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Inspection on 27/02/06 for Hatfield Peverel Lodge Residential and Nursing Home

Also see our care home review for Hatfield Peverel Lodge Residential and Nursing Home for more information

This inspection was carried out on 27th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

A number of residents said that the staff were "very helpful and pleasant", and considered that the home was "well run". Residents generally described the food as "good or excellent". One resident considered that the home was "like a five star hotel". The home had an open management style, and staff responded positively to suggestions, concerns or complaints.

What has improved since the last inspection?

Training was being given a high priority.

What the care home could do better:

The care records would benefit from being more resident focused. They did not always reflect the current condition and care needs of residents. Relatives considered that communication, particularly about health care issues, could be improved. A number of requirements were made in relation to the management of medicines. Appropriate door locks need to be fitted so that they can be used by both residents and staff. Staff need to ensure that care isalways conducted in a manner which promotes residents` privacy and dignity, and offers genuine choices. Staff need further training on the use of bedrails, and safe alternatives for residents with confusion or agitation.

CARE HOMES FOR OLDER PEOPLE Hatfield Peverel Lodge Residential and Nursing Home Crabbs Hill Hatfield Peverel Chelmsford Essex CM3 2NZ Lead Inspector Francesca Halliday Kingfisher House - Unannounced Inspection 27th February – 13th March 2006 09:00 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 Hatfield Peverel Lodge Residential and Nursing Home DS0000015350.V284887.R01.S.doc Version 5.1 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. Hatfield Peverel Lodge Residential and Nursing Home DS0000015350.V284887.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hatfield Peverel Lodge Residential and Nursing Home Crabbs Hill Hatfield Peverel Chelmsford Essex CM3 2NZ 01245 380750 01245 380906 Address 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) www.bupa.co.uk BUPA Care Homes (CFCHomes) Limited Ms Pervine King Care Home 71 Category(ies) of Dementia - over 65 years of age (30), Old age, registration, with number not falling within any other category (8), of places Physical disability over 65 years of age (41) Hatfield Peverel Lodge Residential and Nursing Home DS0000015350.V284887.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Mallard House Persons of either sex, aged 65 years and over, who require nursing care by reason of dementia (not to exceed 30 persons) Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 2 persons) Kingfisher House Persons of either sex, aged 65 years and over, who require nursing care by reason of a physical disability (not to exceed 41 persons) Persons of either sex, aged 65 years and over, who only fall within the category of old age (not to exceed 8 persons) The total number of service users accommodated must not exceed 71 persons 8th November 2005 2. 3. Date of last inspection Brief Description of the Service: Hatfield Peverel Lodge has two separate houses. Kingfisher House is registered to provide nursing and care for up to 41 people over the age of 65, although only 40 beds are in use. Mallard House provides nursing and care for up to 30 people over the age of 65 with dementia. Both houses are two storey buildings with passenger lifts. The home has 67 single rooms, with two shared rooms on Mallard House. Hatfield Peverel Lodge is located approximately half a mile from the centre of Hatfield Peverel village and about one mile from local shops and facilities. There is a bus stop within a quarter of a mile of the home and Hatfield Peverel is on the main London to Colchester train route. Hatfield Peverel Lodge Residential and Nursing Home DS0000015350.V284887.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was to Kingfisher and Robin Houses only. (The name Kingfisher is used throughout the report and refers to both floors of the building). This unannounced inspection visit took place on 27th February 2006. The inspection lasted 9 hours 3 minutes. The inspection process included: discussions with 7 residents, 4 relatives and 5 members of staff (including the head of care of Kingfisher House and the registered manager). The premises and a sample of records were inspected. The GP for Kingfisher House was also spoken with during the inspection. The responsible individual was present at the feedback and discussion following the inspection. Further discussion was held with the manager on 8th and 13th March, and this concluded the inspection process. 18 of the 38 standards were inspected: 8 met the standard, 5 standards had minor shortfalls and 5 standards were not met. The judgements made within the report are based on the observations and evidence gathered during this inspection. What the service does well: What has improved since the last inspection? What they could do better: The care records would benefit from being more resident focused. They did not always reflect the current condition and care needs of residents. Relatives considered that communication, particularly about health care issues, could be improved. A number of requirements were made in relation to the management of medicines. Appropriate door locks need to be fitted so that they can be used by both residents and staff. Staff need to ensure that care is Hatfield Peverel Lodge Residential and Nursing Home DS0000015350.V284887.R01.S.doc Version 5.1 Page 6 always conducted in a manner which promotes residents’ privacy and dignity, and offers genuine choices. Staff need further training on the use of bedrails, and safe alternatives for residents with confusion or agitation. 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. Hatfield Peverel Lodge Residential and Nursing Home DS0000015350.V284887.R01.S.doc Version 5.1 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 Hatfield Peverel Lodge Residential and Nursing Home DS0000015350.V284887.R01.S.doc Version 5.1 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 the following standard(s): 3 and 4 Residents are happy with the assessment process prior to admission, and consider that the home meets their needs. EVIDENCE: The sample of preadmission assessments seen demonstrated a sound assessment process. Residents admitted since the last inspection said that they were happy with the assessment process, and considered that the home met their needs. There was evidence of appropriate reassessment of residents, following changes in condition. Additional clinical training was being given to staff in order to meet a number of residents’ specific needs. Standard 1 was assessed as met at the last inspection on 8th November 2005 (standard 6 not applicable). Hatfield Peverel Lodge Residential and Nursing Home DS0000015350.V284887.R01.S.doc Version 5.1 Page 9 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, 10, 11 Care plans and risk assessments do not always reflect residents’ current condition, risk or care needs, and are not sufficiently resident focused. Relatives would like communication to be given a higher priority. Record keeping of Controlled Drugs is very poor. Staff responded to concerns about privacy, but this is still an area that needs to be improved. EVIDENCE: Some of the care plans sampled were of a good quality, but others had not been updated following changes in residents’ condition. There was evidence of some involvement from residents, and relatives where appropriate, but the care plans were not generally very resident centred. The standard of evaluations had improved, but needed to be updated following major changes in condition and not left until the monthly review. The wound care documentation sampled was poor. It was difficult to establish what wounds were present, how severe they were or whether there had been any progress in healing. Residents had a general health check and were weighed every month. The home had a range of risk assessments. Assessments were not always Hatfield Peverel Lodge Residential and Nursing Home DS0000015350.V284887.R01.S.doc Version 5.1 Page 10 personalised to the individual resident or updated following changes in condition. A resident with a very high risk of developing a pressure sore, whose condition had deteriorated, had not been placed on an appropriate pressure relieving mattress. Residents confirmed that they were able to see their GP when they had any health concerns. There was evidence that staff were encouraging rehabilitation, and that some residents’ mobility had improved considerably since admission. One relative considered that frail residents did not always get sufficiently regular drinks, and said that communication between staff and between staff and relatives could be improved. Another relative considered that they had not been kept fully informed about accidents that had occurred. There was evidence that staff were not always documenting important discussions with relatives. There was evidence that residents were being referred for hospital investigations and treatment where appropriate. One resident was pleased that a member of staff always accompanied them when they needed to go to the hospital. Residents said that they saw the chiropodist and had dental and optical checkups. The GP spoken with said that she was generally very happy with the care. She considered that staff were very caring and generally contacted her appropriately for medical advice. The medicine administration charts sampled were generally well completed. Storage temperatures were being monitored in the clinical room, and for the medicines fridge. However one of the medicine trolleys was being stored in the corridor, the temperature in this area was not being monitored. The homely remedy stock balances were correct. Some medicines only had a label on the outer carton and not on the container itself. The controlled drugs (CD) stock balance of one medicine was not correct, as one administration had not been recorded in the CD register. On seven other occasions the second signature had not been recorded in the register. Some residents at this inspection considered that their privacy and dignity was respected. However one resident said that they did not consider that their privacy was fully respected, as they did not have a key for their door. The manager said that keys were available for all residents’ rooms. However, staff could not use a master key in an emergency if the key was still in the lock. A relative said that they had raised concerns about the privacy of a resident, who had their bath interrupted by numerous staff entering the room. They said that within twenty four hours signs had been produced, which were hung on doors to indicate that care was being carried out. A discussion was held about why staff did not use the locks to the bedroom and bathroom doors, when they were assisting residents with care or personal hygiene. One relative spoken with did not consider that they were getting sufficient support from staff when their relative was terminally ill. However, there was evidence that other relatives had written complementary letters, thanking staff Hatfield Peverel Lodge Residential and Nursing Home DS0000015350.V284887.R01.S.doc Version 5.1 Page 11 for the support given during residents’ last illnesses. Staff had not received any training in terminal care or bereavement counselling. Hatfield Peverel Lodge Residential and Nursing Home DS0000015350.V284887.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 Staff need to ensure that residents are offered genuine choices, and encouraged to take as much control as possible over their lives. EVIDENCE: Standards 12, 13 and 15 were assessed as met at the last inspection on 8th November 2005. Residents at this inspection generally remained very happy with the activities on offer and with the variety and quality of food. One relative said “you couldn’t have wished for a better Christmas, they try to incorporate the family and bend over backwards to help”. One resident described the food as “excellent”. A number of residents considered that they could exercise some choice and control over their lives. However, one resident said that they were not offered a choice about when they got up and went to bed, and considered that they had to fit in with what suited staff. Hatfield Peverel Lodge Residential and Nursing Home DS0000015350.V284887.R01.S.doc Version 5.1 Page 13 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): 18 Staff do not always follow appropriate procedures to protect residents from harm. EVIDENCE: Standard 16 and 18 were assessed as met at the last inspection on 8th November 2005. There was evidence at this inspection that complaints were taken seriously, and positive changes to care and services were made following the raising of suggestions, concerns or complaints. One relative said “staff do listen and try to put things right”. During the inspection two relatives raised concerns about the number of injuries (skin tears and bruises) a resident had sustained since admission. The GP confirmed that the resident’s fragile skin was due to their medical condition and treatment. However, bed rails continued to be used even when it became evident that the resident was injuring themselves on the rails. The resident was agitated and confused, which put them at an even higher risk of injury from the rails. On the day of inspection the bed rails were fitted in such a way as to leave a gap between the rail and mattress, increasing the risk of entrapment and injury. Staff had not followed appropriate procedures and called a multidisciplinary meeting to discuss the resident’s management, or considered alternatives to the use of bed rails. The documentation about the injuries was extremely poor. A complaint, about this resident’s care, was received by the Commission and made to the Protection of Vulnerable Adult (POVA) team. A few staff needed to do POVA training. Hatfield Peverel Lodge Residential and Nursing Home DS0000015350.V284887.R01.S.doc Version 5.1 Page 14 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 The home has an ongoing redecoration programme, but some touching up of scuffed paintwork is needed. EVIDENCE: Ten residents’ bedrooms and the small lounge on the first floor had been redecorated since the last inspection. The manager said that there were plans to change some of the bedroom carpets and corridor carpets later this year. The paintwork in some corridors and doorways was very scuffed from the movement of equipment. Standard 26 was assessed as met at the last inspection on 8th November 2005. The home was very clean on the day of this unannounced inspection. A relative said that the bedroom had not been clean when the resident first moved in. The manager said that unfortunately they had been shown a room that had not been prepared, but that systems were being put in place to prevent this happening again. One relative said that a large number of named Hatfield Peverel Lodge Residential and Nursing Home DS0000015350.V284887.R01.S.doc Version 5.1 Page 15 clothing had not been returned from the laundry, but the items were found following the inspection. Hatfield Peverel Lodge Residential and Nursing Home DS0000015350.V284887.R01.S.doc Version 5.1 Page 16 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 Staffing is at agreed levels, but supervision in the lounge could be improved. Recruitment practices are thorough. Staff training is given a high priority. EVIDENCE: The head of care confirmed that staffing levels were maintained at 8 staff on the morning shift, 7 staff on the evening shift and 4 staff on the night shift. One relative said that there were “No staff sitting in the lounge in the afternoon, and residents don’t have their call bell by them”. The home had sound recruitment practices, with evidence of checks with the Criminal Records Bureau, Protection of Vulnerable Adults register and with the Nursing and Midwifery Council. Standard 30 was assessed as met at the last inspection on 8th November 2005. 10 care assistants had completed NVQ level 2. Since the last inspection nursing staff had received training in the prevention and management of pressure sores and wound care. This training was being cascaded to the care assistants. A number of staff had received training in care of the older person with Parkinson’s disease. The manager said that a further session on wound care was planned and that she hoped to set up training in diabetes care. Hatfield Peverel Lodge Residential and Nursing Home DS0000015350.V284887.R01.S.doc Version 5.1 Page 17 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, 32, 33, 35, 38 The home has an open style of management, in which staff respond positively to feedback from residents and relatives. Training in safe working practices is being given a high priority. EVIDENCE: The manager was an experienced registered nurse, who had completed the NVQ level 4 in management. She encouraged an open, positive and inclusive style of management. A resident described the home as “well run”. The home has a quality assurance programme with systems in place to regularly monitor the quality of services and care. A number of staff were in the process of undertaking a “personal best” course. The course encourages staff to reflect on the care and services they provide, and to identify areas where they can improve and provide their personal best. The home held Hatfield Peverel Lodge Residential and Nursing Home DS0000015350.V284887.R01.S.doc Version 5.1 Page 18 regular relatives meetings, and relatives reported that action was taken when they made suggestions or raised concerns. The manager said that the home did not handle residents’ monies and that services such as hairdressing and chiropody were billed directly to the residents’ representatives. The majority of staff had completed fire safety and moving and handling training, and the head of care was qualified to give training on both these subjects. The majority of staff had started infection control training. A number of staff needed training in food hygiene and health and safety. There was evidence of good systems for servicing and maintenance of equipment. Hatfield Peverel Lodge Residential and Nursing Home DS0000015350.V284887.R01.S.doc Version 5.1 Page 19 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 X X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 1 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 2 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 1 2 X X X X X X X STAFFING Standard No Score 27 2 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 2 Hatfield Peverel Lodge Residential and Nursing Home DS0000015350.V284887.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 27/02/06 2 OP7 15 3 OP8 14(2) The registered person must ensure that care plans cover all assessed needs, are updated following changes in residents’ condition and are resident focused. Informed at the time of inspection. Requirement in previous reports - timescales 17.08.04, 1.03.05 and 08/11/05 not met. The registered person must 27/02/06 ensure that wound care documentation provides evidence of the condition of each wound and clear information on the progress of healing. Informed at the time of inspection. The registered person must 27/02/06 ensure that risk assessments are personalised to the individual resident, are reviewed and updated when residents’ condition changes, and that action is taken to minimise risk once a high risk has been identified. Informed at the time of inspection. Requirement in previous report - timescale 08/11/05 not met. DS0000015350.V284887.R01.S.doc Version 5.1 Hatfield Peverel Lodge Residential and Nursing Home Page 21 4 OP8 12(1)(a) 5 OP8 12(1)(a) 6 OP9 13(2) 7 OP9 13(2) 8 OP9 13(2) 9 OP10 12(4)(a) 10 OP11 18(1)(c) 11 OP14 12(2) The registered person must ensure that residents who need assistance are offered drinks at very regular intervals. Informed at the time of inspection. The registered person must ensure that communication with relatives is given a high priority, and that important discussions are documented. Informed at the time of inspection. The registered person must ensure that nurses follow correct procedures for recording the administration of Controlled Drugs. Informed at the time of inspection. The registered person must ensure that the temperature is monitored in all areas where medicines are stored. Informed at the time of inspection. The registered person must ensure that medicines are labelled on the container as well as or instead of the outer packaging. Informed at the time of inspection. Requirement in previous report - timescale 01/02/06 not met. The registered person must ensure that all bedrooms, bathrooms and toilets have locks that are suitable for residents’ use and are accessible to staff in emergencies, and that staff use the locks to provide privacy whilst carrying out personal care. Informed at the time of inspection. The registered person must ensure that staff receive training in terminal care and bereavement counselling. Informed at the time of inspection. The registered person must ensure that staff enable DS0000015350.V284887.R01.S.doc 27/02/06 27/02/06 27/02/06 27/02/06 27/02/06 27/02/06 27/02/06 27/02/06 Page 22 Hatfield Peverel Lodge Residential and Nursing Home Version 5.1 12 OP18 13(7) 13 OP18 13(7)(8) 14 OP18 13(6) 15 OP19 23(2)(d) 16 OP27 12(1)(a) 17 18 OP38 OP38 13(4) 13(3) residents to make decisions and choices, this particularly refers to the ability to go to bed and get up at a time that suits them. Informed at the time of inspection. The registered person must ensure that staff receive training on restraint and the safe use of bed rails, this particularly refers to their use when a resident is confused and likely to injure themselves. Informed at the time of inspection. The registered person must ensure that staff call a multidisciplinary meeting to discuss a resident’s management, when restraints such as bed rails cause injuries. Informed at the time of inspection. The registered person must confirm that all staff have received POVA training. Informed at the time of inspection. The registered person must ensure that areas of badly scuffed paintwork, in corridors and doorways, are touched up. Informed at the time of inspection. The registered person must ensure that residents in the lounge are supervised, and have access to a call bell at all times. Informed at the time of inspection. The registered person must ensure that all staff receive training in health and safety. The registered person must ensure that all staff receive training in food hygiene. 01/05/06 27/02/06 01/05/06 01/05/06 27/02/06 01/06/06 01/06/06 Hatfield Peverel Lodge Residential and Nursing Home DS0000015350.V284887.R01.S.doc Version 5.1 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hatfield Peverel Lodge Residential and Nursing Home DS0000015350.V284887.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Hatfield Peverel Lodge Residential and Nursing Home DS0000015350.V284887.R01.S.doc Version 5.1 Page 25 - 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. 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