Inspection on 17/04/07 for Grove Court Nursing Home

This inspection was carried out on 17th 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

Grove Court Nursing Home 17/01/06

Grove Court Nursing Home 02/09/04

Grove Court Nursing Home 25/05/04

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

CARE HOMES FOR OLDER PEOPLE Grove Court Nursing Home 13-15 Cardigan Road Headingley Leeds Yorkshire LS6 3AE Lead Inspector Sean Cassidy Pre Unannounced Inspection 17th 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 Grove Court Nursing Home DS0000001343.V299246.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. Grove Court Nursing Home DS0000001343.V299246.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grove Court Nursing Home Address 13-15 Cardigan Road Headingley Leeds Yorkshire LS6 3AE 0113 2304966 0113 2242840 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) Grove Court Nursing Home Limited Mrs Sheila Anne Hinchcliffe Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37), Terminally ill (2) of places Grove Court Nursing Home DS0000001343.V299246.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th January 2006 Brief Description of the Service: Grove Court is a converted and extended property occupying a prominent position on a main road in a suburb of Leeds. It is close to all the main amenities in the area and adjacent to the bus service. The home provides nursing and residential care to 37 older people. Seven beds have now been designated as providing intermediate care. Accommodation is provided on 3 floors there are 31 single bedrooms and 3 shared bedrooms. The majority of bedrooms have en-suite wc facilities. The ground floor has a choice of sitting areas, and a separate dining room. There are small garden areas to the side and front of the building, which, are well used by the service users in the better weather. The fees charged for this home range from £494 to £557.56 per week. Grove Court Nursing Home DS0000001343.V299246.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The accumulated evidence in this report has included: • • • A review of the information held on the home’s file since the last inspection. Information submitted by the registered provider in the pre inspection questionnaire. Information received from service users, relatives, staff and other professionals. An unannounced visit to the home was conducted by one inspector and lasted one day. The majority of this time was spent speaking to residents, management and staff. Residents relatives were contacted by phone and also post. The visit included a tour of the premises. A number of documents were examined which included care files, training files, recruitment files and health and safety details. What the service does well: Residents get a contract/statement of terms and conditions document, this means that they are given information about their rights and obligations. The manager and staff develop good and supportive relationships with residents and their families. Residents and visitors spoke highly of the care and support from staff. There are also good relationships with other healthcare professionals, such as the community nursing staff and the Intermediate Care Team. Visitors said that they are welcomed into the home and staff kept them informed of any changes. Grove Court Nursing Home DS0000001343.V299246.R01.S.doc Version 5.2 Page 6 Residents were happy at the home and said that they had had the opportunity to look round before deciding to move in. One resident described the home as ‘absolutely lovely and spotlessly clean’. Staff treat the residents with respect and residents are able to choose how they wish to spend their time. For example when to get up, go to bed and if they want to stay in their room or join other residents in the lounge. Residents look well cared for. All residents spoke well of staff and they felt that they were kind and caring. The home is furnished and fitted to a high standard. The staff are recruited following a tight recruitment procedure. There is a good training structure in place. What has improved since the last inspection? What they could do better: The Statement of Purpose and Service User Guide needs to be reviewed so that the required information is added. The manager must ensure that an assessment has been obtained on all residents prior to them entering the home. The manager must ensure that when a care need is identified then a care plan is written to reflect this need. All risk assessments must also be reviewed on a monthly basis. Grove Court Nursing Home DS0000001343.V299246.R01.S.doc Version 5.2 Page 7 The daily records do not provide the reader with a clear picture as to how each individual has spent their day in the home. It is recommended that the home provide more evidence to show people are assisted to remain independent with their medications. This should be reflected in the Statement of Purpose and Service User Guide. A more appropriate selfmedication risk assessment is needed to assist this process. A more structured activities programme must be developed to suit the needs of the people living in the home. The home must ensure they seek consultation from the group when planning this programme. Particular attention must be paid to those individuals that have clear dementia needs. 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. Grove Court Nursing Home DS0000001343.V299246.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Grove Court Nursing Home DS0000001343.V299246.R01.S.doc Version 5.2 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 the following standard(s): 1,3 and 6. People who use the service experience good quality outcomes in this area. We made this judgement using a range of evidence including a visit to the service. People using this service receive a good standard of information that keeps them well informed. The admission policy is not implemented for all residents entering the home as some are not assessed prior to moving in. This could present difficulties with care provision. EVIDENCE: The home has developed an information pack that is given to residents when they move in. Residents are provided with a copy of the Service User Guide(SUG) in their room. Good feedback was obtained from both residents and relatives about the standard of information they were given by the home. The home has recently been taken over by new owners and the manager is reviewing the Statement of Purpose and Service User Guide to reflect this. Other required information needs to be added. This will ensure that the Grove Court Nursing Home DS0000001343.V299246.R01.S.doc Version 5.2 Page 10 residents are fully informed and up to date with the services offered by the home. Residents and their relatives said that they were offered the opportunity to visit the premises before making a decision to move in. Two of the three files inspected showed evidence that they had been assessed before a place had been offered to them. One resident admitted for long term care had previously been an Intermediate Care resident. A full assessment was carried out on this person before they were admitted as a long term resident. This is good practice. The home offers an Intermediate Care service. Each of these short term residents are provided with an information pack that includes details as to what services the care home offers. The information contained was relevant and helpful. However, it did not contain the terms and conditions of their stay and therefore those using the service are not fully informed about the service. Residents are confident in the care staff’s ability to meet their rehabilitation needs and it was confirmed that training is provided in this area. Members of the Intermediate Care Team spoke very highly of the staff in the home and they also expressed confidence in their ability to meet the rehabilitation needs of this group of people. Although a designated rehabilitation area is not provided, there is sufficient equipment made available by the home to assist with the rehabilitation process. The registered person does not obtain a thorough assessment for Intermediate Care residents before a place is offered. This could lead to inappropriate admissions to the home and could present difficulties with care provision. Grove Court Nursing Home DS0000001343.V299246.R01.S.doc Version 5.2 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 the following standard(s): 7,8,9 and 10 People who use the service experience good quality outcomes in this area. We made this judgement using a range of evidence including a visit to the service. The home ensures the health and social care needs of people living there are provided for to a good standard. There are some areas of improvement in relation to care planning and risk assessment that are needed and the manager is confident that this will be done. EVIDENCE: The care documentation of three people living in the home was looked at. Each resident is risk assessed in areas such as pressure area care, falls, moving and handling and nutrition. The majority of the documentation reviewed showed that there is a consistent good standard of risk assessment. However, not all risk assessments are reviewed monthly. One person identified, as being at high risk of developing a pressure sore had not had the risk assessment reviewed for over ten months. This person did not have a pressure area care plan in place to assist staff with providing for this care need. The wound care plan of another person indicated that they had not received the correct care prescribed Grove Court Nursing Home DS0000001343.V299246.R01.S.doc Version 5.2 Page 12 in the care plan. One resident with a wound did not have a care plan in place to assist staff with that care need. Two out of three care plans showed evidence that they had been agreed with the person requiring the care. The care plans were written in plain language, easy to understand and considered all areas of the individual’s life including health, personal and social care needs. Although the care plans were reviewed monthly it was difficult to identify from the daily records that the people living there are receiving consistent good quality care. The daily records consisted of, “all care given” “care as plan” “no changes to report.” These records should contain more in depth detail of how people living in the home spend their days. This detail will also provide evidence that the care prescribed is being provided. The management has now begun to implement the Gold Standard Framework and Liverpool Care pathway to assist residents and families with their ‘end of life needs.’ This is good practice. People using the service said they were able to access other health professionals when they needed their input. Information was received from other health professionals who provided positive feedback about the home ensuring that people were referred to them when their input was needed. The home has a medication policy that covers all areas. The records for administration were reviewed and correct. All controlled drugs kept by the home were stored and administered correctly. Some prescribed medications belonging to a resident were not stored correctly. They were in bags in the resident’s room. This was highlighted with the manager who corrected this immediately. No residents in the home self medicate. A document is used to assess whether a resident is able to self medicate. This document should be reviewed and possibly discussed with a pharmacist to ensure it fulfils its purpose. At the moment, it does not enable the user to actually identify whether a resident is able to self medicate or not. The Service User Guide should be altered also. This says that the resident must hand over their tablets and a registered nurse will administer them. This does not promote independence in this area. Those people spoken to and other feedback received praised the staff group and the way in which they respected their privacy and dignity within the home. “ They always help me when I need it.” “ There always seem to a lot of staff on to help you. The buzzers are answered quickly.” “They always knock before they enter. The staff were observed to be courteous and helpful. Grove Court Nursing Home DS0000001343.V299246.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 People who use the service experience good quality outcomes in this area. We made this judgement using a range of evidence including a visit to the service. Service users are supported and encouraged to enjoy a flexible lifestyle. However, this process is not structured and there is an absence of input for those with specific dementia needs. EVIDENCE: People living in the home said that they do get involved in activities if they choose to. The manager has arranged for three volunteers to provide a weekly art and craft class for those residents that want to get involved. An exercise class is also provided weekly. The staff encourage people to attend but attendance is poor. Some residents are provided with the opportunity to go out on group outings to various places such as shopping centres and garden centres. Local churches are involved with the client group on a regular basis and these can be accessed when needed. Hand massages and nail care are regularly carried out with residents and this is recorded in the activities record in the care documentation. A hairdresser also attends every week and residents said they enjoyed this social occasion. A newsletter is now developed on a monthly basis which helps inform residents and their families about up and coming events. This is displayed on a notice Grove Court Nursing Home DS0000001343.V299246.R01.S.doc Version 5.2 Page 14 board at the entrance to the home. Newspapers are also available to residents on a daily basis. Residents said that they could order their own if they wished. The manager is aware that there is no structure to the activities provision with in the home and is planning to review the quality of the service provided in this area. There are a significant number of residents living in the home who have dementia. The activities provided do not take into consideration these special needs and this will have to be addressed within the review. There are no restrictions with visiting times and the feedback obtained from those living there and others was positive. Residents are encouraged to maintain relationships with family and friends whenever possible. This was evidenced in the care planning documentation. The lunchtime meal was observed and this was found to be a social occasion. All tables had tablecloths and condiments set out and looked very presentable. Residents that needed assistance with their meals received it in a respectful and courteous manner. Residents were encouraged to use the dining facilities whenever possible. Comments received about the standard of the food provided were positive. A choice of meal is provided and the cook also provides other alternatives. Grove Court Nursing Home DS0000001343.V299246.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good quality outcomes in this area. We made this judgement using a range of evidence including a visit to the service. Residents are protected from abuse with the majority of staff aware of adult protection procedures. Residents feel safe at the home. A complaints procedure is available for all residents and they feel that any concerns will be taken seriously. EVIDENCE: There is a complaints procedure in place at the home and this is made available to residents and their families. The complaints procedure was displayed on the notice board in the hallway. This document does not contain the required information and therefore does not fully inform the reader of the correct process. One resident said, ‘if anything is wrong you can talk to the staff or manager and they will sort it out’. Another said, “I always inform the manager about any concerns and she is quick to sort it out.” The complaints record was seen and only one complaint had been made since the last inspection. The manager had dealt with the complaint but the records kept did not show that there had been an acceptable outcome and that it had been dealt with within the correct timescales. This could lead to possible dissatisfaction and further complaint. Grove Court Nursing Home DS0000001343.V299246.R01.S.doc Version 5.2 Page 16 The manager has had adult protection training and most staff have now been trained in the protection of vulnerable adults. The staff were clear about what they would do if they suspected any abuse or had an allegation made to them. The manager consults appropriately with the adult protection unit for advice and will involve independent advocates for residents, if necessary. Grove Court Nursing Home DS0000001343.V299246.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience excellent quality outcomes in this area. We made this judgement using a range of evidence including a visit to the service. Residents live in a comfortable, safe and well-maintained environment. EVIDENCE: The standard of the internal environment is very good. Residents and others were very complimentary about the way in which the home is presented. The furnishings of the home are also comfortable and clean. The layout of the physical environment is suitable for the needs of the people living in the home. A new internal nurse call system has been installed. The residents spoken to said they are always provided with the nurse call and use it regularly. The new system allows the manager to review the length of time the staff take to Grove Court Nursing Home DS0000001343.V299246.R01.S.doc Version 5.2 Page 18 attend to buzzers. This is audited regularly and allows the manager to identify areas of concern. This is good practice. There is an ongoing maintenance programme within the home and there is a maintenance man employed to carry out the work. A variety of bathrooms are provided around the building. Baths with fixed hoists and wheel in showers are available. Mobile lifting hoists are also provided. The laundry is situated in the basement area and is kept tidy and well organised. Two industrial washers with sluicing programmes and a large dryer are provided. All the personal laundry for long stay service users is undertaken on site. Residents were positive about the standard of the laundry service provided by the home. The standard of cleanliness in the home was very good. Feedback from residents and relatives and others was very positive. Resident comments were, “ The domestic staff are always very busy and they keep my room very clean and tidy.” “ the home is always spotless.” Grove Court Nursing Home DS0000001343.V299246.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. People who use the service experience good quality outcomes in this area. We made this judgement using a range of evidence including a visit to the service. The home provides suitable numbers of staff that have been recruited and trained to a good standard. EVIDENCE: At the time of the inspection the home was fully staffed. The staff team has remained stable, which helps to provide consistency and continuity of care. The recruitment process was reviewed and was found to be good. The recruitment files seen had all the necessary information needed to ensure the people living in the home were protected as far as possible. Good levels of training are provided for both the qualified nurses and the care staff. The home has a staff group of which more than 50 have received training to NVQ level 2 standard and above. All felt that their training needs were met and felt they were equipped to do their job. The home is now using the common induction standards for care for all new starters and these were being completed to a good standard. Good feedback was given from different sources regarding the competency of the staff group and their ability to meet the needs of the people living there. Grove Court Nursing Home DS0000001343.V299246.R01.S.doc Version 5.2 Page 20 Training is reviewed at supervision and also at the appraisal. One member of staff spoken to said that they had identified training in her annual appraisal and this had been provided and completed over the course of the year. Grove Court Nursing Home DS0000001343.V299246.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. People who use the service experience good quality outcomes in this area. We made this judgement using a range of evidence including a visit to the service. The management of the home is reasonably well organised and results in practices that promote and safeguard the health, safety and well being of the residents. EVIDENCE: The manager is a qualified nurse and maintains her registration with the Nursing and Midwifery Council (NMC) through regular update. She has managed this service for seven years and has obtained the Registered managers award. The manager has adopted good systems and processes to help ensure the home is managed to a good standard. She carries out regular audits in area such as care plans and complaints. Residents’ families are sent anonymous questionnaires to ask about the service provided. The manager Grove Court Nursing Home DS0000001343.V299246.R01.S.doc Version 5.2 Page 22 said that they do not arrange questionnaires to be given to residents as they have tried this in the past without much success. It was advised to try and reintroduce this process so that evidence could be provided to show that residents are actually being asked what their views of the care service are. This would be seen as good practice and essential for ensuring good quality care within the home. The audit information gathered by the manager has been correlated and presented in a suitable format. This is good practice and will help improve the quality of care provided within the home. Residents are informed that the home does not take responsibility for managing personal finances. The home does hold small amounts of money for a number of service users and records are kept of the income, expenditure and balance held. Records are kept of any resident accidents or incidents that occur in the home. The manager ensures that the safety checks for equipment used in the home is up to date and correct. A few issues were identified that need priority attention: • • • Not all the staff have received the correct fire training. An environmental risk assessment has not been carried out. When a person falls and sustains a head injury no neurological observations are carried out and the falls risk assessment is not reviewed. This would help protect the health and safety of the people who work and live in the home. Grove Court Nursing Home DS0000001343.V299246.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 2 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 3 4 x x x x x x 4 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 x 3 x x 2 Grove Court Nursing Home DS0000001343.V299246.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation 4,5 and Sched 1 Requirement The Statement of Purpose and Service User Guide must contain all the required information. This will ensure residents and their representatives are kept fully informed of the services offered by the home. A copy of all assessments must be obtained before a resident is admitted to the home. This will help to prevent any inappropriate admissions to the home. When a care need is identified a care plan must be developed to assist staff to meet this need. This refers to the absence of a pressure relieving care plan for a resident with a high risk in this area. This will help reduce the risk to the individual. All risk assessments must be reviewed monthly. This will help the home to identify any changes in the care a person needs. A structured activities programme must be developed DS0000001343.V299246.R01.S.doc Timescale for action 31/07/07 2 OP3 14(1)(b) 31/05/07 3 OP8 15(1) 31/05/07 4 OP12 16(2)(n) 31/07/07 Grove Court Nursing Home Version 5.2 Page 25 5 OP22 22(4)(7) 6 OP35 24 as a result of consultation with the people living in the home. Particular attention must be paid to residents with dementia when developing this programme. This will help to promote wellbeing within the home. The complaints policy and procedure must contain the required information necessary so that people are made fully aware of the process. An annual quality report must be developed by the home. This will provide evidence to show that the home is committed to maintaining and improving the quality of care it provides. 31/05/07 31/08/07 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 OP9 OP8 Good Practice Recommendations Appropriate systems should be in place to encourage people to be independent with administering their own medications. The daily records should contain more in depth detail of what care has been provided and what the person has been involved in each day. This will assist the home to show evidence that the prescribed care is being provided. The people living in the home should be given more opportunities to provide their views of how the home is run. This will give them an opportunity to maintain and improve the quality of care provided in their home. 3 OP35 Grove Court Nursing Home DS0000001343.V299246.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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. 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