Inspection on 26/04/07 for Fulford Nursing Home

This inspection was carried out on 26th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Fulford Nursing Home 23/04/08

Fulford Nursing Home 25/07/06

Fulford Nursing Home 18/10/05

Fulford Nursing Home 25/01/05

Fulford Nursing Home 27/07/04

Fulford Nursing Home 06/02/04

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

CARE HOMES FOR OLDER PEOPLE Fulford Nursing Home 43 Heslington Lane York North Yorkshire YO10 4HN Lead Inspector Jo Bell Key Unannounced Inspection 26th April 2007 09:15 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 Fulford Nursing Home DS0000028003.V333667.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. Fulford Nursing Home DS0000028003.V333667.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fulford Nursing Home Address 43 Heslington Lane York North Yorkshire YO10 4HN 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) 01904 654269 01904 651919 fulfordnursing@tiscali.co.uk This is york website Mr Raymond Hancock Mrs Donna Crockford Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Fulford Nursing Home DS0000028003.V333667.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 40 years plus Date of last inspection 25th July 2006 Brief Description of the Service: Fulford Nursing Home is a privately owned care home offering nursing care for up to 28 service users. The home is a large detached property with wellmaintained grounds. Service users can access the facilities in Fulford, which include shops, a local church, library, schools, hairdressers and the GP surgery. Weekly fees range from £500 - £580 as at 1st June 2006. Fulford Nursing Home DS0000028003.V333667.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key inspection of the service took place on Thursday 26th April 2007. Prior to the visit a pre-inspection questionnaire was returned. One inspector spent almost six hours at the service speaking with people who live there, staff and the management of the home. During this time three people had their care plans and needs looked at in detail, observation of care practices in the lounge and dining room took place. One mealtime was observed and documentation in relation to individual needs, training, the medication system and quality assurance was viewed and discussed. Both the manager and nominated responsible individual were able to assist during the visit. Aspects of health and safety were checked when parts of the environment were viewed. A range of refurbishment has taken place and this continues to be ongoing. When this has been completed this will enhance the environment for people living in the home. Overall people enjoy living in this home and find the staff kind and caring. What the service does well: What has improved since the last inspection? Many bedrooms have been refurbished and the communal bathrooms and shower rooms are in the process of been completed. People are cared for by staff who receive regular training and supervision. This highlights any practice issues and helps individuals develop in their role which has a positive effect on people living in the home. There are permanent staff who organise activities which are enjoyed by different people depending on what the activity is. The quality assurance system has been developed which has an impact on outcomes for people in the home. For example looking at the care plans and medication system and ensuring views are heard and acted upon through residents meetings. A new call bell system has been fitted, this means that staff are able to respond to people more effectively who need assistance. Fulford Nursing Home DS0000028003.V333667.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. Fulford Nursing Home DS0000028003.V333667.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 Fulford Nursing Home DS0000028003.V333667.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 (Standard 6 is not applicable) People who use the service experience adequate quality outcomes in this area. The needs of individuals are not fully assessed prior to admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three individual pre-admission assessments were examined. The registered manager or one of the registered nurses visits people in their own home or in hospital to complete an initial assessment. Information may also be received from the Care Manager, this was evident in one persons records. A standard form is used, though on all three occasions this was not completed in sufficient detail. It was therefore difficult to ascertain if needs could be fully met. Information regarding health and personal care was discussed along with social needs. In one case the social interests, personal safety, carer and outcome information was left blank with no date or signature regarding who had completed the assessment. Fulford Nursing Home DS0000028003.V333667.R01.S.doc Version 5.2 Page 9 The three people which the assessments related to stated someone had visited them from the home and asked lots of questions, and some forms were filled in. The manager had recently completed an assessment and this was found to be more detailed. She was aware of these individual needs and how they could be met. The previous assessments were discussed and she was aware that further work needs to be carried out to ensure the process is beneficial for the people who are hoping to live in the home. Fulford Nursing Home DS0000028003.V333667.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 People who use the service experience adequate quality outcomes in this area. Health and personal care needs are generally met, though this is not consistent due to lack of comprehensive information available. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The standard of care in the home has improved since the last visit. Observations in the lounge area showed people looking clean and well cared for. Glasses had been cleaned and nails had been cut. One man said he liked living here because the staff look after him well. Generally staff were careful when using hoists and wheelchairs and an explanation was given as to what was happening. On one occasion two members of staff were observed intermittently talking between themselves whilst dealing with a person in the hoist. Care plans are available which are individualised and they contain information regarding personal and healthcare needs. Risk assessments for the use of bed rails, moving and handling and the prevention of pressure sores are Fulford Nursing Home DS0000028003.V333667.R01.S.doc Version 5.2 Page 11 generally completed, though on occasions there was no rationale recorded as to why bed rails were being used. Care plans are currently audited on a three monthly basis by the manager, and one of the registered nurses on duty said he regularly reviews and evaluates the care plans. Again this was generally found to be the case though not all evaluations were up to date. For example, in one instance a ‘dressing’ for a sore area was due to be renewed but this was not evident in the care plan, although this had taken place. It was evident that some of the initial information was missing, and on two occasions it was unclear if death and dying and the need for resuscitation had been discussed with the person living at the home, or with the relatives. This was discussed with the manager. The home is using a nutritional assessment tool, and they are aware which individuals are under or over-weight. Advice is sought from either the GP or hospital dietician if food needs to be fortified or if supplements are needed. In the care plans there is some reference to social interests, however some of this information is kept separately in the activities file. This makes it difficult to identify which activities a person prefers and whether they have participated. This is also apparent when people are weighed. This information is kept in a separate file and only sometimes transferred to the care plans. Consideration needs to be given to keeping all the information in one place. This would avoid duplication and the potential for information to be lost. Evidence in the care plans confirmed that visits from GPs, the Community Mental Health Team and chiropodist take place. One GP was visiting during the inspection. This was also confirmed when speaking to people in the home and in the pre-inspection questionnaire. The home completed Regulation 37 notifications when necessary and are aware of what action to take if a serious injury occurs to any individual. People in the lounge and dining area were observed taking their medication. The drugs trolley was clean and tidy and the registered nurse spoken with had a good understanding of how to administer, record and dispose of medication. Three medication charts were looked at and these were completed correctly. A monitored dosage system is used and a special kit is available to return controlled drugs. The medication room was kept secure and the controlled drugs book was well maintained. Fridge temperatures are taken daily and prescribed supplements are available when required. The manager confirmed that medication audits take place, which were available in the office. No concerns were raised regarding medication. Privacy and dignity was discussed and observed. People were observed being addressed in the correct manner, a good rapport was evident between people living in the home and the staff. This has improved since the last visit. The atmosphere was calm and happy and staff knew each individual well. Some of the shared rooms were viewed and privacy screens were available. Currently Fulford Nursing Home DS0000028003.V333667.R01.S.doc Version 5.2 Page 12 some of the bathing areas are being refurbished, it would be beneficial to have clear either written or pictorial signs stating bathroom/toilet, with a vacant/engaged sign available. This would be extremely useful for the toilet/lounge area into Vine Wing. Fulford Nursing Home DS0000028003.V333667.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 People who use the service experience good quality outcomes in this area. Mealtimes are enjoyable and those using the service are encouraged to participate in activities and be autonomous on a daily basis. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The range of activities in the home has improved. There are two designated activities organisers who have planned trips during the past few months. A visit to Burnby Hall Gardens in Pocklington is due to take place, and a visit to the local church was available in the afternoon of the inspection visit. Television, newspapers, radio and music are available everyday, which was observed. During the residents meeting activities are discussed. A trip to Blackpool to see the illuminations took place last autumn and a visit to Scarborough for fish and chips is planned for summer. Most afternoons some activities take place. It could be skittles, cards, dominoes or one to one chats. All activities are documented and new ideas are incorporated into the activity plan. One lady said she likes just to get some fresh air in the garden, another person said how much she likes going to Scarborough for the day. In the local Fulford Nursing Home DS0000028003.V333667.R01.S.doc Version 5.2 Page 14 community there is a church, library and shops which people in the home can easily access. Autonomy and independence is encouraged and individual needs are taken into account, this includes cultural and religious needs. People in the home are able to make day to day decisions regarding the time they get up and go to bed, what time they dine and how they participate in activities. This was evident at breakfast time, some people had finished in the dining room just after 9am whilst others were observed enjoying tea and toast at 10am. Staff confirmed this was a flexible arrangements to suit individuals. One lady said she visited the hairdresser yesterday and the time was to suit her, she could also decide when she wanted a bath or a shower. Currently residents are deciding what décor would be suitable in the newly refurbished bathroom to make it more homely and comfortable. The lunchtime meal was observed. People in the refurbished dining room looked relaxed and happy whilst enjoying a good standard of food and drink. A menu was on display and speaking with people prior to lunch they were looking forward to either gammon and vegetables or a salad. This was followed by spotted dick or banana custard. The quality of food was good and the portion sizes were suitable. Generally fresh vegetables are used on a daily basis and the joint of gammon being cooked in the kitchen looked extremely appetising. One lady at the table had asked for salad, a member of staff helped her cut some of the food up and a plate guard was available. The salad was beautifully presented and had a mix of fruit, vegetables and homemade coleslaw. It was very evident how much this lady enjoyed her lunch. There were enough staff to give assistance where needed, and this was carried out in a dignified manner. A choice was offered regarding where to dine. Some people stayed in their rooms, or chose to dine in one of the communal areas. There are two permanent cooks, the person working at the inspection was knowledgeable on how to ensure food is nutritionally balanced. Pureed food is blended separately, and soft vegetables and placed on a plate next to the meat or fish. Drinks are available mid morning, during the afternoon and evening. The menus are currently been reviewed to ensure a different choice is offered this is partly because of comments made by residents. The kitchen area was inspected and this was found to be satisfactory with evidence of fresh produce and home-cooking on display. Fulford Nursing Home DS0000028003.V333667.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use the service experience good quality outcomes in this area. Views and opinions of people living at the home are encouraged, and appropriate action is taken regarding complaints and protection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People in the home confirmed that they would be happy to raise any concerns with the nurse in charge or manager of the home. A formal complaints procedure is available and the manager is aware of how this works. A comments book is located in the entrance hall which relatives have put a range of information in. One comment complimented the positive attitude of the manager when she was being shown around the home. People spoken with felt any issues would be dealt with efficiently and quickly. Verbal discussions take place between staff and people living in the home on a daily basis. One anonymous complaint has been made since the last inspection. This was investigated by the provider and was found to be partially substantiated. Appropriate action was taken to address the issues concerned. People said how safe and comfortable they felt in the home. There is a safeguarding adults procedure available and both the manager and registered nurse knew what action to take if an issue regarding abuse is alleged. This Fulford Nursing Home DS0000028003.V333667.R01.S.doc Version 5.2 Page 16 includes making an initial referral and placing somebody on the protection of vulnerable list. Staff are hoping to attend a study day in the next two weeks regarding abuse, and all staff receive training in this area. This was confirmed by staff and in individual training records which were viewed. Fulford Nursing Home DS0000028003.V333667.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): 19 & 26 People who use this service experience adequate quality outcomes in this area. Whilst the home is comfortable and clean there is ongoing refurbishment work which needs to be completed to enhance the environment for everybody. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The environment is pleasant, clean and homely. Refurbishments to the lounge, dining area, individual bedrooms and to the bathing facilities have taken place. This is ongoing and once completed will enhance the environment for those people living and working in the home. Areas have been carpeted, re-painted and new chairs and tables are in use in the dining and lounge areas. The entrance is welcoming and has a pleasant smell. The gardens are well maintained and people using the service commented on how enjoyable it is to sit in the garden and watch the world go by. Fulford Nursing Home DS0000028003.V333667.R01.S.doc Version 5.2 Page 18 It was evident that wheelchairs and hoists are stored in a range of places throughout the home. In some bedrooms the toilets are inaccessible due to equipment been stored in this area. This needs to be reviewed. In one of the bedrooms there was a strong smell of urine which needs to be dealt with. The manager was made aware of this and identified that the domestic staff had not visited this room yet to clean it. Staff do have infection control training as mandatory, this was confirmed in the training records, and evidence of hand-washing equipment was available in many areas of the home. People were observed wearing clean clothes which were well ironed. The laundry room was checked and this had two washing machines and one tumble drier. A designated laundry assistant has recently been employed on a part time basis, and when spoken with confirmed he had received appropriate training to fulfil his role. Clean sheets and towels were evident and the correct procedure for washing and drying clothes was being adhered to. Fulford Nursing Home DS0000028003.V333667.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): 27,28,29 & 30 People who use this service experience good quality outcomes in this area. There are enough staff to care for the people living in the home and they are trained appropriately to help meet individual needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People receiving this service are cared for by suitably trained staff in sufficient numbers. At the visit there were twenty one residents. There was one registered nurse and four carers, in addition to this the manager was supernumerary. Overnight there is usually one registered nurse and two care staff. This is adequate. A new call bell system has been introduced which ensures that staff can respond quickly to people who need assistance. People were observed having their needs met. Many staff have completed NVQ Level 2 or 3 training and more staff are waiting to commence this. Staff have different roles in the home, for example there is a senior carer who is involved with health and safety, and another person who overseas training. This works well as it ensures no areas are missed. New staff receive induction training, this is equivalent to Skills for Care. Two members of staff confirmed they had received mandatory and induction training which covers care practices and the standards required to meet individual needs. Fulford Nursing Home DS0000028003.V333667.R01.S.doc Version 5.2 Page 20 Three staff files were checked, these all had two written references, a police and protection of vulnerable adults check and an application form detailing previous experience and education. Having this robust system helps to protect people living in the home from harm. Fulford Nursing Home DS0000028003.V333667.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): 31,33,35 & 38 People who use this service experience good quality outcomes in this area. Health and safety needs are met and people have their financial needs cared for along with the ability to put their views forward through a good quality assurance system. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is an experienced nurse who has almost completed her registered managers award. She has a good rapport with the staff and with people living in the home. Her role has developed and it is beneficial to the running of the home being able to have supernumerary days to undertake management responsibilities. She is well supported by the management team Fulford Nursing Home DS0000028003.V333667.R01.S.doc Version 5.2 Page 22 and is able to deal with disciplinary matters, supervision issues and day to day running of the home. Her confidence and assertiveness have developed and it is evident that she runs the home in the best interests of the people using the service. The quality assurance system has been developed which includes having two monthly residents meetings (relatives are also invited), sending out questionnaires regarding the standard of care, the food and the environment and undertaking audits regarding care plans, medication, accidents and the kitchen. A policy is available which discussed how views and opinions are sought on a regular basis. The manager is keen to act on ways to develop and improve the service. When a person enters the service a discussion takes place regarding finances. A certain amount of money is kept in the home and people are able to have a ‘pocket money’ type arrangement where they can access a small amount of their own money for toiletries, clothes, hairdressing or chiropody etc. This is recorded and those people spoken with confirmed this takes place. Tokens are available if money is not available. Health and safety was discussed and details of certificates and training were available in the pre-inspection questionnaire and in training files. A fire risk assessment has been completed and a designated person is responsible for carrying out weekly fire alarm tests. Emergency lighting is in place and bedroom doors automatically close in the event of a fire. A moving and handling course was planned, along with an infection control session. A training matrix was available which confirmed that all staff had either attended this training or were due to. A qualified first aider is always on duty and details of this are clearly visible. Staff spoken with also confirmed that regular training takes place. A range of water temperatures were taken (five in total) these were all satisfactory. A monthly record of temperatures was available and these were all acceptable. People in the home said they felt safe. Window restrictors were in use and radiator guards were available. These were felt and the temperature was adequate. No risks regarding safety were found during the visit. Fulford Nursing Home DS0000028003.V333667.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 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 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 2 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 x x 3 Fulford Nursing Home DS0000028003.V333667.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 OP3 Regulation 14 Requirement People’s needs must be fully assessed and documented prior to admission to ensure all staff are aware of health and personal care issues. Bed rail assessments must be completed correctly. Care plans must be evaluated to ensure peoples changing needs are reflected and acted upon appropriately. Any blanks in the care plans must be identified and acted upon by the manager through the audit process. Wheelchairs and hoists must be stored in the correct place and not in bedroom toilets where people reside. The strong smell of urine in one of the bedrooms identified must be removed to ensure it is pleasant to live in this environment for that particular person. DS0000028003.V333667.R01.S.doc Timescale for action 26/05/07 2. OP7 15,12 26/05/07 3. OP19 23 (2) 26/05/07 4. OP26 13 (3) 03/05/07 Fulford Nursing Home 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. 3. Refer to Standard OP7 OP10 OP19 Good Practice Recommendations It would be advisable to keep records pertaining to weight, activities and daily progress sheets in one place. Bathroom, toilet and vacant/engaged signs should be in place to ensure privacy and dignity is maintained. The bathing facilities need to be completed as soon as possible to enhance life for people living in the home. Fulford Nursing Home DS0000028003.V333667.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Fulford Nursing Home DS0000028003.V333667.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!