Inspection on 06/06/06 for Gables Nursing Home

This inspection was carried out on 6th June 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Gables Nursing Home 15/10/09

Gables Nursing Home 14/04/09

Gables Nursing Home 14/01/09

Gables Nursing Home 23/12/08

Gables Nursing Home 21/08/07

Gables Nursing Home 16/09/05

Gables Nursing Home 25/05/05

Gables Nursing Home 19/10/04

Gables Nursing Home 13/05/04

Gables Nursing Home 03/02/04

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

CARE HOMES FOR OLDER PEOPLE Gables Nursing Home Barrows Green, Bradfield Road Leighton Crewe Cheshire CW1 4QW Lead Inspector A Gillian Matthewson Key Unannounced Inspection 09.45 6th June 2006 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 Gables Nursing Home DS0000018725.V287201.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Gables Nursing Home DS0000018725.V287201.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Gables Nursing Home Address Barrows Green, Bradfield Road Leighton Crewe Cheshire CW1 4QW 01270 588952 01270 588952 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) Mr William Preston Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Gables Nursing Home DS0000018725.V287201.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The maximum number of service users must not exeed 34 No more than 34 service users may be accommodated in the category OP - Old age - not falling within any other category Within the maximum number of 34 OP, 5 service users may be aged 55 years and above The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care 16th September 2005 Date of last inspection Brief Description of the Service: The Gables is a care home providing accommodation and nursing care for 34 older people, 5 of whom may be aged between 55 and 65 years of age. The service is located in an extended, detached two storey property, situated in its own grounds in a semi-rural setting on the outskirts of Crewe. The home is easily accessible from Nantwich, Winsford, Middlewich and Sandbach. It is served by local transport and is close to railway networks, being two miles from Crewe station. Bedroom accommodation is situated on both floors and is provided within single bedrooms. All bedrooms are provided with wash hand basins, but there are no en-suite facilities. All rooms have a T.V. point and nurse call system. Day space consists of three lounges, one of which is a smoking area. A separate dining room is also available. There is a passenger lift and staircase providing access to the first floor. The home is registered for nursing and personal care for persons with general physical frailty. In accordance with statutory requirements Registered Nurses are on duty at all times. The fees range from £343.34 per week for personal care only to £390.35 per week for those requiring nursing care. (The NHS provides the home with additional funding for those requiring nursing care, depending on their assessed level of need.) Gables Nursing Home DS0000018725.V287201.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector spent time planning the inspection by reviewing previous inspection reports and the service history over the last twelve months. The inspection took place over seven hours and included a tour of the building, inspection of records and discussion with five residents, five staff, the manager and a team leader from Crewe social services. Comments were generally positive. One resident said ‘I am very happy here’. Another said ‘I’ve no complaints’. Most residents described the staff as being ‘alright’. Feedback was given to the Home Manager and registered person at the end of the inspection. What the service does well: All prospective residents have a full assessment of health and personal care needs by a senior nurse prior to admission, to ensure that the home can meet their needs. Sufficient numbers of staff and adequate equipment are provided. Residents are consulted about their daily preferences, hobbies and interests to ensure that the home provides opportunities for them to fulfil their individual social needs. Residents’ privacy and dignity are maintained and they may receive any visitors they wish at any time. The catering staff provide a healthy and varied diet. The home is clean and well maintained. There is investment in staff training for all levels of staff to equip them and enable them to maintain the skills necessary for providing good quality care. There is a quality assurance system in place, which includes seeking the views of residents and relatives on how the home is performing and how it could improve. Residents also have access to a robust complaints procedure. Gables Nursing Home DS0000018725.V287201.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Gables Nursing Home DS0000018725.V287201.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Gables Nursing Home DS0000018725.V287201.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 3. The quality of this outcome area is good. Prospective residents are provided with most of the information they need to make an informed choice about whether they wish to reside in the home. They also undergo a full assessment of need prior to admission to ensure that the home can meet their needs and are provided with a written contract. EVIDENCE: The home had a statement of purpose and a comprehensive service user guide, which contained all the required information prospective residents would need to make an informed choice, apart from the size of the rooms. See Requirement 1. Each resident was provided with a statement of terms and conditions or contract at the point of moving into the home. However, this did not include a breakdown of the fees payable and by whom or the period fees would be payable for after death. See Recommendation 1. Gables Nursing Home DS0000018725.V287201.R01.S.doc Version 5.1 Page 9 Case tracking was carried out for three residents. In all cases the home manager had been to visit the resident prior to admission to carry out a full assessment of all their personal, health and social care needs and determine whether the home could meet those needs and what equipment would be required. The residents were not admitted until the home had the necessary equipment in place. The assessment document was retained in the residents’ care files, together with copies of the Care Management Assessment provided by social services. The home does not provide intermediate care. Gables Nursing Home DS0000018725.V287201.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. The quality of this outcome area is good. The care planning system provides staff with all the information they need to satisfactorily meet the residents’ individual needs. Residents’ privacy and dignity are maintained. EVIDENCE: Three care plans were examined. They were presented in individual ring binders. All areas of personal care needs were covered in the care plan, together with a life history and a record of residents’ social interests. Care plans contained evidence of consultation with residents and relatives and were signed by them. They were reviewed on a monthly basis or more often if necessary. Residents’ health care needs were recorded and care plans showed that residents were able to access health care services as required. For example, the residents who were part of the case tracking exercise had seen their GPs on a regular basis. Two had received a visit from an optician, two had had consultations with a dietitian, one had been seen by a tissue viability nurse specialist, one had been visited by a renal specialist and one was under the Gables Nursing Home DS0000018725.V287201.R01.S.doc Version 5.1 Page 11 care of the anticoagulant clinic at the local hospital. Arrangements were also in place to afford residents access to a dentist and chiropodist. All medicines were stored in a clinical store. There were adequate medicine storage facilities, including a drugs fridge and controlled drugs cupboard that complied with legislation. An audit of controlled drugs was carried out and found to be correct. Only registered nurses administered the medication. Records were maintained of all medicines received into the home, administered and disposed of. These were completed appropriately. The home had satisfactory arrangements for the disposal of unused medication. The home has a policy that states that residents will be treated with respect and their right to privacy will be upheld. It says that personal care will be given in such a way as to ensure privacy and dignity are maintained, that consultation with health care professionals will take place in residents’ own rooms, that staff will always knock before entering a room, that residents will wear their own clothing and can receive visitors in their own room and may have a private telephone line fitted in their room if they wish. The statement of purpose set out an objective that residents’ needs and values would be respected in matters of religion, culture, race or ethnic origin, sexuality, political affiliation and disabilities. Observation of staff practice, examination of records and discussion with residents confirmed that staff followed these policies. Crewe social services had recently carried out a review of all the residents in the home, which had included consultation with the residents and their families. The team leader said that the vast majority of residents and relatives were very satisfied with the care provided. Gables Nursing Home DS0000018725.V287201.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. The quality of this outcome area is good. The social activities programme provides stimulation and interest for people living in the home. Residents are helped to exercise personal choice in their lives and maintain contact with family and friends. Residents receive a healthy, varied diet according to their assessed requirements and choice. EVIDENCE: The statement of purpose promotes residents’ independence and the right to live in a flexible environment where their choice of routines and activities are met where possible. Observation of staff practice, review of care files and discussion with residents confirmed that this was the case, although one resident said that when she asks to go to bed sometimes she has to wait a while for assistance. The home had a programme of activities that included board games, card games, quizzes, a weekly bingo session and fortnightly musical entertainers. On the day of the inspection a group of residents were playing dominoes. They said this was a regular occurrence in the afternoons. One lady said the staff regularly take her out shopping. Each resident had recently been consulted about their social interests and this was recorded in the care file. Staff said they were planning to hold a barbeque for the residents in the garden now the weather had improved. Throughout the day staff were observed sat chatting to Gables Nursing Home DS0000018725.V287201.R01.S.doc Version 5.1 Page 13 residents in the lounge. A hairdresser visited the home on Wednesdays and Fridays and a religious minister provided communion monthly for those who wanted it. Residents confirmed that they could receive visitors as and when they wished. Residents’ rooms were personalised with their own belongings, such as photographs, pictures, ornaments and small items of their own furniture. There was documentary evidence that residents were consulted about their care plans and that their personal preferences were taken into account in relation to all activities of daily living. Residents confirmed that they could make decisions and choices in relation to their daily lives. The service user guide informed residents that they had this right and also contained information about arrangements for advocacy for those not able to speak for themselves. The home provides a cooked breakfast from 8am, lunch between 12.30 and 13.30, tea between 16.30 and 18.00 and supper between 21.30 and 22.30. Special dietary requirements are catered for. The main meal was served at lunchtime, and on the day of the inspection consisted of pork steaks or mince and onions with boiled potatoes and three vegetables, followed by egg custard or ice cream. Residents were offered a choice of where they wished to take their meal. Staff were seen to regularly offer drinks and fruit to the residents and also provide them on request. They also provided discreet assistance to those who needed help with feeding. Residents said that the food offered in the evening was an assortment of sandwiches, something on toast, crumpets and cakes. Three evenings a week a cook came in to cook a hot meal. Residents said that they enjoyed the food, although one resident said he didn’t get enough to eat in the evening. The manager said she would look into this. The home owner said there was no restriction on the food budget and residents could have whatever they wanted. A member of staff was observed clearing the plates in the dining room. A few residents had left most of their dinner, but she did not enquire why or offer any alternative. See Recommendation 2. Gables Nursing Home DS0000018725.V287201.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. The quality of this outcome area is adequate. Residents have access to a robust complaints procedure and will be protected from abuse when the training is completed. EVIDENCE: The home had a complaints procedure that was included in the service user guide. Residents said that if they had any complaints they would address them to the home owner or manager. The home maintained records of complaints, details of any investigation and action taken. There had been one complaint since the last inspection, which was still under investigation. The home had a satisfactory adult protection procedure in place, which included whistle blowing, but not all staff had received training in what constitutes abuse, how to recognise it and how to report it. This was a requirement of the last inspection. On the day of the inspection the Adult Protection Coordinator of Cheshire County Council was providing a training session to half of the staff. Another session had been arranged for two weeks hence. Gables Nursing Home DS0000018725.V287201.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 24 & 26. The quality of this outcome area is adequate. Residents live in a safe, well maintained and comfortable environment but bathroom facilities should be upgraded to provide residents with a choice. EVIDENCE: A full tour of the home was undertaken during this inspection. The home was well maintained, clean and free from offensive odours. Residents had access to their own rooms, three lounges, a dining room and the garden. The home employs a gardener to keep the grounds clean and tidy and maintain a pleasant area for residents to sit out in. The home has six bathrooms, three with standard baths and chair hoists, and three with standard baths without hoists. Two of the latter were being used for storage. Staff said that the majority of residents could not use a standard bath without a hoist and residents would benefit from a wheel-in shower. See Requirement 2. Gables Nursing Home DS0000018725.V287201.R01.S.doc Version 5.1 Page 16 Gables Nursing Home DS0000018725.V287201.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. The quality of this outcome area is adequate. Staffing numbers and skill mix are appropriate to the assessed needs of the residents. Staff are trained and competent to do their jobs. The improvement in recruitment procedures must be maintained to ensure that residents are protected from abuse. EVIDENCE: Staffing levels were discussed and staffing rotas were examined. The home provided two registered nurses and four care staff from 07.30 until 14.30, one registered nurse and four care staff from 14.30 to 21.30 and one registered nurse and three care staff from 21.30 to 07.30. These levels were sufficient to meet the residents’ needs. The manager was planning to reduce the number of night staff by one because there were only 27 people resident in the home, four of whom did not require nursing care. It was agreed that this would be acceptable as long as the number and dependency of the residents was kept under review and staffing levels increased again if necessary. The home employed seven registered nurses, 24 care staff and 14 ancillary staff. Eight of the care staff had achieved at least an NVQ Level 2 in Care. All care staff were offered the opportunity to attain this qualification. At the previous two inspections it was identified that staff were being employed without having had Criminal Records Bureau checks before starting work in the home. Prior to this inspection the new manager had carried out an audit of the staff files and requested checks for all those staff who did not have Gables Nursing Home DS0000018725.V287201.R01.S.doc Version 5.1 Page 18 them. At the time of the inspection there were two ancillary staff who did not have them. Both staff only worked under supervision and the manager had sent forms off to the Criminal Records Bureau. All of the staff who had been employed since the last inspection had the appropriate checks in place. See Requirement 3. The home employed a training co-ordinator and there was a good training programme in place. Five staff training records were reviewed. Training so far this year for those five members of staff had included safe handling of medicines, communication, diabetes care, tissue viability and training in safe working practices. All staff received an induction on commencement of employment. The induction programme was reviewed and found to include the organisation and the role of the worker, maintaining safety at work, communicating effectively, developing as a worker, confidentiality and personcentred care. It did not include how to recognise and respond to abuse and neglect. This was being covered in the training mentioned previously. See Recommendation 3. Gables Nursing Home DS0000018725.V287201.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 & 38. The quality of this outcome area is adequate. The manager ensures that there is an open, positive and inclusive atmosphere in the home. The home regularly reviews aspects of its performance through a programme of self-review and consultations with residents and relatives. There is a satisfactory system in place for looking after residents’ monies and valuables handed over for safekeeping. In the main, the home promotes and protects the health and safety of residents and staff. EVIDENCE: Gables Nursing Home DS0000018725.V287201.R01.S.doc Version 5.1 Page 20 The manager is a first level Registered Nurse, with previous experience as a deputy manager of another care home. She commenced in post in November 2005. She has submitted an application for registration with the Commission for Social Care Inspection. The management approach at the home was open and created a positive and inclusive atmosphere. This was evidenced on the day of the inspection when the inspector observed the manager interacting with residents, staff and visitors in a positive manner. Residents stated that they felt they could and would approach the manager if they had any concerns. These positive comments were also directed towards Mr Preston the registered provider, who is regularly present within the service. Staff said that they felt the new manager was very approachable and that they felt well supported by her. They also said there had been more consultation with residents lately, particularly about activities. The home uses the Registered Nursing Homes Association quality management tool. This consists of an annual programme of audits, which included the catering, equipment, medication, care plans, staff files, policies and procedures and training. A relatives’ survey had been carried out in January. The responses were seen and most of them were positive. Any issues raised had been individually responded to by the manager. A residents’ survey was due to be carried out and the business plan was due for review at the end of the month. During this inspection the monies held for those residents who were case tracked was checked. This examination evidenced a robust system that was subject to periodic audit by the manager. Supervision records were also examined. Staff were supervised as part of the normal management process on a day to day basis. Most of the registered nurses had received formal, documented supervision in the previous three months and some of the care staff had received it in February. However, several members of staff had not received any formal, documented supervision that covered their practice and career development needs this year. Conversations with staff supported the documentation. See Recommendation 4. Staff records showed that staff received training in safe working practices, including fire safety, moving and handling, food hygiene and infection control. The home provided the necessary equipment to maintain resident and staff safety and the pre-inspection questionnaire demonstrated this was checked and serviced at the required intervals. Accident records were reviewed. These had been completed appropriately and there had been no serious accidents since the last inspection. Gables Nursing Home DS0000018725.V287201.R01.S.doc Version 5.1 Page 21 During the inspection it was noted that the door between the kitchen and the dining room had been propped open with a box of detergent. See Requirement 4. Also, a member of staff was observed taking a resident into the dining room in a wheelchair without footrests. The resident banged her right foot on the dining room door. See Requirement 5. Gables Nursing Home DS0000018725.V287201.R01.S.doc Version 5.1 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 2 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 2 3 X 3 X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 2 X 2 Gables Nursing Home DS0000018725.V287201.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard OP1 OP21 OP29 Regulation 4(1)(c ) 23(2)(j) 19 Requirement The registered person must include the size of rooms in the statement of purpose. The registered person must replace one of the baths without a hoist with a wheel-in shower. The registered person must ensure that a Criminal Records Bureau Disclosure is obtained prior to the employment of any member of staff. (Timescale of 16/09/05 not met.) The registered person must ensure that fire doors are never propped open. The registered person must ensure that footrests are fitted to wheelchairs when transporting residents. Timescale for action 31/07/06 06/12/06 06/06/06 4. 5. OP38 OP38 23(4) (c )(i) 13(4) 06/06/06 06/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000018725.V287201.R01.S.doc Version 5.1 Page 24 Gables Nursing Home 1. 2. 3. 4. Standard OP2 OP15 OP30 OP36 The residents’ contract should include a breakdown of fees payable and by whom and the period fees are payable for after death. If a resident has left a large proportion of a meal provided, staff should enquire why they have done so and offer an alternative. The home’s induction programme should be reviewed to ensure it covers all the Skills for Care induction standards. Staff should receive formal, documented supervision in relation to care practice and career development needs at least six times a year. Gables Nursing Home DS0000018725.V287201.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Gables Nursing Home DS0000018725.V287201.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!