Inspection on 12/06/05 for Glebe Lodge

This inspection was carried out on 12th June 2005.

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

Glebe Lodge 25/11/08

Glebe Lodge 29/11/07

Glebe Lodge 27/06/06

Glebe Lodge 01/11/05

Glebe Lodge 10/11/04

Glebe Lodge 12/05/04

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

CARE HOMES FOR OLDER PEOPLE Glebe Lodge 2 Hall Street Offerton Stockport SK1 4DA Lead Inspector Kathleen Mcall Unannounced 12th June 2005 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 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. Glebe Lodge F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Glebe Lodge Address 2 Hall Street, Offerton, Stockport SK1 4DA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0161 480 2025 0161 480 2025 Care UK Mental Health Partnership Ltd (Arc Healthcare Ltd) Ruth Marshall CRH - CARE HOME 17 MD(E) Mental Disorder - Category(ies) of MD Mental Disorder 3 registration, with number over 65 14 of places Glebe Lodge F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The number of persons for whom residential accommodation is provided shall not exceed 3 people MD and 14 MD (E). Date of last inspection 10th November 2004 Brief Description of the Service: Glebe Lodge is a residential care home that is registered to provide care for up to 17 residents whose primary care needs are due to them having a diagnosed mental illness; three of whom are aged between 50 years and 65 years of age. The registered manager is Mrs Ruth Marshall. Glebe Lodge is one of 75 care homes owned by the Care UK group who focus on providing rehabilitation services for residents with mental health difficulties. Glebe Lodge is a listed building, it is a large, detached house set in its own grounds. All bedrooms are single person occupancy spread over three floors. There are no ensuite facilities at the home, however all bedrooms have a vanity unit. The home has three bathrooms, one of which is in the process of having an assisted bath fitted, a shower is also available for those service users who prefer to shower. The home has two lounges one of which is a smoking lounge and a dining room. There is a large car park to the rear of the house with gardens to the side and front. The home is not suitable for wheelchair users, there is a fourperson passenger lift to assist residents around the home. There are a number of steep steps to the front of the property and ramp access is available to the rear of the home. Glebe Lodge is situated close to the town centre with good access to cinemas, local shops, library and park. Stockport town centre, motorway network and public transport are easily accessible. Glebe Lodge F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over the course of a day. The registered manager was not available at the time of the inspection. The senior carer on duty assisted the inspector throughout the inspection. Care plans, assessment documentation, medication and their storage were examined. The inspector spoke with a number of residents in the home and had discussions with two other members of staff who were on duty at the time of the inspection. A number of residents told the inspector that they were happy with the way the home was meeting their care needs, however a number of other residents told the inspector that they were dissatisfied with the way in which care staff treated them and said that they did not feel confident that their complaints would be listened to and responded to. Others talked about staff ‘bullying’. These issues were dealt with in a separate meeting with the registered providers. One service user comment card was received which showed that the resident liked living at the home, they felt well cared for, they felt that staff treated them well and they felt safe living at the home. In response to the question is your privacy respected? The service user said sometimes, and in response to do you like the food? The service user indicated sometimes. What the service does well: Prospective residents were given information in the form of a service user guide to help them in deciding whether to live at the home. Arrangements were in place to enable prospective residents and their relatives to visit the home prior to their admission. All residents had an assessment of their needs undertaken prior to their admission and were given a contract which stated the terms and conditions of their stay at Glebe Lodge. The home offered comfortable accommodation. Both lounges had been redecorated, recarpeted and refurbished in the last twelve months. The hall stairs and landing areas had recently been redecorated and recarpeted and laminate flooring had been fitted in the dining room. Residents bedrooms were also furnished and equipped to a comfortable standard, many had been personalised by the occupants. The home was clean, tidy, bright and airy throughout. Glebe Lodge F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: There was a problem, with the way in which staff recorded information about a resident, which was felt to be inappropriate. Practices issues around the way in which medication is administered to residents needs to be improved. As the result of a number of complaints being received concerning care staffs approach to residents, staff would benefit from undertaking training in maintaining service users dignity, respect and privacy. The standard of liaison between Glebe Lodge and other mental health professionals was poor and needed to be developed and improved for the benefit of residents. The home has been without assisted bathing facilities since November 2004; consequently those residents that require additional bathing support have been unable to have a bath since then. Staff did not have separate storage, staff room, smoking facilities or an area in which to discuss privately issues concerning residents. The fire safety practices and health and safety practices in the home were inadequate and a number of requirements were served in respect of these. At the time of the inspection several bags of combustible materials were stored In the boiler room and a number of fire doors were wedged open. All rooms on the 1st and 2nd floors to which residents had access to did not have window restrictors fitted, to ensure the safety of residents. Glebe Lodge F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 Page 7 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. Glebe Lodge F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Glebe Lodge F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3 and 5. Sufficient information was available to service users to enable them to make an informed choice about residing at the home. Service users had been issued with a written contract and their care needs were fully assessed before admission. EVIDENCE: Since the last inspection the home had put in place a Statement of Purpose. It is anticipated that new service users to the home will be provided with a copy of this document to help them in deciding whether to live at the home. One service user who had recently been admitted to the home confirmed that they had received this information and that it had been useful. Service users recently admitted to the home had a written contract which detailed the terms and conditions of their stay. Service users were assessed prior to their admission to the home; no service users were admitted to the home without having had their care needs assessed. Assessments were obtained from social workers if they had been involved in the admission. Glebe Lodge F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 Page 10 Arrangements were in place for prospective service users to visit the home prior to their admission; one service user told the inspector that they and their family had visited the home before deciding to move in. The service user said staff had been helpful and made him feel welcome. Glebe Lodge F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10. Despite service users having a care plan, their care needs were not fully met and staff failed to promote the dignity of service users. EVIDENCE: All service users had a care plan, that had been developed using assessment documentation and from discussions held with service users, their relatives and any other significant professionals. Care plans included health needs, personal care needs, social interests, and risk assessments. A daily record sheet was kept in respect of each service user living at the home, the inspector observed that there had been an improvement in the recording style of these and that daily records now contained detailed information, which presented an overall picture of how a service user had presented that day and how their care needs had been met. However the inspector observed unacceptable and inappropriate recordings on a service users file, this issue has been dealt with in a separate letter and an arranged meeting with the registered providers. Glebe Lodge F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 Page 12 Service users had access to GP support, district nursing services, chiropody and CPN services when required. Psychology services were accessed via the GP if required. Periodically some service users were admitted to hospital due to deterioration in their mental health. Staff told the inspector that the hospital did not keep them informed of any changes. Consequently this made it difficult for care staff to fully meet the health needs of the service users concerned. Discharge letters were usually sent to service users GP’s, thus some information could be accessed via a GP at a later date. Medication administration records and the storage of medication at the home were satisfactory. However the inspector observed that staff did not ensure that service users took their medication. The registered manager needs to review the way medicines are administered at the home to ensure that service users had taken their medication. Staff had undertaken training around the issue of how different medicines interact with each other and how these may affect a service users health. Staff said this had provided them with useful insight. A number of service users spoke positively about the way in which care staff met their care needs. However a number of other service users complained that care staff did not treat them with respect, one service user felt ‘bullied’ by care staff. Another service user said that they ‘didn’t feel comfortable in the home’ and complained that staff shouted at him and ignored him. These complaints have been dealt with in a separate letter and an arranged meeting with the registered providers. Glebe Lodge F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15. Not all service users were given the opportunity to exercise choice and control over their lives. Meals provided satisfied the majority of service users expectations. EVIDENCE: Overall the day-to-day routine of the home was varied and flexible and suited the majority of service users. However a number of service users did complain about restrictions having been placed on their lifestyle and choices, for example service users complained about having to eat their meals in their bedrooms without being given a choice. The home offered a limited range of organised activities; this appeared to suit the present service users group. Visitors were made welcome at the home and service users kept in touch with family and friends. Service users confirmed that they could have visitors at all times. There were a small number of service users who did not have a relative, or a representative or an independent advocate who visited them on a regular basis to assist them independently of care staff employed at the home. Glebe Lodge F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 Page 14 The kitchen at Glebe Lodge was designed and fitted with equipment for the storage and preparation of chilled ready-made meals and other food items. Service users comments were mixed with some liking and other disliking the food provided. Several service users said that they understood that it was difficult to meet the preferences of all of the residents all of the time. Glebe Lodge F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18. Service users were not confident that their complaints would be listened to and dealt with in a satisfactory manner. Service users were not protected from abuse in accordance with the homes written policies. EVIDENCE: One service user told the inspector that they had made a complaint and it had been resolved in a satisfactory manner. However a number of complaints were made to the inspector during the course of the inspection. Service users complained about the way in which staff treated and spoke to them. Service users said that they did not feel confident that their complaints would be listened to and dealt with appropriately. Others told the inspector that they felt ‘ there was no point in complaining, nothing was ever done’. These issues are being dealt with in a separate letter and an arranged meeting with the registered providers. At the previous inspection in November 2004 the registered manager was required to provide training in Adult Abuse Protection to all care staff at the home. Whilst a small number of staff had covered adult abuse issue during the course of undertaking NVQ training, a number of other staff had still not received any training in adult protection and how to identify and respond to such incidences. Glebe Lodge F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 24 and 26. Whilst the home provided comfortable accommodation for service users needs, it did not promote the safety of service users and staff living and employed at the home. EVIDENCE: The home provided comfortable accommodation throughout. Both lounges had been redecorated, recarpeted and refurbished in the last twelve months. The hall stairs and landing areas had also been redecorated and recarpeted since the last inspection and laminate flooring had been fitted in the dining room. The grounds of the home were well kept, however the garden bench in the side garden area was severely weather damaged causing it to disintegrate. This needs replacing. A number of service users rooms were seen, these were also furnished and equipped to a comfortable standard, many had been personalised by the occupants. Glebe Lodge F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 Page 17 The home did not comply with the requirements of the fire authority. (See standard 38) Lighting was not provided outside the first floor lift area and a switch to access lighting outside the ground floor lift entrance could not be found. Service users had a choice of two bathrooms, one of which was fitted with a shower. One other bathroom was not in use as the home was in the process of having an assisted bath fitted. The home has been without assisted bathing facilities since November 2004. Service users complained to the inspector that they had not had a bath since November 2004 and were unable to access the other bathing facilities in the home due to their physical health. The home was clean, tidy, bright and airy throughout and was free from any unpleasant odours, with the exception of bedroom 21 which had an odour problem. Staff told the inspector that although the room was cleaned regularly it was difficult to eradicate the odour. Glebe Lodge F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30. The home was sufficiently staffed. Whilst staff had undertaken training in mental health awareness they failed to demonstrate an understanding and application of the principles and values of care. EVIDENCE: At the time of the inspection the home was sufficiently staffed, a staff rota showing which staff is on duty and in what capacity was kept at the home. Since the last inspection staff had completed training relating to specific mental health diagnosis, staff reported that they had found this helpful and that they had gained an insight into how specific mental illnesses affect service users. Staff had also completed training that looked at their interactions with service users at Glebe Lodge. The specifics of what this training involved were not known, however staff would benefit from updating their training in the principles and values of providing care. Staff had completed training in fire safety and moving and handling. Separate facilities for staff were not provided. Consequently staff had nowhere to meet privately to discuss hand over, care plans and other issues regarding service users at the end of their shift. Staff explained that they had to ask service users to leave the dining room in order to have handover etc. Staff were not provided with suitable storage facilities in which to keep personal belongings. The inspector observed that staff had their handbags etc Glebe Lodge F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 Page 19 stored in the kitchen near work surfaces. Staff members frequently smoked in the dining room area whilst on duty, sometimes with service users who smoked and other times when on their break. There were several service users that didn’t smoke and this practice could impinge upon their use of the dining room. The kitchen is accessed via the dining room and the high levels of smoke present a hygiene risk. Staff were not provided with a separate staff room in which to take a break despite being on duty for up to 12 hours. Staff should be enabled to take a break of 20 minutes minimum in separate facilities away from their work. Glebe Lodge F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 and 38 Staff were supervised in their work. The health and safety of staff and service users was not fully safeguarded. EVIDENCE: Staff reported that they received regular supervision to support them with their work. The home did not comply with the requirements of the fire authority, at the time of the inspection several bags of combustible materials were observed to be stored in the boiler room, works required by the fire authority in relation to staff sleeping accommodation were incomplete at the time of the inspection and a number of doors were observed to be wedged open. The issue of fire safety at the home was referred to the local fire authority who undertook an inspection of the premises on the 13th June 2005 and advised that staff accommodation on the second floor must not be used until specific Glebe Lodge F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 Page 21 requirements had been completed and that combustible material accumulated in the boiler room be removed. The home was in the process of arranging to have electromagnetic detents fitted and linked to the fire alarm system at the home. Interim arrangements to deal with this matter had been recommended by the fire officer. A further health and safety issue was identified during the inspection, not all bedrooms windows on the first floor and second floor levels had window restrictors fitted and service users were at risk of injury. A laundry basket, bedding box and a vacuum cleaner were observed to be stored outside the lift entrance, thus restricting access to and from the lift. Heaters, ironing boards and another vacuum cleaner were stored around the home in areas used by service users. Glebe Lodge F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION 2 2 2 2 x 3 x 2 STAFFING Standard No Score 27 2 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 x x x x x x 3 2 Glebe Lodge F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 Page 23 No Are there any outstanding requirements from the last 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 OP 8 Regulation 12(1)(a) 13(b) Requirement The registered provider must establish and maintain appropriate communications with other health professionals when service users are admitted to hospital for treatment, to ensure that care staff have a full understanding of a service users health care needs. The registered provider must ensure that medication is administered safely to service users. The registered provider must ensure that staff at all times respect the privacy and dignity of service users. (Timescale of 10.11.04 not met.) The registered provider must enable service users to make decisions with respect to the care they are to receive and take into account their wishes and feelings. The registered provider must ensure that the complaints procedure is appropriate to the needs of service users, and that service users feel confident to use it. The registered providers must Timescale for action 12th July 2005. 2. OP 9 13(2) 12th June 2005. 12th June 2005. 3. OP 10 12(4)(a) 4. OP12 12(2)(3) 12th June 2005. 5. OP16 22(2) 12th June 2005. 6. OP 18 13(6) 12th Page 24 Glebe Lodge F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 7. 8. OP 19 OP 20 9. OP 21 10. OP 22 11. 12. 13. OP 26 OP 27 OP 30 14. OP 38 provide training in Adult Protection to all care staff employed at the home. (Timescale of 10.02.05 not met) 23(2)(o) The registered providers must replace the worn garden bench in the side garden area. 23(2(p) The registered providers must ensure that light bulbs are fitted to all lights and that service users and staff are aware of where to find light switches. 23(2)(j) The registered providers must provide assisted bathing faciliities to meet the needs of service users. 23(2)(l) The registered providers must provide storage space for ironing boards, heaters and vacuum cleaners used in the home.. 16(2)(k) The registered providers must ensure that bedroom 21 is kept free from odours. 23(3)(a)(ii The registered providers must ) provide storage facilities for staff to store their belongings. 18(1)(c)(i The registered provider must ) ensure that staff recieve training appropriate to the work they perform in the principles and values of care. 13(4)(a() The registered providers must fit b)(c) window restrictors to all rooms to which service users have access to on the 1st and 2nd floors of the home September 2005. 12th August 2005. 12th June 2005. 12th July 2005 12th June 2005. 12th July 2005. 12th September 2005. 12th October 2005. 12th July 2005. 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 OP 7 Good Practice Recommendations The registered provider should review the way in which staff record information on service users’ files and consider F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 Page 25 Glebe Lodge 2. 3. OP 14 OP 27 developing alternative styles of recording. The registered provider should support and assist those service users without relatives or representatives in accessing advocacy services. The registered provider should provide suitable facilities for staff to meet, take a break and discuss in private issues concerning service users. Glebe Lodge F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection 2nd Floor, Heritage Wharf Portland Place Ashton-under-Lyne OL7 0QD 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 Glebe Lodge F54-F04 s8601 Glebe Lodge v221753 120605 Stage 4.doc Version 1.30 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. 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