CARE HOMES FOR OLDER PEOPLE
Five Gables Nursing and Residential Home 32 Denford Road Ringstead Kettering Northants NN14 4DF Lead Inspector
Kim Cowley Unannounced Inspection 24th April 2008 11:00 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 Five Gables Nursing and Residential Home DS0000012614.V363004.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. Five Gables Nursing and Residential Home DS0000012614.V363004.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Five Gables Nursing and Residential Home Address 32 Denford Road Ringstead Kettering Northants NN14 4DF 01933 460414 01933 622807 fivegablesnh@aol.com 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) Jade County Care Homes Limited Darren McGregor Care Home 43 Category(ies) of Dementia (43), Old age, not falling within any registration, with number other category (43) of places Five Gables Nursing and Residential Home DS0000012614.V363004.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The registered provider may provide the following category of service: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary needs on admission to the home are within the following categories: Old age, not falling into any other category - Code OP Dementia - Code DE The maximum number of service users who can be admitted to the home is: 43. 3rd May 2006 2. Date of last inspection Brief Description of the Service: Five Gables Residential Care and Nursing Home can accommodate up to 43 older people, some of who have dementia and/or physical disabilities. The home is situated in the rural village of Ringstead. Residents are accommodated in one of three units depending on their needs. The Villa, at the rear of the property, caters for mainly nursing residents, and has a small dementia unit within it. The Lodge, at the front of the property, accommodates those needing residential care only. The Villa, dementia unit, and most areas of the Lodge are accessible to people with limited mobility. The grounds include a car park, mature gardens, and patio areas. The fees range from £380 to £400 per week. Further information about the home is available from the Registered Manager. Five Gables Nursing and Residential Home DS0000012614.V363004.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes.
This was a key inspection that included a visit to the home and inspection planning. Prior to the visit, we (throughout the report the use of ‘we’ indicates the Commission for Social Care Inspection) spent half a day reviewing information relating to the home. During the course of the inspection, which lasted five hours, we checked the ‘key’ standards as identified in the National Minimum Standards. This was achieved through a method called case tracking. Case tracking means we looked at the care provided to three residents living at the home by meeting them; talking with the staff who support their care; checking records relating to their health and welfare; and viewing their personal accommodation as well as communal living areas. Other issues relating to the running of the home, including health and safety and management issues, were examined. We also talked to six other residents, the Manager, Deputy, one nurse and one carer. What the service does well:
Five Gables is homely and comfortable. The lounges are spacious and the bedrooms individually decorated and unique to their occupants. One resident told us, ‘I brought all my favourite furniture with me and when I’m in my room I feel I am still at home.’ Another said, ‘Five Gables looks like a real home inside.’ All the areas we inspected were clean, tidy and fresh. The home has a relaxed and sociable atmosphere. During the inspection, once lunch was over, staff had time to sit with residents and talk to them on a one to one basis, or join in group discussions. One resident said, ‘I like sitting in the lounge chatting to all the other residents and the staff.’ Another told us, ‘It’s free and easy here.’ Residents in the dementia unit, within the Villa, take part in activities specially designed for them. These include using tactile ‘picture boards’ which help them to reminisce and orientate themselves. The dementia unit is peaceful and the views over the garden from the main lounge contribute to this. Five Gables Nursing and Residential Home DS0000012614.V363004.R01.S.doc Version 5.2 Page 6 Visitors are welcome at the home at any time and can see residents in one of the lounges, or in their rooms. Representatives from a local church and children from a nearby school visit. This helps residents to feel part of the local community. Lunch was served during the inspection and consisted of chicken casserole and Eve’s pudding, with a range of alternatives available. Dining tables were nicely set out with fresh daffodils from the garden on each one. Food is mostly home made and menus showed a healthy and varied diet being provided. The home has an established staff team of experienced nurses and carers. Staffing levels are good which means staff have the time to focus on residents’ quality of life as well as their personal and health care needs. All the residents we talked to praised the staff and the following comments were made, ‘If I need someone, someone always comes’, ‘The staff are very helpful’, and ‘The staff are patient and do a marvellous job.’ What has improved since the last inspection? What they could do better:
Care plans relating to challenging behaviour were either not in place, or lacking in detail. These need to be reviewed and improved to ensure all residents’ needs are identified and met. Some areas of the Lodge need redecorating and floor coverings in communal areas need replacing. This will improve the environment for residents. Five Gables Nursing and Residential Home DS0000012614.V363004.R01.S.doc Version 5.2 Page 7 The laundry is insufficient for the size of the home and there are no designated laundry staff. This has led to clothes being lost or damaged and delays in residents getting their washing done. Action is needed to resolve this problem so residents’ linen and clothing are regularly and effectively laundered. There are a number of hazards in the grounds of the home that could put residents at risk. An Immediate Requirement (a notice that must be complied with within a set timescale, in this instance 24 hours) was issued for the garden and other outside areas to be risk assessed and action taken, where necessary, to improve safety. (Following the inspection to Manager notified us in writing that this has been done.) 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. Five Gables Nursing and Residential Home DS0000012614.V363004.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Five Gables Nursing and Residential Home DS0000012614.V363004.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Residents’ needs are assessed prior to admission to ensure the home is suitable for them. This judgement has been made using available evidence including a visit to this service. (Standard 3 was inspected.) EVIDENCE: People coming to Five Gables are accommodated in either the Villa, the dementia unit within the Villa, or the Lodge, each of which caters for slightly different needs. When they are assessed consideration is given to which part of the home would be suitable for them. The Manager, or a senior nurse, visits them in their homes or in hospital to carry out assessments. During the assessment prospective residents and those close to them have the opportunity to discuss their care needs, and ask questions about the home. This helps to ensure they are involved in the admission process and are able to make an active choice about coming to the home. Prospective residents and their relatives/carers are also encouraged to visit the home prior to moving. The Manager said, ‘We show them all vacant rooms and
Five Gables Nursing and Residential Home DS0000012614.V363004.R01.S.doc Version 5.2 Page 10 allow residents and their families the a choice of accomodation. The buidings are divided into into units that offer nursing, dementia and residential care so residents have a choice of accomodation to meet their needs.’ Most residents we spoke to said they had had some say in coming to the home. One said ‘I looked at two homes and chose this one because I liked the Manager.’ Those who had not made the choice themselves said their relatives had made it for them because they were in hospital and unable to visit to look round. One resident told us she was made welcome when she moved in. She commented, ‘I settled down straight away once I moved in because everyone was so friendly.’ Standard 6 was not inspected, as this home does not provide intermediate care. Five Gables Nursing and Residential Home DS0000012614.V363004.R01.S.doc Version 5.2 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Staff in the home, and in the wider community, meet residents’ health and personal care needs. This judgement has been made using available evidence including a visit to this service. (Standards 7, 8, 9, and 10 were inspected.) EVIDENCE: We looked at a range of care plans and risk assessments. These were generally of a good standard. However care plans relating to challenging behaviour (regarding, for example, continence and ‘wandering’) were either not in place, or lacking in detail. The Manager agreed to review care plans and improve them where necessary. This will ensure that residents’ needs are identified and met. Residents are well supported by local health care professionals. They are registered with three local GP surgeries and staff at these, including district nurses, visit residents and advise staff when necessary. In addition residents are referred to specialist health care professionals, including Macmillan nurses, a falls co-ordinator, a continence advisor, and a Parkinson’s nurse. Five Gables Nursing and Residential Home DS0000012614.V363004.R01.S.doc Version 5.2 Page 12 Nurses, or care staff who have been trained by the home’s contract pharmacist, administer medication. The Manager or Deputy checks the medication records every week to ensure they are accurate and up to date. Residents who are able to are encouraged to self-medicate, following a satisfactory risk assessment, as this helps them to maintain their independence. During the inspection we observed staff treating residents in a respectful and courteous manner. One resident told us, ‘The staff are very kind. They ask us nicely if we’d like to do things.’ Five Gables Nursing and Residential Home DS0000012614.V363004.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): Quality in this outcome area is good. Residents’ social and cultural needs are identified and met. This judgement has been made using available evidence including a visit to this service. (Standards 12, 13, 14, and 15 were inspected.) EVIDENCE: The post of full time activities co-ordinator is currently vacant and the Manager is advertising for a new member of staff to carry out this role. Until then regular activites are still being organised, including visiting entertainers, aromoatherapy, hairdressing, and exercise to music. One resident told us, ‘We have armchair exercise classes and I have a go. It keeps you young.’ The home has a sociable atmosphere and there is a range of lounges so residents can choose where they sit. During the inspection, once lunch was over, staff had time to sit with residents and talk to them on a one to one basis, or join in group discussions. One resident said, ‘I like sitting in the lounge chatting to all the other residents and the staff.’ Residents in the dementia unit, within the Villa, take part in activities specially designed for them. These include using tactile ‘picture boards’ which help them to reminisce and orientate themselves. The dementia unit has a peaceful atmosphere and the views over the garden from the main lounge contribute to
Five Gables Nursing and Residential Home DS0000012614.V363004.R01.S.doc Version 5.2 Page 14 this. It also has high staffing levels, so staff can give residents one to one attention when they need it. Visitors are welcome at the home at any time and can see residents in one of the lounges, or in their rooms. Representatives from a local church and children from a nearby school visit. This helps residents to feel part of the local community. Lunch was served during the inspection and consisted of chicken casserole and Eve’s pudding, with a range of alternatives available. Dining tables were nicely set out with fresh daffodils from the garden on each one. Food is mostly home made and menus showed a healthy and varied diet being provided. Residents’ comments about the food included: ‘The food’s good, there’s nothing wrong with it at all.’ ‘In the evening we have sandwiches but I don’t like them so I have jacket potatoes instead.’ ‘I generally get what I want. They do make an effort.’ ‘They cook the food nicely. We once had meat that was too tough but that only happened once.’ ‘We had chicken casserole today and it was very nice.’ Two residents told us they would like more spicy food. This was reported to Manager who said the menus were currently being reviewed, in consultation with residents, and this information would be added. Five Gables Nursing and Residential Home DS0000012614.V363004.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): Quality in this outcome area is good. Residents and their representatives are encouraged to talk to staff about any concerns they might have. This judgement has been made using available evidence including a visit to this service. (Standards 16 and 18 were inspected.) EVIDENCE: We have received two complaints about this service since the last inspection. The first was referred to the Provider and records showed it was properly addressed with a written response being sent to the complainant. The second, which prompted this inspection, mainly concerned the environment (see Standards 19 to 26). We found the Manager open and helpful when complaints were put to him. He was willing to admit that the staff and management don’t always get things right, and was keen to address complaints so he could bring about improvements to the home. He said residents and relatives could come to him at any time if they had complaints, or could make their views known at residents’ and relatives’ meetings or through the home’s annual ‘quality assurance’ surveys. In addition the complaints procedure is posted throughout the home and all residents and their representatives are given a copy of this. Having a variety of ways of raising concerns helps residents and their representatives to feel confident about letting staff know if there is anything they’re not happy about. Five Gables Nursing and Residential Home DS0000012614.V363004.R01.S.doc Version 5.2 Page 16 The Manager is knowledgeable about his and his staff’s role in safeguarding residents. Staff are trained in safeguarding during their induction and ongoing training at a local college is also provided. The Manager said staff would follow the guidance given to them from the local authority should a safeguarding issue arise. A copy of this guidance is kept in the Manager’s office and regularly discussed at staff meetings so staff know what their responsibilities are. Five Gables Nursing and Residential Home DS0000012614.V363004.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is adequate. The premises are homely and comfortable, but some areas are in need of refurbishment, the grounds need risk assessing, and the laundry is not providing an effective service. This judgement has been made using available evidence including a visit to this service. (Standards 19 and 26 were inspected.) EVIDENCE: Five Gables is homely and comfortable. The lounges and dining areas are spacious and overlook the gardens. All the bedrooms we saw were individually decorated and unique to their occupants. One resident told us, ‘I brought all my favourite furniture with me and when I’m in my room I feel I am still at home.’ Another said, ‘Five Gables looks like a real home inside.’ On the day of inspection all the areas we inspected were clean, tidy and fresh. Cleaners are employed in the Villa seven days a week, and in the Lodge four days a week (on other days the Lodge care staff do the cleaning). All the residents we talked said they were pleased with the cleanliness of the home and they made the following comments:
Five Gables Nursing and Residential Home DS0000012614.V363004.R01.S.doc Version 5.2 Page 18 ‘If you spill something they clean it up straight away and there’s never a smell in here.’ ‘It’s nice and clean here.’ ‘I have no complaints about the cleanliness.’ ‘Two cleaners come in (to the Lodge) a few times a week. They do a good job.’ Improvements have been made to the Villa since the last inspection. New carpets have been laid, bathrooms refurbished to make them more accessible to residents with physical disabilities, and nursing beds purchased for residents to increase their comfort. Most rooms have also been redecorated and the Villa now provides a bright and pleasant environment for residents. The dementia unit, within the Villa, is designed to provide a safe and stimulating environments for residents. There are displays of pictures and familiar objects, and each bedroom door is decorated with something unique to the resident whose room it is. This helps confused residents find their way around and feel at home. The Villa and the dementia unit are well maintained and in good decorative order. However the Lodge, which opened since the last inspection, is in need of improvement. The carpet tiles in communal areas are worn and stained (although clean). In some places they are coming loose and there is a risk someone might trip up on them. These must be replaced. In addition, communal areas and some of the bedrooms are shabby and need redecorating to bring them up to the standard of the rest of the home. The laundry is also posing problems for residents and staff. It is insufficient for the size of the home, as only one washing machine can be on at any time due to difficulties with the electricity supply. In addition there are no designated laundry staff, meaning cleaners and carers have to fit in laundry duties with their other work. This situation has led to clothes being lost or damaged and delays in residents’ getting their washing done. Action must be taken to resolve this problem so residents’ linen and clothing are regularly and effectively laundered. During the inspection we saw there were a number of hazards in the grounds of the home that could put residents at risk. These included small walls with drops behind them, and steps. An Immediate Requirement (a notice that must be complied with within a set timescale, in this instance 24 hours) was issued for the garden and other outside areas to be risk assessed and action taken, where necessary, to improve safety. (Following the inspection to Manager notified us in writing that this has been done.) Five Gables Nursing and Residential Home DS0000012614.V363004.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is good. An established staff team meets residents’ needs. Relationships between staff and residents are warm and caring. This judgement has been made using available evidence including a visit to this service. (Standards 27, 28, 29, and 30 were inspected.) EVIDENCE: Five Gables has an established staff team, most of whom are experienced nurses and carers. Staffing levels are good which means staff have the time to focus on residents’ quality of life as well as their personal and health care needs. All the residents we talked to praised the staff team and the following comments were made: ‘If I need someone, someone always comes.’ ‘The staff are very helpful.’ ‘We’ve got good staff.’ ‘The staff are patient and do a marvellous job.’ Recruitment procedures were discussed with the Manager. He told us that, in order to safeguard residents, all staff are subject to CRB and POVA checks, and references are obtained. The staff at Five Gables are well trained and supervised. Most are qualified nurses or have NVQs (National Vocational Qualifications) in Care. One carer told us, ‘We have a friendly staff team and lots of training opportunities. I’ve gained some new qualifications since I’ve been here.’ The training and
Five Gables Nursing and Residential Home DS0000012614.V363004.R01.S.doc Version 5.2 Page 20 supervision offered at Five Gables helps to ensure that staff have the support they need to do their jobs well. Five Gables Nursing and Residential Home DS0000012614.V363004.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is good. The home is well run in the best interests of residents by an experienced Manager. This judgement has been made using available evidence including a visit to this service. (Standards 31, 33, 35, and 38 were inspected.) EVIDENCE: Since the last inspection a new Manager has been appointed at Five Gables. He is a qualified and experienced nurse who has recently completed the Registered Managers Award (a recognised qualification for people who run care homes). We found him to be a ‘hands-on’ Manager who gets on well with the residents and goes out of his way to spend time with them. He told us, ‘The first thing I do on a Monday morning when I come into work is to go and talk to the residents because they know best what’s going on at Five Gables.’ All the residents we spoke to said they found the Manager to be approachable and helpful. One commented, ‘I like the Manager – he comes and talks to us.
Five Gables Nursing and Residential Home DS0000012614.V363004.R01.S.doc Version 5.2 Page 22 ’The Manager has a full-time Deputy who takes charge when he is away so the home always has management cover. Residents and their representatives have the opportunity to fill in an annual survey about the home. Staff distribute this and there are questions on food, the environment, and social activities. It is recommended that questions on staff and the care provided are added, so residents/relatives are prompted to comment on all aspects of the home. Since the last inspection the kitchen has been refurbished on the advice of the home’s Environmental Health Officer. Five Gables Nursing and Residential Home DS0000012614.V363004.R01.S.doc Version 5.2 Page 23 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 X 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 2 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 2 Five Gables Nursing and Residential Home DS0000012614.V363004.R01.S.doc Version 5.2 Page 24 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 OP7 Regulation 15(1) Requirement Timescale for action 24/05/08 2 OP19 16(2)(c) 3 OP19 13 (4) 4 OP26 16(1)(e) Care plans relating to challenging behaviour were either not in place, or lacking in detail. These must be reviewed and improved to ensure that residents’ needs are identified and met. The carpet tiles in communal 24/07/08 areas in the Lodge must be replaced as they are worn, stained, and potentially a tripping hazard. This will improve the environment and increase resident safety. The garden and other outside 25/04/08 areas must be risk assessed and action taken where necessary, to improve safety. This will help to reduce the risk of accidents. An efficient laundry service must 24/07/08 be put in place so residents’ linen and clothing are regularly and effectively laundered. Five Gables Nursing and Residential Home DS0000012614.V363004.R01.S.doc Version 5.2 Page 25 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 OP19 OP33 Good Practice Recommendations Communal areas and some of the bedrooms in the Lodge are shabby and should be redecorated to bring them up to the standard of the rest of the home. The residents/relatives annual survey should include questions about the staff and the care provided so respondents are prompted to comment on all aspects of the home. Five Gables Nursing and Residential Home DS0000012614.V363004.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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
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