Inspection on 01/07/05 for The Hall Nursing Home

This inspection was carried out on 1st July 2005.

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

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

Other inspections for this house

The Hall Nursing Home 21/02/08

The Hall Nursing Home 22/09/06

The Hall Nursing Home 10/02/06

The Hall Nursing Home 10/03/05

The Hall Nursing Home 29/10/04

The Hall Nursing Home 22/01/04

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

CARE HOMES FOR OLDER PEOPLE The Hall Nursing Home 100 Old Station Road Bromsgrove Worcestershire B60 2AS Lead Inspector Mandy Burton Unannounced 1 July 2005 07:40 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Hall Nursing Home E52 S4112 The Hall NH V234842 010705.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Hall Nursing Home Address 100 Old Station Road Bromsgrove Worcestershire B60 2AS 01527 831375 01527 575071 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Worcestershire Care Group Limited Margaret Anne Green Care Home with Nursing 43 Category(ies) of DE(E) Dementia (over 65) - 12 registration, with number LD Learning Disability - 1 of places OP Old Age - 43 PD Physical Disability - 6 PD(E) Physical Disability (over 65) - 43 TI Terminally Ill - 6 The Hall Nursing Home E52 S4112 The Hall NH V234842 010705.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. An age limit of 55 - 65 applies to people with needs in category PD. 2. 10 beds for the rehabilitation of people over 55 years of age. 3. An age limit of 52 - 65 years applies to the person in category LD. 4. The home may also accommodate 2 people under 65 years with a learning disability and a physical disability. Date of last inspection 10 March 2005 Brief Description of the Service: The Hall Nursing home is a well established care home with nursing situated in a quite residential area close to the centre of Bromsgrove. It is set in attractive, well maintained gardens with paved seating areas which are accessible to residents and their visitors. Accommodation is provided over two floors. A passenger lift provides access to the first floor. In addition to providing long term and permanent accommodation, the home has a self contained rehabilitation unit. The home is owned by Worcestershire Care Group Limited , which also owns another establishement, The Meadows Nursing Home in Lydiate Ash. The Hall Nursing Home E52 S4112 The Hall NH V234842 010705.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 07.40 am. It took place over a period of seven hours. The main focus of this inspection was to assess care practice and to review progress made by the home to address requirements made at the previous inspection on 10.03.05. It was also necessary during this inspection to investigate a complaint raised with the Commission for Social Care Inspection in relation to staffing. A partial tour of the home took place and a selection of staff and care records were examined. Six residents and six staff were spoken to. What the service does well: What has improved since the last inspection? What they could do better: Regular updating of care plans to ensure plans accurately reflect care practice and the individual care needs of residents will ensure continuity of care and prevent residents being placed at risk. The Hall Nursing Home E52 S4112 The Hall NH V234842 010705.doc Version 1.40 Page 6 By addressing outstanding requirements in relation to records kept in relation to medication administration risks to residents will be eliminated 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 Hall Nursing Home E52 S4112 The Hall NH V234842 010705.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Hall Nursing Home E52 S4112 The Hall NH V234842 010705.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, 4 and 6 Residents’ individual needs are assessed prior to them moving into the home in order to ensure they receive appropriate care and the services required when they move in to the home. Residents admitted for rehabilitation are well supported by staffs, which enables them to regain confidence and maintain independent living skills and prepare to return to their own home. EVIDENCE: Individual records are kept for each resident. The pre admission records of three residents were examined and each included an assessment carried out by a trained nurse prior to the resident’s admission. The quality of assessments was good, identifying the individual needs and preferences of each resident. There was also evidence that staff from the home had accessed any relevant information relating to the care of each resident from relevant professionals. A resident was able to confirm that they had met with staff from the home prior to their admission. Discussion took place about the benefits of having a copy of the respective Community Care Assessment prior to a decision being made to admit a The Hall Nursing Home E52 S4112 The Hall NH V234842 010705.doc Version 1.40 Page 9 resident to the home, and the potential problems, which can arise if this is delayed. During this visit a number of staff were overheard talking with residents. Relationships between staff and residents were very relaxed and friendly. Staff spoken to had a good understanding of each resident and their individual needs. A shift handover session was observed. The report given by the night sister to day staff was very informative and provided an overview of the condition of each resident and any significant change that had occurred during the night. The nursing home has a ten bedded rehabilitation unit which is self contained and staffed separately. Four Residents residing on the rehabilitation unit were spoken to, all of which were very satisfied with the care they had received during their stay, with one resident describing the care they had received as ‘fantastic’. One resident made specific reference to the fact that they valued being able to continue decision-making and to maintain independent living skills in the same way, as they would have done at home. The Hall Nursing Home E52 S4112 The Hall NH V234842 010705.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 Appropriate systems are in place for care planning and health care screening however the failure to ensure records reflect the acute needs of some residents admitted to the home, and to ensure records are updated when changes occur could put residents’ health and welfare at risk. The systems for the administration of medication are good but poor standards of record keeping continues to place residents at risk. Personal support is offered in a way, which promotes the privacy and dignity of the residents and promotes independence. EVIDENCE: The care records of four residents were examined. Daily progress notes are recorded for each resident. Records seen were generally very informative and provided evidence of residents receiving regular exercise, participating in social activities and an overview of each resident’s health and well being. Daily notes for one resident were not however consecutively numbered. Not all care plans seen reflected the content of the pre admission assessment and failed to accurately detail the current care needs of the residents concerned. The community care review for one resident identified that they had difficulties communicating and were therefore unable to use the nurse call. The review stated that staff were having to observe the resident at regular intervals. A The Hall Nursing Home E52 S4112 The Hall NH V234842 010705.doc Version 1.40 Page 11 care plan for this resident which highlighted a potential risk of falls stated that staff must ensure the resident concerned had their call bell accessible to them. This action was not consistent with information contained in the review. Daily notes for one resident referred to concerns by staff in relation to weight loss and recorded that the resident’s weight should be reviewed and food supplements offered. The care plan for this resident did not however make reference to the frequency of weight recording. It was noted that staff were not following requirements detailed in one resident’s care documentation in relation to blood sugar monitoring. There was evidence that residents or their representatives had countersigned care plans. This was further confirmed in discussions with one resident who reported that they had seen and agreed their care plans. Records seen showed that appropriate action had been taken by staff when changes were noted in the residents well being. Records relating to wound care management were good with evidence that photographs were being taken to evaluate progress. Since the last inspection some staff have attended a study day in respect of nutritional issues. As a result of their findings the home has introduced a new nutritional screening tool. The tool has been introduced for all residents. Discussion took place about the need to ensure the previous screening tool is no longer in use. Further discussion took place with staff about the need to archive records, which are no longer applicable/active to prevent confusion. One resident had a care plan relating to issue about a catheter but no longer had a catheter in place. Care plans for residents in the rehabilitation unit included specific plans as applicable for maintaining independent living skills such as cooking, and demonstrated how staff were supporting and reassuring each resident. The home has it’s own physiotherapist and occupational therapist who visit the home and provide advice and support to both residents and staff. One resident commented that staff regularly remind them to undertake exercises specified by the physiotherapist. Medication administration records (MAR) were examined. A number of records were noted to be incomplete with gaps noted in the recording with no reason for the omission. Not all additions and amendments to the prescription recorded on MAR charts had been signed/countersigned by the person responsible for completing the entry. These issues were also highlighted at the previous inspection. Records seen for one resident showed that their medication was not being given in accordance with the original prescription. One resident was self-medicating. Lockable storage was available to them The records for one resident on the rehabilitation unit showed that staff had initiated a request for a medication review on their admission to the home. The Hall Nursing Home E52 S4112 The Hall NH V234842 010705.doc Version 1.40 Page 12 Observations made indicated that residents in the home were treated with respect and their dignity maintained. The atmosphere was very relaxed and relationships between residents and staff were seen to be warm and friendly. Residents spoken to said staff treated them well. Staff were observed knocking on doors before entering residents rooms. The Hall Nursing Home E52 S4112 The Hall NH V234842 010705.doc Version 1.40 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 Residents in this home are encouraged to be independent as able and make choices and decisions about how they wish to spend their time. The dietary needs of residents are well catered for with a balanced and varied selection of food available, which meets resident’s tastes and choices. A range of social activities and opportunities are made available to residents providing stimulation and an opportunity to pursue leisure interests. EVIDENCE: Residents spoken to were able to confirm that they are able to make choices in respect of daily living. One resident said that staff do not ‘interfere’ and let them carry on with out disruption. All residents spoken to were very complimentary of the food served to them and the choices made available to them. One resident said ‘Meals are lovely, I have put weight on since I have been here’. A system has been introduced whereby a catering form is completed for residents on their admission to the home. The form records any specific dietary requirements and any likes or dislikes. This information is then passed onto catering staff. Records seen during this inspection and discussion with catering staff indicate that while this system is being implemented well for nursing residents, it has not always been carried out for residents admitted to The Hall Nursing Home E52 S4112 The Hall NH V234842 010705.doc Version 1.40 Page 14 the rehabilitation unit and their individual likes and dislikes had not always been made known to catering staff. The kitchen was noted to be well organised and clean and tidy. The home has a four-week rolling menu. Monthly catering meetings are held to discuss any particular issues and any changes that may be required to the menu. Residents are consulted each day about their choice at mealtimes. Since the last inspection the catering manager has developed a photographic menu, which comprises of a book containing photographs of all menu choices. This book can then be taken with staff when they speak to residents about their preference at mealtimes and is reported to be particularly helpful to residents with a hearing impairment. The lunchtime routine was observed. The meal served was well presented and residents were given ample portions. Staff were observed assisting residents as necessary. This was carried out in a relaxed and caring manner. Since the last inspection a second part time activities coordinator has been appointed. Records were seen of social activities pursued by residents. Records showed a variety of opportunities were made available to residents. Residents on the rehabilitation unit were supported as desired to continue with any social interaction /opportunities they may have had in place before their admission. Residents spoken to confirmed that they could receive visitors at any reasonable time and that visits could take place in private. The Hall Nursing Home E52 S4112 The Hall NH V234842 010705.doc Version 1.40 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The complaints process in the home is good. Residents feel that staff are approachable and are confident to discuss any concerns, knowing that they will be taken seriously. EVIDENCE: All residents spoken to were happy with the care they received and said that if they had any concerns they would know who to talk to and would feel confident to do so. On resident spoken to said that they had previously raised concerns at mealtime. They were impressed by the response they received and the fact their concerns were taken seriously. They said that every effort was made to improve the service they received. Since the last inspection the commission for social care inspection has received a complaint in relation to staffing at the home. This complaint was investigated during this unannounced inspection. The complaint was partly upheld and some recommendations for good practice identified. Records were seen of a complaint made by a resident, which was investigated by the home. Records seen showed that appropriate internal investigations were undertaken in accordance with the home’s policies and procedures. The Hall Nursing Home E52 S4112 The Hall NH V234842 010705.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 24, 25 and 26 The general standard of the environment within this home is good and provides residents with a clean, comfortable and homely place to live in. Some residents are being placed at risk while radiators are not suitably guarded. EVIDENCE: A partial tour of the home took place. The home was noted to be generally well maintained internally and externally. There was however two issues highlighted for further action; It was noted that two radiators in one shared bedroom were not guarded or had low surface temperatures. External bolts were observed on sluice room doors and the cellar. While bolts are in place there is a risk that a person could be inadvertently locked in these areas. A more suitable method of securing the doors is required. Some residents were seen independently mobilising about the home and the grounds and accessing communal areas or their own rooms. Several bedrooms were seen which appeared clean and very homely and showed that residents had been able to bring in personal items including furniture with them into the home. The Hall Nursing Home E52 S4112 The Hall NH V234842 010705.doc Version 1.40 Page 17 Residents have access to several communal areas. Residents on the rehabilitation unit have their own designated communal area, but are also able to access facilities in the main part of the home too. One resident commented on the difficulties at mealtimes, as the unit does not have a defined dining room. The resident said that they found themselves having to do something they would not normally do at home, such as either eat their meal in their bedroom or in an armchair in the lounge with a portable table. The resident recognised that they could access the main dining room but said that they preferred to eat with friends they have made on the rehabilitation unit. Appropriate infection control measure were in place and staff were observed carrying out duties and demonstrating safe practice. The Hall Nursing Home E52 S4112 The Hall NH V234842 010705.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, 30 Adequate numbers of staff are on duty, which ensures residents individual needs can be met and they are kept safe. Residents are protected by the homes through recruitment practices. Arrangements for the induction of staff are good and staff receive appropriate training in order to ensure they have the necessary skills and knowledge to care for residents and to ensure their ongoing safety. EVIDENCE: On the day of this inspection 36 residents were living in the home. The home was adequately staffed at the time of inspection. Rotas detailed staff on duty twenty-four hours each day. The atmosphere within the home was very relaxed and unhurried. Residents spoken to all said they felt there were enough staff on duty to meet their needs and call bells were answered promptly. Relationships between staff and residents were very positive and staff were heard talking to residents in a warm and friendly manner. One resident said that staff were kind to them and that the best part of the home was being able to have a laugh and a joke with the staff Records relating to staff were examined. Records seen showed that the home’s recruitment policies and procedures are adhered to. The home has a designated training coordinator. Since the last inspection Worcestershire Care Group have provided a training centre which is away from the home and is already being used for staff training purposes. Another recent addition has been a new programme for staff induction. A mentor pack was seen during this visit, which provided evidence of the training new staff would be receiving The Hall Nursing Home E52 S4112 The Hall NH V234842 010705.doc Version 1.40 Page 19 Several care staff from the home are participating in a 20-week training course held at the training centre. Staff attend at regular intervals over the 20 weeks and training covers all aspects of care practice. This course will reportedly be ongoing and it is hoped all staff will have the opportunity to attend over a period of time. Professional publications are displayed in the home and are readily accessible to all staff to keep up to date with good practice. The home also takes students on placement from a local university. The Hall Nursing Home E52 S4112 The Hall NH V234842 010705.doc Version 1.40 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36, 37 and 38 Health and safety practices are generally good, but further improvements to address fire safety matters, cover radiators, and increase the frequency of checks to hot water outlets would eliminate risks to residents. EVIDENCE: The home manager was absent at the time of this inspection and the home was being managed by the deputy who was very efficient and committed to ensure standards are maintained during the manager’s absence. Procedures are place for staff to receive regular supervision. Four supervision records were seen. Records showed that one member of staff had not received supervision for six months and the supervision for another member of staff had been delayed. The deputy manager acknowledged the delays, which were due to the demands of additional responsibilities during the manager’s absence. There was however evidence that the staff concerned had received appraisals during this period. The Hall Nursing Home E52 S4112 The Hall NH V234842 010705.doc Version 1.40 Page 21 All records were stored securely. Some shortfalls were evident in records relating to medication administration (see previous findings in relation to standard 9). Positive health and safety practices are promoted. A notice board was seen which had a display relating to fire safety. The board was located in an area, which could be seen by all staff. In addition to this a poster was displayed for the attention of staff, residents and visitors highlighting the risks associated with the hot weather and sunburn and detailed action to be taken to eliminate risks. Fire safety documentation was seen. The fire safety officer inspected the home in January 2005, and highlighted several issues for action. Discussions have since taken place and the home is working with the fire officer to address the issues. A health and safety meeting was due to take place later in the month and it was reported that fire safety would be reviewed. Systems are in place for regular maintenance checks of equipment. It was reported that routine checks are carried out on hot water outlets every three months. It is recommended that the frequency of these checks be increased. A Certificate was seen which confirmed that an electrical inspection had taken Place in December 2004. External bolts were observed on sluice room doors and the cellar. While bolts are in place there is a risk that a person could be inadvertently locked in these areas. A more suitable method of securing the doors is required. The Hall Nursing Home E52 S4112 The Hall NH V234842 010705.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x x 3 2 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x 2 2 2 The Hall Nursing Home E52 S4112 The Hall NH V234842 010705.doc Version 1.40 Page 23 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7,8 Regulation 12(1) 15(1) 12(1) 15(1) 13(2) Requirement All care plans must reflect residents assesssd needs and accurately reflect the current care to be provided to them . Staff must ensure that the blood sugar levels of residents with diabetees are appropriately monitored and recorded . All medication must be administered as prescribed and staff must sign for all medication adminstered and document a code for any medication omitted or refused. (Previous requirement 10.03.05 not met) Any written additions or amendments to medication administration records must be supported by signatures/countersignatures. (Previous requirement 10.03.05 not met) The radiator identified in one shared room must be guarded or have a low surface temperature. Bolts on sluice room doors and the cellar must be replaced with coded number pad door entry systems. Timescale for action Immediate and ongoing. Immediate and ongoing. Immediate and onging. 2. 7, 8 3. 9 , 37 4. 9 , 37 13(2) Immediate and ongoing. 5. 6. 25 38 13(4) 13(4) 30th August 2005 30th August 2005 7. The Hall Nursing Home E52 S4112 The Hall NH V234842 010705.doc Version 1.40 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. 3. 4. Refer to Standard 7 15 38 Good Practice Recommendations All care plans no longer applicable should be archived seperately to current documentation to prevent confusion. Sytems should be put in place to ensure information regarding the dietary likes and dislikes of all residents on the rehabilitation unit is passed on to catering staff. Water temeperatures from hot water outlets should be randomly tested weekly and all outlets tested at least once a month. The Hall Nursing Home E52 S4112 The Hall NH V234842 010705.doc Version 1.40 Page 25 Commission for Social Care Inspection The Coach House John Comyn Drive, Perdiswell Park Droitwich Road Worcester WR3 7NW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Hall Nursing Home E52 S4112 The Hall NH V234842 010705.doc Version 1.40 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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