Inspection on 19/04/07 for Gloucester House Nursing Home

This inspection was carried out on 19th 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

Gloucester House Nursing Home 06/06/06

Gloucester House Nursing Home 03/11/05

Gloucester House Nursing Home 25/05/05

Gloucester House Nursing Home 14/12/04

Gloucester House Nursing Home 29/06/04

Gloucester House Nursing Home 11/02/04

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

CARE HOMES FOR OLDER PEOPLE Gloucester House Nursing Home Lansdowne Road Sevenoaks Kent TN13 3XU Lead Inspector Ruth Burnham Key Unannounced Inspection 19th April 2007 09:30 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 Gloucester House Nursing Home DS0000026173.V334877.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. Gloucester House Nursing Home DS0000026173.V334877.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gloucester House Nursing Home Address Lansdowne Road Sevenoaks Kent TN13 3XU 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) 01732 741488 01732 741664 gloucester@agecare.org.uk AgeCare, The Royal Surgical Aid Society Mrs Philippa Jane Saunders Care Home 54 Category(ies) of Old age, not falling within any other category registration, with number (54), Physical disability (10), Terminally ill (10) of places Gloucester House Nursing Home DS0000026173.V334877.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th June 2006 Brief Description of the Service: Gloucester House Nursing Home is a care home providing nursing care for 54 Older People. Age Care, The Royal Surgical Aid Society, is the registered provider. The home is a purpose built two-storey building. Accommodation is on two floors. A 13-person passenger lift is available. Bedroom accommodation comprises 42 single and six double bedrooms. All bedrooms have ensuite facilities. The home is divided into four villages. Each village has two day rooms. In addition to these day rooms, a large communal dining room and lounge is situated on the ground floor. A library/computer room is located on the first floor. All rooms used by residents are connected to the nurse call system. The rear gardens are designed to enable physically disabled and wheelchair users to move easily around. The home is approximately one mile from the main A25 trunk road and Sevenoaks Town Centre. Sevenoaks has a good range of amenities including shops, banks, places of worship, restaurants, cinema and theatre. Sevenoaks is served by public transport, including rail services to London and the Kent and Sussex Coast. There is ample car parking. Current fees range from £2784.00 to £4069.00 per month. Gloucester House Nursing Home DS0000026173.V334877.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key inspection was carried out by Ruth Burnham, regulatory inspector, including an unannounced site visit to the home between 9.15am and 5.30pm on Thursday 19 April 2007. During the site visit a number of residents, the manager and staff were spoken to, both privately and in groups. A number of records were examined. A staff handover session was observed and lunch was eaten with a group of residents. Practice was observed throughout the visit. A tour of part of the home was made. As part of the key inspection process comment cards are provided. At the time of writing this report, only 2 responses had been received, both from care professionals. These were positive. Comments included: From health and social care professionals: ‘The staff are always welcoming and helpful.’ ‘The care given to the terminally ill is excellent’. ‘Some of the care plans could be improved but on the whole they are satisfactory’ What the service does well: Residents or their families are supported to make the transition into Gloucester House as smooth as possible. People who live in the home have their health and personal care needs met to a good standard. The home involves external professionals in the care pf residents wherever necessary. Residents say they are treated with respect and are able to make choices about their lives. There are meetings which they can attend and staff who they say are approachable. Care in later stages of life is good with pain relief and personal support given. Residents have a range of activities which they can join in and personal interests are encouraged and developed. Visitors are welcomed to the home. The management involve residents in the running of the home, they encourage comment and suggestions act on these to improve systems and services which will enhance residents’ quality of life. Each resident has an en-suite facility and a room which they can personalise. Staff are available in numbers which generally meet residents needs. Staff are committed and trained to provide care to older people who require nursing care to a high standard. Gloucester House Nursing Home DS0000026173.V334877.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Gloucester House Nursing Home DS0000026173.V334877.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 Gloucester House Nursing Home DS0000026173.V334877.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 – 6 Quality in this outcome area is good. People who are considering moving into the home are provided with good information about life at Gloucester House to enable them to decide if this home will meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who are considering moving into the home have written and taped information to help them make a judgement whether the home will be suitable. All residents spoken to viewed their move to Gloucester house as a positive one. It was evident that the home can meet the needs of those accommodated there. Residents spoke of meeting the manager before they were admitted, they remembered being asked questions, including their likes and dislikes. Residents’ files held copies of the initial assessment which contained evidence from a range of sources including mental and physical health assessments. Gloucester House Nursing Home DS0000026173.V334877.R01.S.doc Version 5.2 Page 9 It is often the families of residents who are involved in arranging and choosing a suitable home. Visits by prospective residents or their family are welcomed, there are opportunities to meet other residents and view the available room. Residents are offered a trial period where they can judge whether the home is right for them. Intermediate or rehabilitative care is not offered. Gloucester House Nursing Home DS0000026173.V334877.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 – 11 Quality in this outcome area is good. People who live in the home have their care and nursing needs met in a way that respects their privacy and promotes their dignity. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home benefit from the opportunity to be involved in planning their care. The nurses plan how their nursing needs will be met in discussion with each resident. Families are also involved in care planning processes where appropriate. The plan in most cases includes the basic information necessary to plan the individual’s care and is well structured with information clear and accessible. New systems have been introduced to improve the quality of information available about social history, social, recreational and spiritual needs and preferences. People are protected from harm through the inclusion in the care planning process of risk assessments, including those in response to accidents or untoward incidents. Care plans examined during the visit were up to date and took note of changing needs. The health and wellbeing of residents is monitored via daily records, entries examined largely focussed on physical needs. The manager agreed that some Gloucester House Nursing Home DS0000026173.V334877.R01.S.doc Version 5.2 Page 11 further training was needed about broadening the scope of these records. However it was clear, through observation during the inspection and conversation with staff and residents, that carers and nursing staff know the residents very well and are committed to promoting their emotional, social, psychological and spiritual needs. Residents have access to health care services that meet their assessed needs both within the home and in the local community. Care plans have a section to record interventions from other professionals. Those seen included reference to optical, dental, physiotherapy and chiropody services. The majority of residents use the same GP. Where a resident has moved locally they may remain with their own GP. Residents’ health is monitored and appropriate action taken where necessary. The home seeks professional advice on health care issues, acts upon it and generally is able to provide the aids and equipment recommended. There is evidence in the care plan of health care treatment and intervention, and a record of general health care information including weight monitoring and nutritional information. The home has a medication policy which is accessible to staff. Medication records are generally up to date for each resident and medicines received, administered and disposed of are recorded. There are suitable facilities to store medication and to dispense them from. People spoken to who live in the home said that staff always treat them with respect. Staff are aware of the need to treat residents with respect and to consider dignity when delivering personal care. This was observed throughout the inspection. Residents said they appreciate the qualities of the permanent staff. The home arranges for residents to enjoy the privacy of their own rooms and provides fixed screens in shared rooms. Residents spoken to were happy with the way that staff care for them and respect their dignity. The home has policies and procedures, which inform staff how they should handle dying and death. The home has received many commendations about the care they give at this time. The wishes of residents about terminal care and arrangements after death are not always recorded, but staff are able to give an account of the arrangements. The manager has introduced new forms for gathering this information. Gloucester House Nursing Home DS0000026173.V334877.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 – 15 Quality in this outcome area is good. People who live in the home enjoy flexible routines which recognise their individuality. They are encouraged to exercise control over their own lives. Systems promote choice and independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home benefit from flexible routines which are planned around the residents’ needs and wishes. Residents are encouraged to live as life as close as possible to the way they had been used to at home. People are encouraged to take control of their lives and be actively involved in the running of the home. Regular residents meetings are held and there is always opportunity for one to one chats with the manager, senior staff and advocates. Residents said they feel comfortable in talking to staff and the manager and know they would be listened to. The home takes residents feedback seriously and makes changes where possible. Staff listen to residents and make considerable effort to provide a flexible service, which enables them to enjoy a better quality of life. Gloucester House Nursing Home DS0000026173.V334877.R01.S.doc Version 5.2 Page 13 People enjoy the opportunity to take part in a variety of activities. An activities coordinator is employed who works 7 hours each weekday. The activities coordinator demonstrated a commitment to providing activities for older people including activities familiar to the group such as bingo, looking at ways a former hobby could be continued and encouraging new ideas. There is as strong emphasis on artwork, excellent pictures painted by residents are displayed around the home. The activities coordinator has had training in the specific needs of people who are suffering from dementia and is introducing additional activities for this group. Family and friends feel welcome and know they can visit the home at any time. Staff always make time to talk to visitors and share information with the agreement of the resident. The design of the home provides seating areas within the communal areas of the home where residents can entertain their visitors, in addition to the privacy of their own room. Residents individuality is well supported, they said they are encouraged to maintain independence but will be assisted in areas where they need help. Residents are encouraged to take responsibility for their own financial affairs and to use their money as they wish. Residents have the opportunity to bring personal items with them to the home and are encouraged to keep personal effects which are important to them in their own room. People who live in the home enjoy a wide variety of good quality, home cooked foods. The inspector was able to join a group of residents for lunch where the preparation, presentation, quality, choice and service was excellent.. The cook understands the preferences of residents and aims to offer old favourites and for people to try more unfamiliar food. Residents said the standard of food is good, they particularly enjoy afternoon tea which is served with home made cakes. They also enjoy being offered a glass of red or white wine or sherry at lunch. There had been a wine and sherry tasting session at a recent residents meeting where they had been able to choose the ones they preferred. There is always the choice of cooked breakfast in the morning. People who need additional help at mealtimes are given discreet assistance, care staff are aware of the importance of ensuring residents are unhurried and comfortable with the process. There is a main dining room on the ground floor with additional dining areas on each wing. Tables are set attractively with the necessary cutlery and aids to help individuals during their meal. A number of residents choose to eat in their rooms. One resident said he could have a cup of tea anytime, day or night and that night staff often brought him a cup of tea without being asked, just because he had rung the bell. There are facilities for staff and visitors to make a drink with serveries on each floor, staff take round the drink trolley between meals. Drinks are readily available in bedrooms and the lounges. Gloucester House Nursing Home DS0000026173.V334877.R01.S.doc Version 5.2 Page 14 Gloucester House Nursing Home DS0000026173.V334877.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 Quality in this outcome area is good. People who live in the home are listened to and are encouraged to offer comment or complaint. They are protected from abuse by well trained and competent staff and clear policies and procedures. Their rights are upheld. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home are free to offer comment or complaint; there is a comments book on the reception desk which people are using for compliments and concerns. Residents who were spoken to understood how to make a complaint and were clear that they would speak to the manager ‘who always sorts it out for us’. The service has a clear complaints procedure which is available within the home. Complaints are recorded and feedback is given to the complainant. Residents said they have plenty of opportunities to voice opinions about the home through regular meetings as well as informal chats and know they will be listened to. People who live in the home are protected from harm. There is a good understanding of the duty of care and of maintaining the safety of residents. There are local and AgeCare policies and procedures regarding protection of residents, including access to the Kent & Medway Joint Working Protocol. Staff spoken to clearly understand adult protection issues and know how to recognise when action should be taken, when and who to refer any incident on Gloucester House Nursing Home DS0000026173.V334877.R01.S.doc Version 5.2 Page 16 to. The outcomes from any referral are satisfactorily managed, with issues resolved in collaboration with other professionals. Residents feel safe and supported. The home’s aims and objectives include the rights of residents. Residents are supported to live as independently as possible, exercising their rights to make choices and decisions with assistance when needed. Those who wish to place an election vote are supported to do so. The service policies refer to the rights of the resident in their placement. Staff are aware of the policies and work to them. Gloucester House Nursing Home DS0000026173.V334877.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 Quality in this outcome area is good. People who live in the home benefit from the comfortable and homely environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home benefit from the comfortable and homely environment. There is a rolling programme to improve the decoration, fixtures and fittings. The gardens are well laid out and were particularly attractive in the spring sunshine. There are a number of single rooms, a few double rooms, all of which have ensuite facilities. The accommodation is arranged on 2 floors with a lift between floors. Those residents who are in shared rooms were aware when they chose the home that they would have to share. Residents can personalise their rooms and choose where they sit in the range of communal areas. Gloucester House Nursing Home DS0000026173.V334877.R01.S.doc Version 5.2 Page 18 Residents say they are comfortable, the home is clean, warm, well lit . In addition to en-suite facilities there are communal toilets near the lounges and dining room, plus a toilet for visitors. Staff have their own rest area. There are a number of assisted baths. Each wing has a sluice facility. The kitchen and laundry are well equipped. Gloucester House Nursing Home DS0000026173.V334877.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 – 30 Quality in this outcome area is good. People who live in the home are cared by a well trained, committed and enthusiastic team of staff who understand and anticipate residents’ needs and wishes. They are protected through sound recruitment procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home praised the staff who care for them. Staffing rotas try to take into account the times of high and low activity, residents and staff felt there was a good ratio of staff to residents with normally adequate time to provide health and personal care and support. Agency staff are used from time to time. People are cared for by staff who are suitably trained. The service recognises the importance of training, and delivers where possible a programme that meets any statutory requirements. Residents feel that staff are trained and able to deliver their care needs. Training records showed that qualified staff have opportunities to update their skills, care staff are encouraged to undertake NVQ training with 70 of staff now qualified to NVQ level 2 or above. Gloucester House Nursing Home DS0000026173.V334877.R01.S.doc Version 5.2 Page 20 Staff spoken to were clear regarding their role and what is expected of them. Residents said that staff working with them know what they are meant to do, and that they are generally able to meet their needs. Interaction between staff and residents during the inspection was warm, friendly and supportive. The handover between shifts was observed and the commitment, enthusiasm and knowledge of residents needs expressed during this time was impressive. People who live in the home are protected through sound recruitment procedures. Staff files which were examined showed that all necessary checks are carried out prior to appointment. New staff are provided with structured induction training and work with an experienced member of staff for some time before working alone with residents. Gloucester House Nursing Home DS0000026173.V334877.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 – 38 Quality in this outcome area is good. The quality of life of people who live in the home is enhanced through the opportunity to be involved in the running of the home. The home is managed in the best interests of the residents. Their safety is promoted through good record keeping, safe working practices and regular environmental safety checks. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home benefit from the experience and competence of the well qualified management team. The manager makes sure progress is made towards national minimum standards for older people. Residents said the manager is approachable and they would always speak to her if they had any concerns. Staff said the manager is very supportive. Gloucester House Nursing Home DS0000026173.V334877.R01.S.doc Version 5.2 Page 22 The manager involves the people who live there in the running of the home. There are regular residents meetings and surveys have been carried out. Staff meetings are also held regularly. The long term security of people who live in the home is promoted through sound business practice. The registered person is aware of the need to plan the business activity of the home, and manage the finances and resources to deliver the business plan. The home has recruited a finance manager and improvements are already evident in the increased budget available for maintenance and projects. The service provider takes responsibility for the home’s accounts and business development. There is suitable business insurance with details of cover for residents’ property included in the service users guide. Monthly visits are made by a representative of the organisation with reports of the visit supplied to the commission. Notifications of incidents and accidents affecting the wellbeing of residents are properly recorded and notified to the appropriate authorities. Residents have the opportunity to manage their own money if they wish, and facilities are provided to help keep it safe, including lockable space in individual rooms. The home does not currently manage residents’ personal monies. The home does not act as an agent or appointee to residents. The manager and deputy share responsibility for staff supervision and peer support. Supervision of staff is adequate and more staff are being trained to supervise. The pre inspection questionnaire recorded that servicing and maintenance of services and supplies are carried out in a timely fashion promoting the safety of residents. Kitchen repairs have been carried out in line with Environmental Health recommendations. Staff are able to detail the procedures in the event of fire. Good working practices were observed to reduce the risks of cross infection and meet relevant legislation. Safety posters are displayed in the appropriate places. Gloucester House Nursing Home DS0000026173.V334877.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 3 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 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 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Gloucester House Nursing Home DS0000026173.V334877.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. Standard Regulation Requirement Timescale for action 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 OP7 Good Practice Recommendations Care plans should be further expanded to include clear guidance for staff in how to meet the personal, social, emotional, and spiritual needs of residents in line with there needs and preferences. The daily record should record how interventions specified in the body of the care plan are being achieved 2. OP7 Gloucester House Nursing Home DS0000026173.V334877.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Gloucester House Nursing Home DS0000026173.V334877.R01.S.doc Version 5.2 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!