Inspection on 04/10/07 for Grosvenor Hall

This inspection was carried out on 4th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

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

CARE HOMES FOR OLDER PEOPLE Grosvenor Hall Lancashire Hill Stockport Cheshire SK4 1RH Lead Inspector Bernard Tracey Unannounced Inspection 4th October 2007 07:45 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 Grosvenor Hall DS0000069123.V351526.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. Grosvenor Hall DS0000069123.V351526.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grosvenor Hall Address Lancashire Hill Stockport Cheshire SK4 1RH 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) 0161 480 3634 0161 429 0307 Grosvenor Care (Cheshire) Ltd ** Post Vacant *** Care Home 54 Category(ies) of Dementia - over 65 years of age (22), Old age, registration, with number not falling within any other category (54), of places Physical disability (8) Grosvenor Hall DS0000069123.V351526.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only. Care home with Nursing code N, to people of the following gender:Either. Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category - Code OP. Dementia over 65 years of age - Code DE (E) (maximum number of places: 22) Physical disability over 45 years - Code PD (maximum number of places: 8) The maximum number of people who can be accommodated is: 54 Date of last inspection NEW SERVICE Brief Description of the Service: Grosvenor Hall is a listed building that has been converted from an orphanage into a facility as a care home and is situated on a main road close to the Stockport town centre. The home provides nursing and personal care for up to 54 service users accommodated on two floors. Fees for accommodation and care at the home range from £415.00 to £450.00 per week. Additional charges are also made for hairdressing and chiropody services, newspapers and personal toiletries. The majority of bedrooms are single en-suite. There are separate lounges and dining rooms, two quiet lounges offering a variety of settings in which service users are able to receive visitors, socialise and participate in activities. The home is on a main bus route with a bus stop outside. There is ample parking for visitors’ cars. Grosvenor Hall DS0000069123.V351526.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first key inspection of the home under the ownership of Grosvenor Care, and it included a site visit to the home. The manager was not made aware that this inspection was going to take place. Several weeks before the inspection, questionnaires were sent out to doctors, social workers and nurses, as well as to the residents and their relatives. The questionnaires asked what people thought of the care and services provided by the home. The manager was also asked to fill in a questionnaire, called an Annual Quality Assurance Assessment (AQAA), telling us what they thought they did well, what they need to do better and what they have improved upon. Where appropriate, these comments have been included in the report. We spent over five hours at the home. During this time, we looked at care and medicine records to ensure that health and care needs were met and also studied how information was given to people before they decided to move into the home. A tour of the building was undertaken and time was spent looking at records regarding safety in the home. We also examined files that contained information about how the staff were recruited for their jobs, as well as records about staff training. We spent time speaking to four residents, as well as speaking to seven staff, including the new manager and the Operations Manager. We have received one complaint about the service and found that the manager was able to respond in detail to the concerns with a satisfactory outcome. The fees in this service range from £415.00 to £450.00 per week at the time of the visit. There are extra charges for Chiropody, hairdressing and newspapers/magazines. What the service does well: Residents benefit from an experienced and stable staff team. They are provided with a good amount of individual care and attention and supported to maintain control over their lives, and the decisions they make are respected. The new owners and management team are committed to providing a high standard of care in the home. Care staff receive a range of training to give them the skills and knowledge to meet residents’ needs. Grosvenor Hall DS0000069123.V351526.R01.S.doc Version 5.2 Page 6 The home had some care staff that had worked at the home for a long time and the residents said that they liked the staff and felt safe in the home. 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. Grosvenor Hall DS0000069123.V351526.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 Grosvenor Hall DS0000069123.V351526.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 2 3 Standard 6 does not apply Quality in this outcome area is good. The system for ensuring that all prospective residents had a detailed assessment undertaken prior to admission to the home, gave an assurance both to residents, relatives and staff that a resident was only admitted if the home could meet their needs. This judgement has been made using available evidence including a visit to this service EVIDENCE: In the Annual Quality Assurance Audit (AQAA) the manager tells us that all potential residents and their relatives are offered the opportunity to visit the home at any time prior to admission and where appropriate a taster visit can be arranged to offer potential residents the opportunity to spend time in the home prior to making their decision. All residents, including those who fund their own care, have a written contract and no resident is admitted with the exception of Rapid Response Admissions, Grosvenor Hall DS0000069123.V351526.R01.S.doc Version 5.2 Page 9 without the Home Manager visiting the resident and undertaking an assessment of needs. Service User Guides, incorporating terms and conditions are available in all rooms and in reception areas and copies of the last CSCI report are also available in reception areas. Documentary evidence was seen within the care plans, pre-admission assessments and resident files and through discussion with a recent admissions relatives and the resident, who were able to confirm that the admission to the home was informed and that the manager had ben the one who had come to visit them in hospital before their admission On two occasions recently, residents assessed and admitted on a temporary basis have opted to make the home their permanent residence as they have felt that their needs were so well catered for and a number of respite admissions have requested to book further respite care at the home as they have felt happy with the care they have received. Grosvenor Hall DS0000069123.V351526.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 Quality in this outcome area is adequate. Care plans do not always fully demonstrate how aspects of health, personal and social care needs would be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We examined 4 care plans during our visit to the service. The manager had informed us in the completed self assessment sent before the visit (AQAA), that care plan documentation was under review by the new owners, therefore a selection of newly completed plans was looked at. The detail contained in the care plans varied, as did the consistency of records maintained in them. Of the 4 care plans we examined in detail, two care plans gave clear instructions and guidance on how the care needs of the residents were to be met. They were reviewed monthly and any changes were noted and acted upon. However one care plan indicated that a resident had not been weighed since June despite evidence that she had been losing weight according to previous recordings. An assessment to monitor skin integrity had been completed and Grosvenor Hall DS0000069123.V351526.R01.S.doc Version 5.2 Page 11 an appropriate pressure-relieving mattress had been in use. The individual had also been assessed as at risk of falling, a care plan to inform the staff how this risk is minimised had not been devised. A further care plan examined indicated that a resident had no nutritional assessment and had not been weighed in the preceding month. There was no evidence of relatives and the resident being involved in the drawing up and review of care plans were seen, though we were informed in the AQAA that relatives and residents are offered the opportunity to review care plans on a formal basis,quarterly, in order to ensure their agreement with the plan of care and where appropriate make ammendments to the care plan. The residents benefit from twice weekly visits from the homes GP who also visits on request Residents also have regular access to visiting optician, chiropodist and dentist. One relative had commented that she felt the staff should be more aware of the need to fit hearing aids correctly and to ensure that the resident was able to hear adequately when the aid had been fitted, as this was not always the case in her experience. The medications system was safe. Medications were securely stored; the prescription administration sheets were filled in accurately and there was an accurate record of medicines received into the home and arrangements have been made for the disposal of unused medicines for those residents receiving nursing care. The home has obtained a contract with a designated and registered company to dispose of these medicines. Appropriately trained staff administered medication to residents. As part of the pre-admission assessment process, prospective residents are assessed as to their ability to manage their own medication, currently only one resident does so and appropriate support is provided by the care staff to enable this to continue. Residents wishes regarding gender preferences of carers involved in personal hygiene and continence care are documented within the care plan and are actively promoted through staff deployment where practicable to maximise respect and dignity for clients and all residents are addressed by their preferred form of address. Grosvenor Hall DS0000069123.V351526.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 The quality outcome in this area was considered good The social activities in the home, provide the residents with enjoyment and interest and is planned to meet individual preference. The dietary needs of the residents are well catered for with a balanced and varied selection of food available that meets the residents’ tastes and choices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Great importance is attached to ensuring that residents are given the opportunity for stimulation through leisure and recreational activities. An activities organiser is in place that encourages residents to participate in the day’s activities and ensures that individual attention is given as well as the more organised group programme. Outings are arranged on a regular basis and details are posted on the notice board. During the course of conversations, residents spoke frequently about making choices, for example, in relation to what they do during the day, what time they got up or went to bed, and whether they spent time with others or alone. The home has contact with a local church whose members visit the home on a regular basis. Grosvenor Hall DS0000069123.V351526.R01.S.doc Version 5.2 Page 13 Relatives are invited to meetings, which are held at the home every two months The dining tables were appropriately set for breakfast and lunch. Without exception residents received appropriate and sensitive assistance with their meals. The lunchtime meal was taken in a relaxed environment, soft music playing in the background, with staff and residents regularly interacting with each other. Time was taken for residents to eat their meals and staff would ask each person if had they finished or would like a further helping. Staff were observed to assist those residents requiring help in a caring, sensitive and unhurried way, gently encouraging the resident to continue with their meal until they had finished eating. Menus were nutritious and balanced and included a good variety of meat, fish, fresh vegetables and fruit. The home confirmed that, should a resident request something that was not on the menu, alternative meals were available. Residents said they were asked in the morning what they would like from the choices for lunch and tea and all felt this was a good idea. There were many compliments and expressed satisfaction by residents and relatives in respect of the food offered by the home. A night snack box is now available to allow residents who wish to have a hot snack overnight access to hot food. Fruit bowls are available in communal areas to allow residents to snack on fruit as and when they wish. Residents have two hot meal options at lunch and a hot or cold option at teatime and residents who have soft diets now receive the same menu as those on normal diets to increase variety. Tables are set with cups,saucers,cutlery and condiments for all meals and trays are provided for those who wish to eat in their rooms. Grosvenor Hall DS0000069123.V351526.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 18 Quality in this outcome area is good Residents and relatives have confidence that their concerns will be dealt with. Abuse policies and procedures are in place to protect the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A discussion with residents and relatives indicated that there was a general awareness of how to make a complaint. The complaints procedure was displayed in the reception area. It was easy to understand and gave an assurance that complaints would be responded to within 28 days. The complaints procedure had also been given out to each resident. A copy of the Local Authorities Vulnerable Adults Procedure was in place and a discussion with the senior staff identified that they were very aware of the procedure to follow in the event of any allegation of abuse. Training in the protection of vulnerable adults has been undertaken by some staff and is ongoing. Examination of the home’s complaint file indicated that of the 4 complaints received since May 2007, 3 were investigated and formally responded to within 48 hours of receipt as evidenced by the complaints file. One complaint remains unresolved at the time or writing. One letter has been received from Stockport Contracts and Performance thanking the home for the prompt reponse and thoroughness of investigation to a complaint received and a second complaint received directly to the home was referred to Contracts and Performance by Grosvenor Hall DS0000069123.V351526.R01.S.doc Version 5.2 Page 15 the Home. There was one allegation made by a resident in June 2007 pertaining to the conduct of a staff member, all POVA protocols were followed and the investigation proved the allegation not to be upheld. Grosvenor Hall DS0000069123.V351526.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 26 The quality outcome in this area was considered Good. The accommodation is of a good standard. It is a safe, clean and comfortable environment, for the residents to live in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Grosvenor Hall is a listed building that has ben converted from an orphanage into a facility for care . Residents are accommodated on two floors; there is a passenger lift and other adaptations around the home to assist people with limited mobility. The majority of bedrooms are single with an en suite toilet and hand basin. There are assisted bathing facilities and plenty of spacious toilets around the home. There are several dining rooms / lounges for communal use. The large reception area is used for social gatherings. To the rear and side of the building is an ample car park. There is a plan to make improvements to Grosvenor Hall DS0000069123.V351526.R01.S.doc Version 5.2 Page 17 the front of the home, with the construction of an extended patio area to improve the entrance area and first impressions of the building, as well as providing additional amenities for residents to use. When we visited we found that the home had undergone a major refurbishment under the new owners. We discussed further planned environmental improvements with the Operations Manager, which confirmed the information that had been provided by the Manager in the Annual Quality Assurance Assessment that had been completed by the home as part of the Inspection. We were told that major investment since May 2007 has resulted in all communal areas being redecorated, the roof undergoing extensive repairs to make it watertight, new bed linen,duvets and pillows as well as towels and flannels have been bought for all residents. New crockery has been purchased for the home and wipeable tableclothes and condiment sets have vastly improved the dining areas. New cleaning rotas and equipment have been brought into effect to improve standards of cleanliness and reduce any odours within the home and pictures have been put up to increase the homes overall demeanour. All pressure relieving mattresses and hoists have been audited and where necessary undergone repairs. New cleaning products and odourisers have been deployed throughout the home and landings have been cleared of defunct equipment. Our observations confirmed much of what was contained in the AQAA. Grosvenor Hall DS0000069123.V351526.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 30 Quality in this outcome area is good. The residents were cared for by sufficient numbers of staff that were suitably qualified and trained and therefore had the knowledge and skills to meet the residents’ needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the site visit sufficient staff were on duty to meet residents care needs. Rotas showed that staff were regularly available in sufficient numbers by day and by night to ensure that care was properly provided. The staff and the manager said that in their opinion there was enough staff to meet the needs and dependency levels of the residents living at the home. We examined the staff rotas and found that as well as employing care staff, the home also employs domestic, catering and maintenance staff. The deputy manager and the staff described a largely stable staff group some of whom have worked at the home for a considerable time, which ensures that residents are cared for by people they know and are familiar with. Staff morale was improving under the new owners with staff saying that “there is a good atmosphere” and that “we work together well as a group”. Grosvenor Hall DS0000069123.V351526.R01.S.doc Version 5.2 Page 19 The residents said that the staff are “kind”, “happy to help” and that they were “patient and considerate”. Staff members interviewed, were able to demonstrate that they had a clear idea of their role and responsibilities within the home. They were able to describe their role within the team, to support residents, as well as their specific responsibilities as key worker to the residents. Fifty percent of the care assistants had an NVQ (national vocational qualification) in care, which is good. All staff complete an induction and foundation training course. There was also evidence of recent training on safeguarding vulnerable adults, fire safety, continence care, wound care and care planning. Planned training sessions for the future included dementia care, and further training in care planning. We examined a selection of staff personnel files and the home’s recruitment practice. All necessary information was in place in line with good practice guidance, including an appropriate application form, job description, photograph, a signed contract of employment, references and a Criminal Record Bureau disclosure The home employed a mixed race staff group and the manager promoted good working relations, and new staff were well supported whilst settling into their role. Grosvenor Hall DS0000069123.V351526.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 34 35 36 38 Quality in this outcome area is good. Service users benefit from living in a well-run home where their safety and welfare are promoted and protected. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: A new manager was appointed following the takeover of the home in May who took up post from 23rd May 2007. On the day of our vist we were informed that this manager had now left the home and we were able to meet with her replacement. An application for registration with the Commission of Social Care Inspection will be needed in respect of the new post holder. In the AQAA we were told that a formal monthly audit programme has been developed for medication and care plans as well as monthly pressure sore Grosvenor Hall DS0000069123.V351526.R01.S.doc Version 5.2 Page 21 monitoring, accident statistics and staffing levels. This was confirmed in conversation with the manager and examination of the audit process. CSCI notifications are sent either via fax or post as soon as is practicable following an incident (usually within 24 hours). All residents financial records are accessible to the resident and/or their nominated representatives and all personal monies received are receipted and kept within the homes safe. All receipts are kept for the purpose of audit and copies are available on request. The Home Manager undertakes personal supervision sessions with staff and staff are supervised at all times by either RGN or senior carers. All equipment is checked on a regular basis and fire drills are carried out monthly. The Operations Manager reported that all appropriate health and safety requirements were met. Staff confirmed the availability and mandatory use of personal protective equipment, such as disposable gloves and aprons. There was documentary evidence seen on staff files confirming that training had been undertaken in connection with health and safety, moving and handling, food hygiene and first aid. Grosvenor Hall DS0000069123.V351526.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 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 X 3 3 X 3 X 3 Grosvenor Hall DS0000069123.V351526.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NEW SERVICE 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 OP7 Regulation 15 Requirement Timescale for action 10/12/07 2 OP8 13(4(c) 3. OP8 14 (1) (a) (2) 4. OP31 9 (1) (2) (a) (b) Each service user must have a care plan in place that accurately reflects their present needs so that the care staff will be able to give them the right care. Risk assessments must be 10/12/07 reviewed and updated and action needed to address the risks, be transferred to each persons care plan. Attention should be specifically given to pressure sores, weight loss and infections. This will ensure that each resident will have a plan in place, which will try to make sure the risks are lessened and the right care given. Nutritional screening must be 10/12/07 undertaken to ensure that an accurate record of residents’ weights is maintained and appropriate action taken, including referral to the dietician, if needed. The home’s manager must apply 30/12/07 to the Commission for Social Care Inspection to become registered. Grosvenor Hall DS0000069123.V351526.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP7 OP19 Good Practice Recommendations Wherever possible the individual or their representative should be involved in the review of the care plan. The current programme of refurbishment should be completed as soon as possible to improve the environment for the residents. Grosvenor Hall DS0000069123.V351526.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Grosvenor Hall DS0000069123.V351526.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!