Inspection on 16/07/07 for Folkestone Nursing Home

This inspection was carried out on 16th July 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Folkestone Nursing Home 02/05/08

Folkestone Nursing Home 07/01/08

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

CARE HOMES FOR OLDER PEOPLE Folkestone Nursing Home 25 Folkestone Road East Ham London E6 6BX Lead Inspector Sarah Greaves Unannounced Inspection 16th July 2007 02:00 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 Folkestone Nursing Home DS0000068609.V345414.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. Folkestone Nursing Home DS0000068609.V345414.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Folkestone Nursing Home Address 25 Folkestone Road East Ham London E6 6BX 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) 020 8548 4310 020 8472 5076 folkestonenursinghome@hotmail.co.uk Folkestone Nursing Home Edna Pearlina Kumi Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43) of places Folkestone Nursing Home DS0000068609.V345414.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Not Applicable Brief Description of the Service: Folkestone Nursing Home is a 43- bedded care home for older people. The service provides general nursing care, general residential care and residential care for people with dementia. The care home occupies a three storey purpose built premises in a residential street. The building has a lift. Folkestone Nursing Home can be accessed by bus and there are car parking spaces for visitors. Folkestone Nursing Home DS0000068609.V345414.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection of this service since the care home was registered in January 2007. The inspector was informed that residents have been moving in since June 2007; at the time of this inspection there were nine people living at Folkestone Nursing Home. Two people were receiving nursing care, four people were permanently admitted for general residential care and the remaining three residents were staying at the care home for residential respite care. The inspector gathered information through speaking to the residents and joining four residents for their evening meal. The inspector also spoke to nursing and care staff, and the registered manager. Two care plans were read during this inspection, and the storage and administration of medication was checked. The inspector also looked at policies, procedures, health and safety documents and toured the premises. What the service does well: What has improved since the last inspection? Not applicable as this is the first key inspection by the Commission for Social Care Inspection. Folkestone Nursing Home DS0000068609.V345414.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Folkestone Nursing Home DS0000068609.V345414.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 Folkestone Nursing Home DS0000068609.V345414.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): 1,3 and 5. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People are provided with suitable information about the service and their care needs are appropriately assessed; however, the service needs to more actively promote opportunities for pre-admission visits. EVIDENCE: The inspector was provided with copies of the Statement of Purpose and the Service Users Guide. It was noted that there was a typing error regarding the registered manager’s qualifications, which was discussed during the course of the inspection. The home states that ‘every person will get a nurse who will look after him or her’; the inspector was not clear how that statement applied to people admitted for residential (non-nursing) care. The inspector noted that a statement regarding confidentiality did not advise prospective residents that Folkestone Nursing Home DS0000068609.V345414.R01.S.doc Version 5.2 Page 9 there might be circumstances in which it will be necessary to breach an individual’s confidentiality in order to safeguard their welfare. At the time of this inspection, all of the residents had been placed at the home via the involvement of their local social services. Residents had received comprehensive assessments of their health and social care needs prior to moving in, which were conducted by appropriate external professionals. The home also undertook its own assessment in order to ensure that the needs of individuals can be met. The two care plans read by the inspector indicated that staff at the care home used these assessments as a basis for developing care plans. Via discussion with the registered manager, the inspector was informed that some of the residents had not visited the home prior to moving in, but their relatives had looked around on their behalf. The registered manager stated that the home encouraged all prospective new residents to visit but this did not always occur due to the relatives stating that there were transport problems and/or a person being considered too frail to make a visit. At the time of this inspection seven out of the nine residents were assessed to require residential care, therefore the inspector would have anticipated that a greater number of people would not have experienced limitations due to frailty or lack of suitable transport. The registered manager is recommended to monitor this situation, liaising with the placing authorities where necessary in order to facilitate previsits to the service and recording any circumstances that have prevented prospective residents from visiting. The home’s Statement of Purpose reports that service would like prospective residents to ideally spend a whole day at Folkestone House, preferably with an overnight visit. It is acknowledged that some residents might refuse an invitation to undertake a pre-visit. Standard 6 was not applicable for assessment, as the service does not offer intermediate care. Folkestone Nursing Home DS0000068609.V345414.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 and 11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The health care needs of residents were addressed in their care plans, although the home needed to demonstrate more rigorous approaches to recording information relating to peoples’ weight, and to ‘end of life’ care. The home needs to ensure that podiatry health care needs are addressed, and some improvements are required to the home’s management of medication. EVIDENCE: The inspector read two care plans. Due to the fact that residents were very newly admitted, it was not possible to assess how effectively the service reviewed the care planning objectives. The format of the care plans appeared appropriate for the health and social care needs of older people. The inspector noted that the care plans contained nutritional risk assessments that included prompts for staff to record whether a resident had lost or gained weight. Folkestone Nursing Home DS0000068609.V345414.R01.S.doc Version 5.2 Page 11 However, there was no recognised clinical tool (for example, the Body Mass Index chart) to determine whether an individual’s weight was of concern. The inspector was informed that arrangements had been made for the medical needs of residents to be met by a local practice of General Practitioners. It was observed that one of the residents needed podiatry care. The inspector was concerned to be informed by the registered manager that this person could not access a podiatrist as they had been placed at the home from a borough in North London. There was no recorded information within this person’s care plan to demonstrate that appropriate measures had been taken, such as contacting the local Primary Care Trust podiatry manager for guidance, informing the social worker and discussions with the resident (and their representatives, if applicable) to see if they wished to pursue privately purchased podiatry care as a temporary or permanent option. The registered manager reported that the continuing care nurses from the Primary Care Trust were undertaking their assessment and monitoring role for the residents admitted for nursing care. The inspector checked the home’s storage and administration of medication. It was noted that a label for a prescribed medication had been altered by biro pen. Staff were not able to explain who had made this alteration and the reason. The medication was prescribed for a resident who had transferred to Folkestone Nursing Home from a Newham Primary Care Trust (PCT) unit for older people. The inspector requested to see the discharge letter from the PCT unit and was informed that the unit had not sent a discharge letter. The inspector contacted the PCT unit and was informed that it was their policy to send discharge letters. The registered manager was advised that omissions of essential information need to be followed up, and the home needed to verify and document that they were giving the correct dosage of medication. The inspector observed that the care home was using a British National Formulary (BNF) medications guide that was dated March 2003. The registered manager was recommended to provide a current BNF guide, which should be changed annually. The inspector found that the care plans contained information as to whether residents wished to be resuscitated or not. It was noted that one of these documents had been signed by a staff nurse, but not by the resident, General Practitioner or next of kin. The registered manager was advised of the need to ensure that such decisions were demonstrated to have been met in a fully inclusive and responsible manner. Folkestone Nursing Home DS0000068609.V345414.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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offered residents opportunities to engage in activities and maintain links with the community. However, the scope of available entertainments and social pursuits was limited and is expected to increase as the home becomes more established. The food service was good, although the menu plans needed more details. EVIDENCE: Via discussions with the registered manager and some of the residents, the inspector was informed that the home offered activities such as playing bingo, listening to music, manicures, going for walks and visits from the hairdresser. Some residents liked to read and were able to receive their chosen newspapers. The registered manager stated that the home proposed to offer a wider range of activities once more residents had moved in; these activities would be planned in accordance to the preferences of the residents. Folkestone Nursing Home DS0000068609.V345414.R01.S.doc Version 5.2 Page 13 The home offered a flexible visiting policy. During this inspection there were no visitors at the premises, although residents told the inspector that their visitors were welcomed. The home’s Service User Guide stated that people would be supported to attend religious services in the community; at the time of this inspection none of the residents wished for this assistance. A number of the residents were unable to explain to the inspector about the choices that they made due to their cognitive impairment; however, people were observed to make decisions at their evening meal, including whether they dined communally or in their own bedroom. A resident told the inspector that he was very pleased that the home had accommodated himself and his wife (also a resident) in accordance to their wishes regarding the arrangement of their rooms. The inspector joined a small group of four people for their evening meal, which was pleasantly presented and enjoyed. At the time of this inspection the home were able to prepare meals in accordance to any individual preferences due to the limited number of residents. The registered manager stated that the service would wish to continue to be as flexible as possible through offering a selection of ‘off menu’ choices, even when the home reached its full capacity. The inspector looked at the current menu, which needed more detail to demonstrate choices of vegetables, fruits and salads (for example, the registered manager reported that the current residents have been requesting a daily salad to accompany their main meal but this positive practice was not evident from reading the menu). Folkestone Nursing Home DS0000068609.V345414.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 and 18 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The home provided a satisfactory complaints procedure; however, it was not possible to test how the home managed complaints. Amendments were needed to the Adult Protection procedure and whistle blowing policy. EVIDENCE: The home produced a satisfactory complaints procedure; there had been no complaints received by the home at the time of this inspection. The complaints procedure was made available to residents and their representatives, within the Service User Guide. The inspector read the service’s Adult Protection policy. Although the registered manager was clear about when to contact the local Safeguarding Adults Team, the inspector found that the written policy needed more specific guidance to ensure that all staff will properly interpret it. The inspector suggested that the home should contact the local Safeguarding Adults Team for information about local procedures, training and any other relevant issues identified by this team. The home’s whistle-blowing policy did not clearly state the role of the Commission for Social Care Inspection, including guidance that staff can directly report any concerns about the conduct of the service (anonymously, if they wish to). Folkestone Nursing Home DS0000068609.V345414.R01.S.doc Version 5.2 Page 15 Folkestone Nursing Home DS0000068609.V345414.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, 20, 24 and 26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are provided with a welcoming and comfortable environment. EVIDENCE: The premises were found to be pleasantly decorated, clean and comfortable. There were forty-three en-suite bedrooms situated on four floors, including four rooms on the lower ground floor with limited natural light. The registered manager stated that these four bedrooms were intended for respite care (if all other bedrooms were occupied). Six of the bedrooms offered balconies with safety rails. At the time of this inspection, all of the residents were placed on one floor and had been able to select a bedroom of their choice. The home provided a separate dining room, although residents could choose to dine in Folkestone Nursing Home DS0000068609.V345414.R01.S.doc Version 5.2 Page 17 their own rooms or a communal lounge (a suitable table and chairs were available in the lounge visited by the inspector at evening meal time). The inspector viewed some empty bedrooms and also chatted to a few residents in their rooms. Bedrooms were noted to be well presented and personalised with small items of furniture, photographs and other personal effects. It was acknowledged that people at the home for respite care might not wish to personalise their rooms in the manner of permanent residents. The inspector noted that some communal areas needed paintings and other homely touches. The registered manager stated that this would be addressed via consultation with residents, once more people moved into the home. Although the home appeared hygienic, an unpleasant odour was detected in one specific area of the home. The cause of this odour could not be immediately identified at the time of the inspection; the registered manager stated that she would promptly address this concern. Folkestone Nursing Home DS0000068609.V345414.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 and 29 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The service has had a very limited opportunity to demonstrate its commitment to staff training, although training plans have been developed. Residents must be protected through rigorous and safe recruitment practices. EVIDENCE: The inspector looked at a staffing rota, which indicated that a sufficient number of staff was allocated on each shift, including an appropriate mix of registered nurses and care workers. Due to the home employing a limited number of staff, (due to the limited number of residents) the inspector was unable to gather sufficient information to assess the quality of the staff’s training. It was noted that experienced nursing and care staff with prior care home employment had been recruited; therefore, staff possessed essential mandatory training (such as moving and handling) as well as other training relevant to the service. The registered manager stated that the home had not commenced its own training programme but this training would include moving and handling, health and safety, food hygiene, infection control, medication and safeguarding vulnerable adults. The inspector was informed that training would focus on the individual Folkestone Nursing Home DS0000068609.V345414.R01.S.doc Version 5.2 Page 19 health problems of residents at the home, including dementia care training. The inspector would anticipate that training would also be provided in tissue viability care, palliative care and diversity needs. The inspector looked at four staff files. It was noted that the home had not properly recorded that a POVA First (Protection of Vulnerable Adults) telephone check had been made prior to allowing staff to commence work at the home. The registered manager was unable to find the two references for one file, although the other three files contained two references. The home’s application form asked applicants to explain any gaps in their employment. The inspector found that one application form did not provide sufficient information to explain gaps; the home did not produce written evidence to demonstrate that this issue was explored during the recruitment interview. The home’s achievement of a staff team in which 50 of the care staff has attained National Qualifications in Care at level 2 will be assessed at the next inspection, taking into account that staff recruitment was an ongoing process at the time of this inspection. Folkestone Nursing Home DS0000068609.V345414.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 and 38 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The registered manager demonstrated some good practices to meet the needs of the residents; however, improvements are needed in order to raise the standard of the service. Systems were in place to provide residents with a safe environment, but the home must evidence a valid gas safety check. EVIDENCE: The registered manager is a registered general nurse and is presently undertaking a management qualification. This is her first post as a registered manager having previously been employed as a deputy manager at two care Folkestone Nursing Home DS0000068609.V345414.R01.S.doc Version 5.2 Page 21 homes that provided nursing care. Issues noted at this inspection (for example, poor recruitment practices, an unacceptable delay in attentively pursuing podiatry care for a resident and the concerns within this report regarding medication practices) have highlighted some development areas for the registered manager. It is noted that the registered manager has an external clinical supervisor as the registered provider (owner) does not have a care services background. The home was not in a position to demonstrate the effectiveness of its quality assurance systems, due to being newly operative. The registered manager stated that the registered provider had been undertaking unannounced monthly person-in-charge (PIC) visits since the premises received its registration in January 2007. The arrangements for auditing the quality of care (such as reading and evaluating the contents of a random selection of the care plans as part of the PIC visits) will be assessed at the next inspection, taking into account that residents have been moving in since June 2007. The key National Minimum Standard 35 was not tested at this inspection. The inspector checked the following documents, which were found to be satisfactory: 1) electrical installations check by a competent person 2) public liability insurance certificate 3) portable electrical appliances testing 4) annual water treatment and 5) fire safety checks, including maintenance of equipment and fire alarm testing. The home was unable to produce evidence of current gas safety testing. Folkestone Nursing Home DS0000068609.V345414.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 2 X 3 X 2 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 X 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 X X X 3 X 2 STAFFING Standard No Score 27 3 28 2 29 1 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X X X 2 Folkestone Nursing Home DS0000068609.V345414.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Not Applicable as this is the first inspection 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 5 Requirement The registered manager must ensure that the Service User Guide is amended as detailed in this report, so that residents and their representatives have accurate information about the service. The registered manager must ensure that the needs of residents to access external health care are very actively pursued, so that the health and welfare of people is promoted. The registered manager must ensure that correct procedures are followed if a resident’s medication label has been written on by an unknown source, in order to ensure that residents’ medication needs are safely met. The registered manager must ensure that the ‘end of life’ information within the care plans has been attained through a multi professional approach, including liaison with residents’ doctors, so that people receive appropriate medical and health DS0000068609.V345414.R01.S.doc Timescale for action 31/10/07 2. OP8 12(1) (a) 31/08/07 3. OP9 13 (2) 31/08/07 4. OP11 15 31/10/07 Folkestone Nursing Home Version 5.2 Page 24 5. OP15 17(2) 6. OP18 13 (6) care to meet their individualised needs. The registered manager must ensure that the menu plans contain sufficient detail to enable any person inspecting the record to determine if the nutritional needs of residents are being addressed. (1) The registered manager must ensure that amendments are made to the Adult Protection procedure in order to ensure that residents are protected. (2) The registered manager must ensure that staff are made fully aware that they can inform the Commission of any concerns related to the conduct of the home. The registered manager must demonstrate the safe recruitment of staff, including evidence of POVA First checks, two references in each file and a documented exploration of any gaps in employment. The registered manager must ensure that the home has a current gas safety check, so that residents and all other persons that enter the premises are provided with a safe environment. 30/09/07 30/09/07 7. OP29 19 30/09/07 8. OP38 13 (4) 30/09/07 Folkestone Nursing Home DS0000068609.V345414.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. Refer to Standard OP5 Good Practice Recommendations The home should more actively promote prospective residents rights to view the premises before they move in, so that people can be assured that they have been offered choice. The home needs to demonstrate an effective system for determining if a resident has lost (or gained, if relevant) a concerning amount of weight, so that any changing nutritional needs of people can be comprehensively understood and addressed. The home should provide staff with current issues of the British National Formulary medication guidance book. 2. OP7 3 OP9 Folkestone Nursing Home DS0000068609.V345414.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU 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. 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