to their care needs and there are no life plans in place. The care plans are limited to their social, personal and nursing care needs. Dunollie Nursing Home DS0000043116.V280473.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, 14 and 15. The daily routines are much more flexible and service users have more control over what they do each day. EVIDENCE: A lot of the service users are local to the area and living in the home enables them to have regular contact with their families. Close family members are welcome to spend as much time as they wish with their relatives and help with their care. The staff and a number of the service users said that there is greater flexibility around the routines of daily living and that the service users have more choice about rising and retiring times, meals and mealtimes. The changes that have been made to mealtimes give service users more time for a leisurely breakfast and time to build up an appetite for lunch and tea. The changes in the daily routines give staff more time to spend with the service users and give greater attention to their personal and nursing care needs. There is a lot more social activity going on both during the day and in the evenings, the twice monthly social evening is a great success and service users who do not normally take part in organised activities have been doing so. Dunollie Nursing Home DS0000043116.V280473.R01.S.doc Version 5.1 Page 14 Some changes have been made to improve and increase the social activities for those service users who have physical disabilities, which enable them to socialise in the evenings outside of the home and to enjoy holidays. A full review of the services for service users who have a physical disability to make sure that they have opportunities to take part in developing their life plan and that staff with the necessary training and skills are employed to work alongside these service users. The service users said that the food had improved and there was plenty of choice. Whilst service users do have a choice of where to take there meals the dining rooms are used much more, giving people more opportunity to socialise and to be assisted where needed. Some service users have their meals in the small dining room and staff were observed to be standing up whilst giving the assistance. This indicated a lack of interest in what is an important part of the day for service users both socially and for their physical wellbeing. There are concerns that the menu is not in the main developed from the service users likes, dislikes and nutritional needs. There is no clear system in place for formal meetings to take place between the appointed manager and the cooks to make sure that the menus reflect the needs of the service users. There was no evidence to show that the catering staff have attend training courses relative to the service users dietary needs. Dunollie Nursing Home DS0000043116.V280473.R01.S.doc Version 5.1 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 the following standard(s): 16 and 18. The response to complaints has improved but the poor recruitment practices and lack of abuse awareness training does not safeguard service users. EVIDENCE: The appointed manager has taken a positive approach to complaints that have been made and has carried out the investigations according to the procedure. People have been kept informed as to the progress and outcomes of the investigations. Service users are asked if they have concerns about life in the home and the care they receive and relatives meetings have taken place, this gives people the opportunity to voice their views and for any required action to be taken to resolve these. A small number of the staff group have attended abuse awareness training and the staff that spoken with were clear that they would report any suspicion of abuse but they were unaware of the local authorities policy for the protection of vulnerable adults. The outcomes of a recent investigation of abuse identified a number of areas in which the staff failed to safeguard the welfare of a service user. These outcomes must been addressed and all staff must attend abuse awareness training and have a full understanding of the policy and procedure for reporting any allegation or suspicion of abuse and poor care practices. Following the last inspection the staff records were audited and an action plan was in place for all of the required records to be in place. This plan has not been followed as staff have been employed prior to the required checks being carried out. Dunollie Nursing Home DS0000043116.V280473.R01.S.doc Version 5.1 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, 22, 25 and 26 The standard of the environment has improved but more needs to be done to make sure service users are safe at all times. EVIDENCE: A full inspection of the premises and facilities was carried out and the home was found to be warm and bright and apart from the large dining room was free from offensive odours. There was a range of equipment available to assist service users with their mobility including assisted baths, hoists and wheelchairs. A number of the service users had bed safety rails, which were fitted with bumpers, but there were no written risk assessments in place for their use and no evidence that the bed rails were checked on a regular basis to make sure that they are functional and safe. There is no call bell system in the small dining room for service users to gain the attention of staff. Dunollie Nursing Home DS0000043116.V280473.R01.S.doc Version 5.1 Page 17 There was a fire risk assessment in place but there was no evidence to show what action had been taken to address the issues that had been identified. The main boiler had been checked and a number of issues were identified but there was no evidence to confirm that his work had been carried out. The following safety certificates were not available to confirm that the following had been tested and was fit for use. Fire Safety Equipment Tests, Passenger Lift Testing Certificate Water Test Certificate for Legionella. There was no evidence to show that the emergency lighting has been tested or that staff had attended fire training. The hall carpet on the corridor of rooms 19 to 22 needs to be replaced. Dunollie Nursing Home DS0000043116.V280473.R01.S.doc Version 5.1 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 and 30 The staffing levels have been increased but the poor recruitment practices and lack of staff training leaves service users at risk. EVIDENCE: The staff met with said that there had been some improvements in the communication systems in the home and that all staff attend the handovers, which keeps them informed about the service users. Care staff are now responsible for keeping care records but some staff don’t always complete the records, as they do not always have the time. The staff rotas showed that the numbers of staff on duty during the day have been increased and further changes are planned to change the shift times for the benefit of the service users. Dunollie is a large home and the accommodation is over 3 floors plus the Garden Wing. To make sure that the service users receive the care and attention they need overnight the staffing levels need to be increased from 3 to 4. A number of staff records were looked at and it was found that the required references has not been taken up, one application form had a gap in employment history and this had not been addressed. The required CRB checks had not been carried out. A copy of a CRB certificate had been accepted and a work permit for another establishment had been accepted. There was no evidence of staff induction and no planned programme for staff training Dunollie Nursing Home DS0000043116.V280473.R01.S.doc Version 5.1 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 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, 32, 36, 37 and 38. Some improvements have been made in the management of the home but a clear plan needs to be produced to show how this is to done in the best interests of the service users. EVIDENCE: The appointed manager of the home is a qualified nurse and has completed the Registered Managers Award. An application to be considered for registration of the appointed manager must be submitted to the Commission. A number of changes in the daily routines, the increase in the numbers of staff on duty and an increase in the social activities have improved the lives of the service users. A staff supervision procedure has been implemented but not all staff have been supervised. To make sure that this process is effective supervision training needs to be made available to all staff. Dunollie Nursing Home DS0000043116.V280473.R01.S.doc Version 5.1 Page 20 Appropriate arrangements have been made to keep records secure but the standard of record keeping needs to improve. There is a health and safety policy and procedure in place and staff said that they have attended health and safety training, including moving and handling, first aid and fire training. A number of the required certificates were not available and appropriate action has not been taken to make sure service users and staff are safe and there was insufficient evidence to show that staff had attended health and safety training. Dunollie Nursing Home DS0000043116.V280473.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 1 X 1 1 3 X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 1 X X 1 X X 1 1 STAFFING Standard No Score 27 1 28 1 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 3 2 X X 2 1 1 Dunollie Nursing Home DS0000043116.V280473.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 4 and 5 Requirement Timescale for action 30/01/06 2 OP3 14(1)(c) (d). 3 OP7 15(1) (2) 4 OP9 13 (1)(b)(2) The registered person is required to provide each service user with a copy of the service user guide to the home. The registered person is required 30/01/06 to keep accurate records of the outcomes of the assessments of service users. To evidence that the outcomes of the assessments have been discussed and agreed with the service users or their representatives. (This requirement is outstanding from the previous inspection.) The registered person is required 30/01/06 to have in place a care plan as to how the service users needs in respect of their health and welfare are to be met. To keep the care plans under regular review. (This requirement is outstanding from the previous inspection.) The registered person is required 30/01/06 to keep make sure service users receive their prescribed medication and to keep accurate DS0000043116.V280473.R01.S.doc Version 5.1 Dunollie Nursing Home Page 23 5 OP18 13(6) 6 OP19 13 (c) 7 8 OP19 OP26 16(2)(c) 16(k) 9 10 OP27 OP29 18(a) 19 11 OP30 18(c) 12 OP31 8 (1) medication administration records. The registered person is required to make arrangements for all staff to attend abuse awareness training and to be conversant with local authorities procedure for reporting abuse issues. (This requirement is outstanding from the previous inspection.) The registered person is required to ensure that all risks to the health and safety of service users are eliminated. To have risk assessments in place for the use of bed safety rails. To install a call bell facility in the small dining room. To have the required safety certificates in place and evidence of the action taken to address areas of risk. The registered person is required to replace the carpet on the corridor outside rooms 19-22. The registered person is required to make arrangements for the large dining room to be cleaned and free from offensive odours. The registered person is required to increase the staffing levels overnight from 3 to 4. The registered person is required to carryout robust recruitment and selection practices and to have the required records in place prior to employment. (This requirement remains outstanding from the previous inspection.) The registered person is required to have a staff training programme in place and to keep a record of all training undertaken. The registered person is required to submit an application for registration of the appointed DS0000043116.V280473.R01.S.doc 30/01/06 30/01/06 30/03/06 30/12/05 30/12/05 30/01/06 30/01/06 30/01/06 Dunollie Nursing Home Version 5.1 Page 24 13 OP37 17 manager to be considered by the Commission. The registered person is required to have the required records in place, up to date and available for inspection. 30/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP11 OP15 Good Practice Recommendations It is recommended that arrangements be made for staff to undertake palliative care training before service users within the category of TI are admitted to the home. It is recommended that arrangements be made for meeting to take place between the appointed manager and the catering staff to discuss the menus to make sure they reflect the dietary needs of the service users. It is recommended that all staff are supervised on a regular basis. 3 OP36 Dunollie Nursing Home DS0000043116.V280473.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Dunollie Nursing Home DS0000043116.V280473.R01.S.doc Version 5.1 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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