Inspection on 23/08/07 for Heaton Grange

This inspection was carried out on 23rd August 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Heaton Grange 25/01/10

Heaton Grange 18/07/06

Heaton Grange 07/02/06

Heaton Grange 16/08/05

Similar services:

Snydale Care Home

Abbey The

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Heaton Grange 425(a) Toller Lane Heaton Bradford West Yorkshire BD9 4NN Lead Inspector Pamela Cunningham Unannounced Inspection 23rd August 2007 10:30 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 Heaton Grange DS0000064467.V345298.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. Heaton Grange DS0000064467.V345298.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heaton Grange Address 425(a) Toller Lane Heaton Bradford West Yorkshire BD9 4NN 01274 494439 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) Mr Deepak Patel Mrs Susan Miller Care Home 20 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (15), of places Physical disability over 65 years of age (3) Heaton Grange DS0000064467.V345298.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th July 2006 Brief Description of the Service: Heaton Grange is a single storey detached residence situated in the Heaton area of Bradford approximately 3 miles from the city centre. There are carparking facilities to the front and the home is on a public transport route. A local shop is within walking distance. A patio and garden area has seating for the service users. The living accommodation consists of an open plan lounge and dining area with a conservatory to the front of the home. Bedrooms provide single and double occupancy with bathrooms and toilets all based on one level. Disabled access is via a ramp to the front door. On the day of the visit fees charged for care provided were between £305.34 and £341.04 per week. Additional charges are made for hairdressing, chiropody newspapers and toiletries. Heaton Grange DS0000064467.V345298.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The visit was made on 23 August 2007 and lasted six hours. The home did not know that this was going to happen. The purpose of this visit was to make sure that the home was being managed for the benefit and well being of the residents. Most of the day was spent talking to residents, relatives, management and staff, to find out what it is like to live, work and visit Heaton Grange. Other records in the home were looked at such as staff files, complaints, health and safety information and accidents records. Before the visit was planned the provider was asked to carry out a quality assessment of the service stating what they did well, what was in place to prove this, what improvements had been made over the last twelve months and what was planned for the year ahead. This document is called the Annual Quality Assurance Assessment and will be referred to in the report as the AQAA. Other information asked for included what policies and procedures are in place, when they were last reviewed and when maintenance and safety checks were carried out. Questionnaires were sent to people living in the home, their relatives and healthcare professionals before the visit took place. These people were selected using information provided in the AQAA. No surveys had been returned at the time of the visit, so apart from speaking to relatives and residents during the visit it was not possible to get the views the people surveyed which included GP’s and other health professionals. The person in charge of the home was the Manager Mrs Susan Miller who was made aware of the findings at the end of the inspection. What the service does well: This is a service, which is run in the best interests of the service users. Service users are treated with respect and dignity. Heaton Grange DS0000064467.V345298.R01.S.doc Version 5.2 Page 6 The atmosphere in the home is homely, warm and friendly with cheerful and relaxed staff who are focussed on meeting the needs of the service users. The home employs a stable staff team, who are enthusiastic about their jobs, some having been at the home for many years. This is good for the people living in the home because it helps to maintain consistency and continuity of care as well good relationships. People who use the service are fully assessed prior to admission to the home and are informed that the home can meet their needs. Daily records give a good account of how service users have spent their day and what care and support have been given. Meals are of a good standard and were spoken about favourably by service users. The gardens are very tidy and safe for the residents to use. What has improved since the last inspection? What they could do better: Information on care provided by the district nurses could be kept in the care file of the person receiving the nursing care. This is with particular regard to treatment of pressure sores. A more secure storage area should be sought for the positioning of the storage of medication, which is currently the manager’s office, and in sight of a window. The new area must also have facilities for washing hand and medicine pots. Amounts of medicines received into the home should also be accounted for on the MAR charts. Heaton Grange DS0000064467.V345298.R01.S.doc Version 5.2 Page 7 Consideration must be given to improving the natural lighting and ventilation in the bedroom adjoining the smoking area. Recruitment checks include a reference from the current or most recent employer. Arrangements must be made for having the water system checked for Legionella. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Heaton Grange DS0000064467.V345298.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 Heaton Grange DS0000064467.V345298.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 5 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The pre admission assessment forms were good but these must accurately reflect peoples’ needs to ensure care needs are not overlooked when planning the care. EVIDENCE: Information in the AQAA said the Statement of Purpose and function for the home and the service user guide are updated regularly. The provider and manager confirmed this and said certain information about numbers of staff trained to NVQ level 2 and above had been added, and that the information about the manager having successfully completed the NVQ level 4 The service user guide is given to relatives in large print style. Heaton Grange DS0000064467.V345298.R01.S.doc Version 5.2 Page 10 The manager said she does all the pre admission assessments; however on looking at the care documentation of one of the service users there was no documentation to evidence this procedure had taken place. She was advised to do an assessment of his needs so that she would have a base line to work from should his condition deteriorate. However pre admission assessments for two other service users contained enough information to put together a plan of care within a short time of being admitted to the home. All people who receive a service are provided with a statement of terms and conditions be they publicly or privately funded which sets out the services they can expect to receive. Heaton Grange DS0000064467.V345298.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Peoples personal, health and social care needs are met and they are treated with respect, however the system used for medication control needs to be re assessed and adequate facilities provided for storage and hand washing. EVIDENCE: Three care plans were inspected. All but one of them had evidence to support a pre admission assessment had taken place before the resident came to live at the home. The other two pre admission assessments had enough information in them for the home to be able to put together a plan of care that would demonstrate the health care needs of the resident. However, although the daily record of care identified the resident was being treated for a pressure sore by the district nurses who visit the home, the home had no record of this, as the only information was kept by the district nurse delivering the care. Heaton Grange DS0000064467.V345298.R01.S.doc Version 5.2 Page 12 There was also no evidence that either the resident or the relative had been involved in the care planning process, however on talking to relatives they told me they had been involved, but had not been asked to sign to say they had been. The medication system the home uses was checked. The home uses a monitored dosage system of medication control. Each service user receives their medication from individual blister packs prepared and delivered to the home by the supplying pharmacist. These are stored in a wooden cabinet in the manager’s office. This is not ideal as not only is it in full view of a window, but there is no hand washing facility provided. MAR (Medication administration) record sheets were checked and had been completed satisfactorily when medicines had been given, however there was no evidence the manager had checked the medicines in on entering the home, as these were not entered onto the MAR charts. I took advice from the CSCI chief pharmacist regarding this. Heaton Grange DS0000064467.V345298.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People can exercise choice and control over their lives and maintain contact with family and friends. EVIDENCE: The atmosphere in the home was warm, friendly and welcoming. Some visitors who arrived at during the visit said that they were always made welcome by the staff and could call in at any time. The home does not employ an activity co-ordinator. The care staff on duty on each shift provides activities for the people who receive a service. Residents told me they do not get to go on outings unless they are taken out by their relatives, however two ladies said the manager takes them out shopping, and one person had been taken out by the manager to choose the wallpaper, bedding and curtains for her room. Apart from those residents going out on their own, and those being taken out by relatives and the manager, it would appear there is no other community contact. The manager said she had contacted the community involvement Heaton Grange DS0000064467.V345298.R01.S.doc Version 5.2 Page 14 project “Older Peoples Health in mind” to give her some inventive ideas on activities for older people. Residents spoken to said they had been involved in choosing the new conservatory lighting and dining furniture, and were pleased to be involved. They also said they were able to receive visitors any time they liked and see them in privacy. One lady who I spoke to who has lived at Heaton Grange for just over two years said the food was very good and the staff very nice, but that she was a bit bored as there was not entertainment she liked. Another resident who said he had lived at the home a good few years had had a good past life, the food was very nice and that he had the choice of when he got up and went to bed. He also said he liked watching TV and when the weather is good, he goes out into town. He also said he enjoyed doing some gardening. Another male resident said he was pleased with the care his mother had received when she was in the home. His brother said he thought the care was very good, and the staff very kind. He also said he thought his brother had improved since coming to live at the home. He said he has had meals provided, and they were lovely and hot and with a choice. He knows the owner who had made himself know to him, and said he thought the home had improved since the current owner bought Heaton Grange. I inspected the kitchen for cleanliness and looked at the menus. Although menus were four weekly and rotational. Meals are dictated by the residents. The chef said he often prepares four or five different meals to suit the resident’s preferences. The kitchen was clean and domestic in style. The chef showed me a document he was using called “Safer food better businesses”. This had been given to him by the environmental health inspector when the kitchen was last inspected in July 2006. I asked to look at the records he keeps, however he stopped keeping records of core food temperatures and fridge and freezer temperatures following the last kitchen inspection. When asked about this he said the inspector had told him there was no requirement for him to keep records, as he was the only person who worked in the kitchen. Following the site visit I spoke to the Environmental Health Department who advised, as good practice, he should be keeping records of core food temperatures at least twice a week, and keeping daily records of the temperatures of the fridges and freezers. The chef was aware of additives he can add to food to make it more nutritious, and was aware of the likes and dislikes of all the residents. Food was stored safely in the fridge in the kitchen, however the fridge needs replacing as the seal around the door was very badly perished. This means food in the fridge might not be stored at the correct temperature of between 2 and 8ο Celsius, and because there were no records kept this could not be checked. Heaton Grange DS0000064467.V345298.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People feel safe living in the home and know who to talk to if the have any concerns. EVIDENCE: The home has a complaints policy and procedure in place. There were no surveys returned by people living in the home and their relatives before the visit and therefore views about how they felt about the home could not be taken into consideration. However, residents spoken to said they knew how to complain but had nothing to complain about, and relatives said that they were aware of the complaints procedure and who to talk to if they had a concern. They said that the staff were responsive and would deal with things as soon as they had been mentioned. A healthcare professional who was visiting the home at the time of the site visit said she had no concerns and would certainly speak to the manager if she had. Heaton Grange DS0000064467.V345298.R01.S.doc Version 5.2 Page 16 The manager said that records of complaints/concerns received and any taken would be kept. Information from the AQAA said that no complaints had been received in the last twelve months. The AQAA states that policies and procedures are in place around adult protection and abuse. The manager said they been updated in line with the local authority policy, “No Secrets” All staff spoken had received training in this area and were very clear that they would not hesitate to report suspected or actual abuse to the manager or the provider. They were also aware that they can report concerns directly to the CSCI and social services. Heaton Grange DS0000064467.V345298.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a clean, tidy and well-maintained home that is suitable for their needs. EVIDENCE: The entrance to the home is from the main road and through the same entrance as another home next to it. There is no visible signage to help people find the home, and this was commented on by one of the visitors. This is an on going source of discontent as the owner of the care home next to Heaton Grange who will not allow signage on what she states is her land. This has also been identified by the emergency ambulance services. Heaton Grange DS0000064467.V345298.R01.S.doc Version 5.2 Page 18 The manager said the staff have to wait on the main road to direct them to the home. The owner is strongly advised to contact the Bradford Fire and Rescue Service regarding this, as it could put the residents at risk if there was a fire in the home. I looked around the interior of the building. It is a purpose built home, is all on one level and has level access. It was clean and with no unpleasant odours. Disabled access is via a ramp to the front door. Gardeners have been employed since the last visit and the grounds looked very tidy, and were safe for the residents to wander. At the time of the visit a Gazebo was being put up in the garden for the benefit of the people who live there. One of the bedrooms still does not provide a satisfactory level of natural light or ventilation as the window opens onto an enclosed area, which is used as a smoking area. The provider said he has bought a Velux window for this room, however the resident occupying the room is reluctant to have it fitted. There is double room on the end of the building. It is the intention of the provider to make some structural alterations in this are to convert then into single rooms with ensuite facilities. Other improvements to be made are regarding an extension to one of the rooms, and the removal of one of the bathrooms to convert it into a wet room. Some people were happy for their rooms to be seen. The small size of some bedrooms limits the scope of personal possessions such as furniture but the contents in some rooms reflected the interests of the occupant. Residents spoken to said they were very pleased with their rooms, and one lady commented on how clean the windows were, and that they were cleaned inside and out monthly. Heaton Grange DS0000064467.V345298.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are enough staff on duty to meet peoples needs. Evidence seen in the training programme and comments made by the staff on duty will make sure that they are all suitably qualified and competent to meet peoples needs. However the induction training provided does not comply with Skills For Care common Induction standards EVIDENCE: The home employs a stable staff team who are enthusiastic about their jobs, some having been at the home for many years. This is good for the people living in the home because it helps to maintain consistency and continuity of care as well good relationships. On the day of the visit there were enough staff on duty to meet the needs of the people who live there. Two recruitment files were looked at, one being for the most recent employee. The newest care worker was working in the home under the supervision of a more experienced carer. Their file showed that two satisfactory written references had been obtained, however neither was from the most recent or Heaton Grange DS0000064467.V345298.R01.S.doc Version 5.2 Page 20 current employer. The manager said she had tried to obtain a reference from the recent employer but had not been able to. Staff training records were looked at and these identified staff were being provided with adequate training on a variety of subjects to allow them to be able to give the care needed. Information in the AQAA said there are eight care staff who have obtained NVQ qualifications at level 2, and that there are another four staff doing the training. On talking to the care staff on duty they confirmed they had been provided with induction training., however on discussing this with the manager it was clear she was not aware of the transition to Skills For Care. She was told how to find the information she needed. Other training provided and attended by the staff I spoke to during the visit included the mandatory Fire Safety and Manual handling training. Food Hygiene, Health and Safety, First Aid. Palliative Care and Safeguarding Adults. One of the carers I spoke to who has worked at the home for 13 years said the owner was very interested in staff training and she was well supported by the manager. Another member of staff who has worked at the home for five years said she received good support from the manager who was always there, and that she had seen some changes for the better since the current provider owned the home. Heaton Grange DS0000064467.V345298.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run and managed by a manager who is fit to be in charge. The home is run in the best interests of the service users. EVIDENCE: The manager has worked at the home for 15years; two and a half were as senior carer. Since the last inspection she has successfully completed the NVQ level 4 and said she was now in tending to do the Registered Managers Award. She has an open door style of management and encourages resident and relatives to see her if they have any concerns The service users benefit from Heaton Grange DS0000064467.V345298.R01.S.doc Version 5.2 Page 22 the management approach at the home, where their best interests are kept in mind with any decisions that are made. Staff and service users gave positive feedback about the manager, saying that she is always approachable and always sorts things out. The personal monies held in the home for one service user was checked as part of this visit. These were found to tally with the clear records held. Receipts for purchases are also kept. Staff generally receive supervision every two months and those spoken to said that they have felt that this has been valuable. Since the last inspection a new fire alarm system and nurse call system have been installed, the commissioning certificates for these made available for me to look at. There have been two fire drills carried out since the last inspection. Hot water temperatures are checked and recorded as required. There are quality-monitoring systems in place for the home. The manager said surveys are sent out to relatives twice a year and the results made available for any interested parties All health and safety checks had been carried out, however there is no evidence the cold water supply has been tested for Legionella and this is required. Information was given to the manager on having this test done. Heaton Grange DS0000064467.V345298.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 X 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 3 17 X 18 3 3 3 X X X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 3 2 Heaton Grange DS0000064467.V345298.R01.S.doc Version 5.2 Page 24 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 OP9 Regulation 13 Requirement The registered provider must make alternative secure arrangements for the safe storage of medication. The area should contain facilities for hand washing. Timescale for action 01/12/07 2. OP25 Reg 23(2)p 3. OP29 19 4. OP38 13 (3) The registered provider must 01/12/07 continue to attempt to improve the natural lighting and ventilation in the bedroom adjoining the smoking area. (previous timescale of 31/12/06 unmet) The registered provider must 01/11/07 ensure recruitment checks include a reference from the current or most recent employer. The registered provider must 01/11/07 make arrangements for the water system to be checked annually for Legionella. Heaton Grange DS0000064467.V345298.R01.S.doc Version 5.2 Page 25 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. 5. Refer to Standard OP7 OP9 OP12 OP15 OP19 Good Practice Recommendations Care plans should contain information about care provided by the district nursing services. This is with particular reference to the treatment of pressure sores Ensure amounts of medication received into the home are identified on the MAR charts. Activities provided in the home could be more inventive and chosen to suit the resident’s preferences. Records of core food temperatures should be checked at least twice a week and records kept, and fridge and freezer temperatures should be checked daily. Steps should be taken to make the home more visible from the road Heaton Grange DS0000064467.V345298.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Heaton Grange DS0000064467.V345298.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!