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Inspection on 31/01/07 for Elm Lodge Nursing & Residential Home

Also see our care home review for Elm Lodge Nursing & Residential Home for more information

This inspection was carried out on 31st January 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The way the staff manage medication on residents behalf at this home is good. Staff follow systems in the home so that stocks of medication needed by the residents are always in place and stored correctly. Also records show that staff give out the medication as the Doctor has prescribed. This means residents benefit from a level of well being associated with having medication on time and when needed. Staff at this home continue to be good at contacting healthcare professionals if the residents need their help and support. Many residents need advice from speech therapists for example if they are having difficulty with swallowing, and this is arranged for them. So residents benefit from specialist advice in how they should receive the care and support that they need. Many of the residents feel that the staff and volunteers at the home provide a varied activity programme. The home have established links with local schools and religious organisations so residents benefit from maintaining community links. In addition coffee mornings, pub lunches and trips to garden centres also take place. Many residents spoken with said how much they enjoyed these activities, one resident said " l like it when we have entertainment, in fact l look forward to it and its pretty good here".

What has improved since the last inspection?

When the home was last inspected staff had not always made sure that when they helped residents in the toilet or bathrooms that the door was always kept closed. During this inspection they were seen to do this. This is so important to make sure this takes place all the time to maintain the privacy and dignity of every resident.

What the care home could do better:

Some of the areas the home could do better in include the way the home writes about the individual needs of each resident these are called a care plan. The care plans still need to be clearer in the guidance they give to staff on exactly how they should be supporting the residents to meet their needs. This is very important and has to be in place so that all residents receive continuity of care. One example was when a resident had been identified as being at risk of falling, but their care plan did not contain what staff should do to reduce this risk, they must give clearer guidance. Also the information that the staff gather on residents needs before they move into the home also needs to improve. The home does have a document that it uses, but the amount of information written on it was not enough to show all the physical, social and emotional needs of the resident. This is needed so that the home can be clear if they will be able to provide the care and support needed by the resident.

CARE HOMES FOR OLDER PEOPLE Elm Lodge Nursing & Residential Home 18 Stoke Road Linslade Leighton Buzzard Bedfordshire LU7 2SW Lead Inspector Katrina Derbyshire Unannounced Inspection 31st January 2007 10:55 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 Elm Lodge Nursing & Residential Home DS0000017674.V326859.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. Elm Lodge Nursing & Residential Home DS0000017674.V326859.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elm Lodge Nursing & Residential Home Address 18 Stoke Road Linslade Leighton Buzzard Bedfordshire LU7 2SW 01525 371117 01525 854537 elmlodge@hotmail.co.uk 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) Elm Lodge Nursing and Residential Home ** Post Vacant *** Care Home 51 Category(ies) of Dementia - over 65 years of age (26), Old age, registration, with number not falling within any other category (51), of places Physical disability over 65 years of age (51) Elm Lodge Nursing & Residential Home DS0000017674.V326859.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is permitted to accommodate one named service user (ref variation V25634), in the category of PD from 30 September 2005 up to their discharge from the home. That the home is permitted to accommodate two service users under the age of 65 in the categories of PD and DE only. 20th November 2005 2. Date of last inspection Brief Description of the Service: Elm Lodge is an extended Victorian House situated in Linslade on the outskirts of Leighton Buzzard. There are good road links to Milton Keynes, Bedford, Aylesbury and Luton and the centre of Linslade is within walking distance. There is parking available at the home and it is set in attractive grounds. The home can provide residential or nursing care depending on the assessed needs of residents. There are 49 single rooms and 1 room that can be used for shared occupancy providing a total of 51 places. There are 12 rooms with en-suites and various communal facilities including 6 separate lounges, dining areas, bathrooms and toilets located throughout the home. As the home has been converted and extended, the accommodation ranges across different floors and there is lift access to all areas. The fees for this home vary from £397.00 per week for residential placements, to £546.00 per week. Elm Lodge Nursing & Residential Home DS0000017674.V326859.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was to undertake a key inspection. This unannounced inspection was carried out on 31st January 2007. The manager Mrs. Lyn Searle was present throughout the inspection. During the inspection areas of the home were visited and the inspector spent time with residents’ mainly in the ground floor sitting area of the home. The care of four residents’ was examined by looking at their records and interviewing the residents’ and staff who look after them. The views of residents and their feedback have been used alongside information from the home to assess the outcomes within each standard alongside documentary evidence provided by the home. Evidence used and judgements made within the main body of the report include information from this visit. Observations of care practice and communication between the residents’ and staff was also made at the inspection. The focus of this inspection was to look at the key standards and to follow up on previous requirements. What the service does well: The way the staff manage medication on residents behalf at this home is good. Staff follow systems in the home so that stocks of medication needed by the residents are always in place and stored correctly. Also records show that staff give out the medication as the Doctor has prescribed. This means residents benefit from a level of well being associated with having medication on time and when needed. Staff at this home continue to be good at contacting healthcare professionals if the residents need their help and support. Many residents need advice from speech therapists for example if they are having difficulty with swallowing, and this is arranged for them. So residents benefit from specialist advice in how they should receive the care and support that they need. Many of the residents feel that the staff and volunteers at the home provide a varied activity programme. The home have established links with local schools and religious organisations so residents benefit from maintaining community links. In addition coffee mornings, pub lunches and trips to garden centres also take place. Many residents spoken with said how much they enjoyed these activities, one resident said “ l like it when we have entertainment, in fact l look forward to it and its pretty good here”. Elm Lodge Nursing & Residential Home DS0000017674.V326859.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Elm Lodge Nursing & Residential Home DS0000017674.V326859.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 Elm Lodge Nursing & Residential Home DS0000017674.V326859.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&6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The information collect on residents needs prior to their admission, is not always sufficient for the home to make an informed decision on whether they can meet the resident’s needs. EVIDENCE: On examination of pre admission records of residents selected for case tracking, a standard format was seen to be in place. Headings were seen to include the physical, social and emotional needs, however the actual entries made within these sections was not sufficient to make clear all the needs of the residents. One example was that no entry had been made to indicate the social needs of the residents or their specific likes and dislikes. Discussion was held with the manager regarding this and a requirement is made that full information must be gathered prior to the admission of all residents. In Elm Lodge Nursing & Residential Home DS0000017674.V326859.R01.S.doc Version 5.2 Page 9 addition these must then directly link with the care plans. The home should consider keeping all these documents together as they should be used by all staff in the delivery of care to the residents. Intermediate care is not offered. Elm Lodge Nursing & Residential Home DS0000017674.V326859.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 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The medication at this home continues to be well managed promoting better health for the residents. EVIDENCE: Care plans in the main were in place for each assessed need and were kept in ring binder folders in the manager’s office. However as described in the choice of home section these need to be directly linked to the assessment of needs undertaken prior to the admission of the resident. Improvements were noted however further development is still needed. One example was that a resident had been prescribed a high calorie drink, but the care plan did not state which one, how much and when it should be given or if the residents intake should be monitored. Consideration also needs to be given to allowing easier access to Elm Lodge Nursing & Residential Home DS0000017674.V326859.R01.S.doc Version 5.2 Page 11 these records for staff to ensure they are used throughout the day by the staff at the home. Residents spoken with confirmed that they could see their General Practitioner when needed. At the time of this visit a General Practitioner was visiting the home to undertake a review of residents medication alongside the manager to ensure that residents were being prescribed the correct medication. Documentary evidence was also seen that residents had received treatment from services such as chiropody and opticians. Assessment of risk in relation to nutritional needs and skin integrity had also been undertaken by staff at the home for the residents. Equipment was also seen to be in place including pressure relieving mattresses and these were noted to be set correctly in accordance with the residents needs. Feedback received from residents through comment cards indicated that they felt that their privacy was maintained in the home. A requirement had been made at the previous inspection relating to staff assisting two residents to the toilet and not closing the door. During this visit it was observed that all staff who assisted residents in this way ensured that the doors remained closed. As previously assessed the medication systems in the home were organised and promoted safe practice. The receipt and storage of medication was secure, and the administration of all medicines was seen to follow current best practice guidelines. Registered nurses are responsible for the administration of medicines and receive regular training updates, which are certificated. All returns are receipted and records were up to date and accurate. However the home should reduce the amount of stock that it keeps and this was discussed with the manager at this visit. Elm Lodge Nursing & Residential Home DS0000017674.V326859.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents at this home feel that arrangements in place for activities are good and meet their social needs. EVIDENCE: Several residents spoke of the activities available to them in the home and one resident commented “ l like the bingo”. Information supplied by the home to the Commission for Social Care Inspection showed that activities arranged in the home included picnics, church services and visiting professional singers. The Bedfordshire library service also visits the home and residents said that a volunteer at the home would visit regularly and would offer quizzes. Several residents during this inspection were seen to receive visitors. A family member of one resident said “ we find the staff in this part of the home very helpful and they make us feel welcome”. Residents spoken to spoke of being able to receive visitors when they wished and many would chose to see them in the privacy of their own rooms. The manager confirmed that the home Elm Lodge Nursing & Residential Home DS0000017674.V326859.R01.S.doc Version 5.2 Page 13 continued to invite relatives and friends to certain events that the home organised. Entries were also seen within residents records that demonstrated that the staff at the home would contact residents nominated next of kin if there had been a change in their well being, one example of this was following an accident and the contact details had been recorded by the staff member. Options available to residents in maintaining control, independence and choices in their lives included, choice of meals, voting, choice of clothing, access to a complaints procedure and access to community healthcare support. Residents and records confirmed that the choices associated with people’s daily lives were available to them whilst living in this home. The views of the residents received through return comment cards to the Commission for Social Care Inspection regarding the catering in the home was in the main complimentary. At this visit residents were seen to be given a choice at lunchtime, the options available reflected the information detailed on the menus at the home. Protein, carbohydrates and vegetables were noted to be offered daily providing a balanced diet. Elm Lodge Nursing & Residential Home DS0000017674.V326859.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems in place at this home for receiving and investigating complaints is good so residents are assured that their concerns will be acted upon. EVIDENCE: The homes complaints procedure was seen to be displayed in the home, it gave timescales on when the complainant would receive a response and to whom you could complain to. Information received by the Commission for Social Care Inspection in 2006 was investigated by the home. The records supplied demonstrated that the home had been methodical in their investigation and responded within the timescales outlined in their own procedure. Residents views received by the Commission for Social Care Inspection through return comment cards indicate that the residents are aware of their right to complain, and feel that if they needed to they would be comfortable to doing so. Records supplied by the home to the Commission for Social Care Inspection show that staff had undertaken training in the protection of vulnerable adults. On interviewing staff they demonstrated a good level of knowledge on the Elm Lodge Nursing & Residential Home DS0000017674.V326859.R01.S.doc Version 5.2 Page 15 types of abuse including physical and psychological. In addition the homes procedure in this area was examined, its content however did not reflect the local guidance and no copy of this was at the home. Through discussion it was confirmed that the home had sought to gain a copy of this and had been unsuccessful. The management and staff at the home did demonstrate an understanding of the need to refer any allegation or suspected abuse therefore this standard has been assessed as being met although a requirement will still be made to secure the local guidance. Elm Lodge Nursing & Residential Home DS0000017674.V326859.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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of accommodation at this home is sufficient to provide a comfortable environment for the residents to live in. EVIDENCE: Several communal areas, toilets, bathrooms and residents individual rooms were seen at this visit. All the areas visited were clean and free of any odours. Residents rooms contained seating, small tables and facilities for washing alongside containing personal effects for example ornaments and photographs. In the large lounge area of the home, many residents remain seated in their armchairs to eat their meals and a small table is supplied for them to use. A Elm Lodge Nursing & Residential Home DS0000017674.V326859.R01.S.doc Version 5.2 Page 17 limited amount of designated dining space is available in this area and on the lower level of the home. In the main the home was seen to be decorated to an acceptable standard, however there are areas that require redecoration, one example was some of the toilet areas and was discussed with the manager at the end of this visit. Clinical waste was seen to be disposed of by an appropriate contractor and hand washing facilities were sited throughout the home. Elm Lodge Nursing & Residential Home DS0000017674.V326859.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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The recruitment procedures at the home continue to be robust and help protect the residents. EVIDENCE: The homes recruitment policy and procedures as previously assessed are clear and comprehensive, documents submitted by the home to the Commission for Social Care Inspection show that no change has taken place to these policies. References are taken prior to staffs’ commencement and the relevant Criminal Records Bureau check is also carried out and evidence of this having been undertaken was seen. Certificates of qualifications are present within staff files. The residents at the home are supported by a team of qualified nurses, care assistants, catering, housekeeping and administration staff. The rotas supplied by the home show that there are sufficient numbers of staff on duty throughout the day and night to meet the needs of the residents at this time. Residents confirmed that staff were available to help and assist them when they need help. Elm Lodge Nursing & Residential Home DS0000017674.V326859.R01.S.doc Version 5.2 Page 19 Training records examined that were supplied by the home show that staff had undertaken statutory training, including moving and handling, fire safety and food hygiene. In addition staff confirmed that they had attended a variety of courses including dementia awareness. Residents spoken with felt that the staff had a satisfactory level of knowledge and felt confident in their abilities to meet their needs. Staff were questioned on the individual needs of some of the residents, through this they demonstrated a good level of understanding of the needs of the residents. One staff member had an exceptional level of knowledge relating to one resident, and was able to describe their individual likes, dislikes, family history and the level of care and support needed. Elm Lodge Nursing & Residential Home DS0000017674.V326859.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 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health and safety in the home continues to be managed well and protects the residents from harm. EVIDENCE: All the staff spoken with at this visit spoke highly of the manager. They felt that she was approachable and would always listen if they had any concerns and felt that she always aimed to put the needs of the residents first and would look at ways to improve the standard of care. Residents also spoke favourably of her approach and found her to be “ warm and caring”. Discussion Elm Lodge Nursing & Residential Home DS0000017674.V326859.R01.S.doc Version 5.2 Page 21 was held with the manager at this visit and the need for her to now submit an application to the Commission for Social Care Inspection for the Registered manager. Documentary evidence was seen that showed that the home had undertaken a survey to gain the views of residents and their representatives. Where areas had been raised the staff at the home had taken action to remedy this and make improvements for example the laundering of clothes. Small amounts of monies were managed by the home on behalf of residents and written records of this were seen. Balances that were checked were noted to be correct. The home must however ensure that individual receipting is available for services such as hairdressing so that a clearer audit trail is in place. Health and safety records maintained by the home show that safety checks are carried out to ensure equipment in the home is kept in good working order. Copies of the most recent inspections undertaken by the fire service and environmental health were seen and evidence was also seen that work had been undertaken in response to any recommendations made. Where staff were seen to assist residents in moving during this visit, the transfer was noted to follow safe practice for both the residents and staff. In addition staff training records and staff themselves confirmed that they receive regular health and safety training one example was fire safety. Elm Lodge Nursing & Residential Home DS0000017674.V326859.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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Elm Lodge Nursing & Residential Home DS0000017674.V326859.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14(1) Requirement A comprehensive assessment must be undertaken prior to an admission of a resident that then links into the care planning so that residents know if the home will be able to meet their needs in full. Care plans must contain sufficient guidance and instructions to staff on the support and care that they should provide. (Previous requirement timescale of 28/02/06 not met) Timescale for action 30/04/07 2. OP7 12(1a) & 15 30/04/07 3. OP18 13(6) 4. OP19 23(2)(d) The home must secure the local 31/03/07 policy on the protection of vulnerable adults to ensure all suspected incidences of abuse are investigated as outlined within the policy. Redecoration must be 31/05/07 undertaken in areas such as the toilets on the higher level floor to ensure residents have a pleasant environment in which to live. Elm Lodge Nursing & Residential Home DS0000017674.V326859.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 OP2 Good Practice Recommendations Consideration should be given that all care records be kept together to ensure they are used by staff in their daily duties at the home. These include assessments, care plans, daily records and risk assessments. The home should reduce the amount of stock that it holds for some medication; they should only have sufficient stock in place for the current prescribing period. 2. OP9 Elm Lodge Nursing & Residential Home DS0000017674.V326859.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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 Elm Lodge Nursing & Residential Home DS0000017674.V326859.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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