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Inspection on 06/07/05 for Hurst Manor Nursing and Residential Home

Also see our care home review for Hurst Manor Nursing and Residential Home for more information

This inspection was carried out on 6th July 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

Hurst Manor is managed professionally and capably. The ethos at the home is welcoming and friendly. Staff care for residents sensitively. Activities continue to be thought out and presented well. Meals are good; the variety of meals is maintained. The accommodation for residents is of a high standard. There is a strong team spirit at the home demonstrated in the staff group. The home`s management fosters this.

What has improved since the last inspection?

One recommendation was made as a result of the last inspection. This was to devise and implement a risk assessment tool for residents participating in outside trips. The home has done this and risk assessments for outside trips are completed in individual care plans. This has been a busy year at Hurst Manor. The CSCI has recently registered the 11 bed garden wing extension. The accommodation and facilities in this extension are of a superior and impressive standard. The home is also continuing to improve resident bedroom and staff facilities in the original home. Building work is progressing to improve 4 bedrooms with en-suite facilities and a staff room. The home has also recently been awarded the Investors In People award. The home is continuing to benefit from the support and training of a management consultant.

What the care home could do better:

Three recommendations have been made during this inspection. The recommendations are for improving information given in resident contracts, providing clearer information in care plans for residents monitored on a heart regulating drug and for demonstrating openly the home`s method of ensuring equal opportunities for new staff at interview.

CARE HOMES FOR OLDER PEOPLE Hurst Manor Nursing and Residential Home Hurst Martock Somerset TA12 6JU Lead Inspector Judith Roper Unannounced 6th July 2005 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. Hurst Manor Nursing and Residential Home D53 - D02 S3267 Hurst Manor V235959 060705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hurst Manor Nursing and Residential Home Address Hurst Martock Somerset TA12 6JU 01935 823467 01935 825728 michael@hurstmanor.co.uk Hurst Manor Limited 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) Mrs Ada Susan Aldworth Care Home with Nursing 36 Category(ies) of Old Age registration, with number of places Hurst Manor Nursing and Residential Home D53 - D02 S3267 Hurst Manor V235959 060705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Elderly persons of either sex, not less than 60 years, who require general nursing care. 2. Up to fifteen places for personal care. Date of last inspection 8th February 2005 Brief Description of the Service: Hurst Manor is a three storey Grade II listed Georgian House situated in the centre of the village of Martock. The home is set in grounds, laid to lawn and flower beds. The home currently provides up to 30 places for nursing care and 15 places out of the total 36 registered places can be for personal care. Day care is provided for service users requiring nursing care within the registered numbers. The home has recently registered the garden wing extension, included in the registered bed numbers. The quality of the garden wing is exceptionally high, offering en-suite bedrooms, a shared bathroom, communal and office space, landscaped gardens and parking spaces. Hurst Manor Nursing and Residential Home D53 - D02 S3267 Hurst Manor V235959 060705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day between the hours of 10. 30 am – 2 pm. 27 residents were at the home on the morning of the inspection. (Another person was admitted to the home during the inspection). There are currently some vacancies at the home although referrals are high and some admissions are waiting for builders to complete room upgrades. These people will be admitted as soon as the rooms are ready. The inspector was able to see and to speak with many residents. One relative was available to talk to the inspector during the inspection. All gave positive feedback to the inspector about the home. Staff on duty were able to give time to speak with the inspector. The proprietor Mr. Lawson and the manager Mrs. Aldworth were available for comment during the inspection. The inspector would like to thank Mr. Lawson and his staff for their time and hospitality shown to the inspector during her visit. It was a busy day at the home. A team leaders meeting was being held in the morning and a general staff meeting was held in the afternoon. This is the first inspection using the new CSCI reporting format, which focuses on outcome statements for National Minimum Standards. The inspector’s aim on this inspection visit was to seek views on the quality of the service from as many service users as possible and to speak to staff and any visiting relatives. Records examined were care plans, activity records, preadmission assessments, resident contracts, staff recruitment files and medication records; other records will be examined at subsequent inspection visits. This inspection has found that the home continues to demonstrate its commitment to providing high quality care and accommodation for residents. What the service does well: Hurst Manor is managed professionally and capably. The ethos at the home is welcoming and friendly. Staff care for residents sensitively. Activities continue to be thought out and presented well. Meals are good; the variety of meals is maintained. The accommodation for residents is of a high standard. There is a strong team spirit at the home demonstrated in the staff group. The home’s management fosters this. Hurst Manor Nursing and Residential Home D53 - D02 S3267 Hurst Manor V235959 060705 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hurst Manor Nursing and Residential Home D53 - D02 S3267 Hurst Manor V235959 060705 Stage 4.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 Hurst Manor Nursing and Residential Home D53 - D02 S3267 Hurst Manor V235959 060705 Stage 4.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) 1 - 6. The home provides up to date information about the home for enquiries and new admissions in order for people to make an informed choice to continue with the application process or trial period following admission. Contracts are in place for residents. It is recommended that more information be included in contracts regarding the room to be occupied and reasons for a room change whilst a person is living at the home. This would protect both parties in the contract. Pre-admission processes are robust to ensure that the placement is appropriate. EVIDENCE: The home has a Statement of Purpose and Service User’s Guide. These documents are in the process of being updated to reflect the recent addition of available registered rooms in the home and the increased communal facilities provided. Hurst Manor Nursing and Residential Home D53 - D02 S3267 Hurst Manor V235959 060705 Stage 4.doc Version 1.40 Page 9 A sample of resident contracts was inspected. All residents’ case tracked by the inspector had signed contracts with the home. The inspector recommended to the proprietor that it would provide better clear information in order to protect both parties if the contract stated the room to be occupied and reasons, whether resident/family led or home led, why a room change may be required or requested. For example this might include a resident preferring the view from an alternative available room or if the clinical needs change for a resident requiring a room change (such as decreased mobility). Urgent health and safety reasons or routine room redecoration (temporary relocation) may also be potential reasons for a room move. The proprietor was advised that information given in contracts stated that the home was subject to the Registered Home’s Act 1984 but that the Care Standards Act 2000 has superseded this Act. He said that he would amend this information forthwith. In discussion with the matron, nursing staff and a recently admitted resident, the home has policies and procedures for assessing the suitability of a referred resident. Care plans demonstrated good pre-admission assessments by the home and the home had obtained assessments of a new resident’s need from a placement officer’s community assessment report. A relative of a recently admitted resident confirmed the opportunity given by the home of viewing facilities and discussion with the home’s management to whether the home could meet their family member’s needs. The staff team are established and have appropriate training in order to meet the needs of current residents. Pre-admission processes are documented and the decision to whether the home can meet the need of a resident being referred to the home is made only following an assessment by the home. The home has accessed successfully in the past the services of a community rehabilitation team to provide intermediate rehabilitation care for residents. Hurst Manor Nursing and Residential Home D53 - D02 S3267 Hurst Manor V235959 060705 Stage 4.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 - 11. Care plans are reviewed regularly and include the residents or family in the devising/reviewing of a plan. This makes care plans person centred and meaningful for staff to provide individual care. It has been recommended that where residents are taking a heart monitoring drug that the home needs to provide a full rationale for daily heart monitoring for every resident who is receiving this cardiac therapy. Residents receive appropriate care and attention from the home’s staff and community health care professionals. This means that an extended professional network of care provider’s meets residents care needs. Medication management is safe. Residents are receiving medications from trained and competent nursing staff that follow the home’s procedures. Residents are spoken to and treated with dignity and respect. This maintains resident’s self-esteem and sense of worth. Palliative care is sensitive and professional. Residents are receiving good care at the end of their lives. EVIDENCE: Hurst Manor Nursing and Residential Home D53 - D02 S3267 Hurst Manor V235959 060705 Stage 4.doc Version 1.40 Page 11 Four care plans were inspected in detail as part of the case tracking process for those residents. Two other care plans were inspected briefly. Care plans reflect individual current needs. Risk assessment tools are completed for both environmental and clinical issues, plans are reviewed monthly and residents or family members are consulted regarding their written plan of care. Social histories and activity plans are very well maintained. It was recommended to the matron that residents on Digoxin heart regulating therapy needed a fuller rationale in care plans to when the drug can be omitted following daily routine pulse recordings by nursing staff. Only one of three care plans inspected where a resident received Digoxin therapy had a clear explanation and rationale for heart rate monitoring. Care records demonstrated that residents receive community health care monitoring visits and access to chiropody, dentistry, opticians’ where appropriate. Pressure area care risk assessments were completed and appropriate care and equipment provided. Medications management was inspected. The home’s records of medications administered and storage of medication was in order. The home had recently received a community pharmacist inspection. This pharmacist reported a good management of medications in the home and no recommendations were made to the home in their report. Residents spoken with confirmed that the staff in the home speak to them with grace and respect. A visiting relative echoed this finding. The inspector observed staff interacting with residents in a polite and friendly manner during the inspection visit. The home supports residents in their terminal stages of life. The home has policies and procedures and staff training in order to provide this care professionally. Equipment in the home is appropriate to manage terminal care. The home reports any deaths in the home to the CSCI with a report of terminal care given. The death of a recent resident was discussed with the matron. Staff provide 1:1 support for a resident who is dying. Hurst Manor Nursing and Residential Home D53 - D02 S3267 Hurst Manor V235959 060705 Stage 4.doc Version 1.40 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 standard(s) 12 - 15. Social activities provided at the home are imaginative and frequent. Residents are stimulated at the home. Visitors are welcomed. Visitors have access to a key-worker and the management said that they would ensure that all families knew who their relative’s key-worker was so that relatives felt that they had a named contact in the home that knew their family member well. Residents are encouraged to exercise choice and self-determination in order to maintain self-esteem. This is supported by the home’s policies and procedures and ethos. Meals are relaxed. Choices of dishes are good and varied. Dining spaces are pleasing. EVIDENCE: The home’s activity coordinator and administrator manage activities in the home. Activities are planned weekly and a schedule is provided for residents. Activities take place every day and include group and individual activities in the home and outside trips. Residents said that they enjoyed the activities offered and the enthusiasm of activity workers. Resident’s activity profiles and records of activities undertaken are very well documented. The home’s activity staff Hurst Manor Nursing and Residential Home D53 - D02 S3267 Hurst Manor V235959 060705 Stage 4.doc Version 1.40 Page 13 and management have been sourcing additional sensory equipment and ideas for sensory sessions for the home by undertaking field trips to specialist facilities where sensory therapies for older people are established. The home welcomes visitors and families and provides good private space for families to meet with relatives. The home had an open day for families and the local community the day prior to the inspection in order to formally open the new garden wing. The home operates a key-worker system. One relative was not aware of this. The matron said that this would be addressed to staff as an agenda item for the afternoon’s staff meeting. Choice and self-determination is promoted in the home as documented in care plans. Resident meetings are held and placement reviews are held for residents to discuss their care. Lunch was observed. The dining spaces are congenial to a relaxed and social mealtime. Residents needing assistance at mealtimes were observed to be cared for sensitively and professionally by individual staff members. Residents have a choice of main meal. Hurst Manor Nursing and Residential Home D53 - D02 S3267 Hurst Manor V235959 060705 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18. Complaints procedures are transparent giving residents and relatives clear guidance how to raise concerns or complaints. Procedures to protect adults from abuse are in place and staff are trained in abuse detection or reporting of concerns. This would promote a professional response to an allegation of abuse in the home should it arise. EVIDENCE: The complaints procedure is displayed in the home. Residents were complimentary regarding the staff and home’s management. The home has received no complaints since the last inspection visit. The home has appropriate policies and procedures for the protection of vulnerable adults. Training for staff in abuse detection is provided. The home has a whistle blowing procedure. Hurst Manor Nursing and Residential Home D53 - D02 S3267 Hurst Manor V235959 060705 Stage 4.doc Version 1.40 Page 15 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 - 26. Hurst Manor provides a high standard of accommodation. The elegant listed building is furnished in keeping with the stylish exterior. Residents and visitors appreciate this. EVIDENCE: The garden wing at Hurst Manor was officially opened on the 5th of July 2005 after being registered with the CSCI. The 11 single en-suite bedrooms and communal spaces in this wing of the home provide a very high quality living and working space for the home. The wing had been built to exceed National Minimum Standards and it includes pleasing landscaped accessible gardens and an inner courtyard. Resident, visitor and staff comments on the new wing included descriptions such as ‘beautiful’, ‘lovely’ ‘very well done’ and ‘stylish’. The proprietor is also currently upgrading facilities in the main home. Four bedrooms are being improved and a larger new staff room is being provided. During the inspector’s tour of the building to assess the home’s environment the following observations were made; The fixtures and furniture in the home are of good quality. Medical equipment is provided to meet nursing care needs. Bathrooms and toilets are provided in sufficient numbers to meet Hurst Manor Nursing and Residential Home D53 - D02 S3267 Hurst Manor V235959 060705 Stage 4.doc Version 1.40 Page 16 needs. There are several lounges in the home offering communal or more private spaces. The laundry is sufficiently equipped to meet the needs of the additional registered rooms. Infection control practices in the home are clear and adhered to by staff. The home is clean and the environment is fresh looking. Hurst Manor Nursing and Residential Home D53 - D02 S3267 Hurst Manor V235959 060705 Stage 4.doc Version 1.40 Page 17 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, 28, 29. The staffing levels at the home are sufficient to meet the needs of current residents. There is a high proportion of care staff holding the NVQ qualification in care. This provides a layer of care staff with a professional qualification. Staff employment practices are safe and robust. This protects residents. A recommendation has been made that staff interview notes are recorded on a pro-forma sheet. This would demonstrate openly that the home operates within equal opportunities guidelines. EVIDENCE: The staffing levels for the home following the registration of the additional rooms had been agreed between the home owner and the CSCI. The home is complying with this staffing notice. The home admits a maximum of 30 nursing residents. There is at least one registered nurse on duty at all times in the home. The number of ancillary staff in addition to care and nursing staff are sufficient to ensure that the home is managed well. There is a strong commitment to continuing staff training in the home. Most care staff hold the NVQ qualification in care at level 2. Several others are training to level 3. Team leader care staff are employed to supervise junior care staff. Hurst Manor Nursing and Residential Home D53 - D02 S3267 Hurst Manor V235959 060705 Stage 4.doc Version 1.40 Page 18 Staff recruitment records were inspected for two recently employed staff. The information held in staff files was in accordance of Schedule 2 of the National Minimum Standards. The administrator was able to demonstrate both verbally and by documentary evidence a good understanding of adult protection vetting procedures for the employment of new staff. A discussion was held with the management regarding the written recording of staff interview notes. It is recommended that the home devise a pro-forma sheet for staff interviews as this would demonstrate transparency in equal opportunities in the home’s employment procedures. Hurst Manor Nursing and Residential Home D53 - D02 S3267 Hurst Manor V235959 060705 Stage 4.doc Version 1.40 Page 19 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) 31,32,33,36,37,38. Management at the home is competent and fosters an open but professional ethos at the home. Quality assurance processes are formal as well as informal. The home is able to demonstrate that it seeks the views of people using its services and responds to views raised to improve upon services. Health and safety issues are managed competently. Residents live in a safe environment. EVIDENCE: Mr. Lawson owns the home and the registered manager is Mrs. Aldworth. They work closely to manage the home between them. The home has benefited from the input of a management consultant over the last year. His input has been throughout the entire staffing structure. The result is that the Hurst Manor Nursing and Residential Home D53 - D02 S3267 Hurst Manor V235959 060705 Stage 4.doc Version 1.40 Page 20 home has a strong ethos of staff accountability and that staff seem a cohesive unit. The home has formal quality assurance processes from an annual quality questionnaire to regular staff and resident meetings and staff supervision sessions. Records relating to residents and staff were stored appropriately in accordance with Data Protection principles. The matron informs the CSCI of serious or notifiable accidents in the home. Appropriate records are maintained for accidents in the home and reporting to RIDDOR, if appropriate. The inspector observed staff assisting residents to move position. Staff followed best practice handling techniques. The current building work in the home is being managed and cordoned off safely. Hurst Manor Nursing and Residential Home D53 - D02 S3267 Hurst Manor V235959 060705 Stage 4.doc Version 1.40 Page 21 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 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 4 4 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 4 3 x x 4 3 3 Hurst Manor Nursing and Residential Home D53 - D02 S3267 Hurst Manor V235959 060705 Stage 4.doc Version 1.40 Page 22 Are there any outstanding requirements from the last inspection? No requirements were made at 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 Regulation Requirement No requirements were identified at this inspection. Timescale for action 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. Refer to Standard OP2 Good Practice Recommendations It is recommended that the propretor ammends contracts for residents by including in the contract between the home and resident any reasons why a room change may be indicated during admission. Such reasons could include a physical deterioration of the residents mobility, routine room maintenance (including redecoration) or for urgent health and safety considerations. This information in the contract, in addition to the usual room to be occupied, would protect both parties by clarifying reasons to be discussed should the home believe that the resident needs to move rooms at the home. It is recommended that where a resident is taking digoxin therapy that a full and clear explanation to when the drug should be omitted following pulse recording is written in the individuals care plan. It is recommended that the home devises a pro forma interview sheet for questions asked at interview for staff applicants. This would ensure that equal opportunities processes had been applied. D53 - D02 S3267 Hurst Manor V235959 060705 Stage 4.doc Version 1.40 Page 23 2. OP7 3. OP20 Hurst Manor Nursing and Residential Home Hurst Manor Nursing and Residential Home D53 - D02 S3267 Hurst Manor V235959 060705 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier Taunton TA1 4AL 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 Hurst Manor Nursing and Residential Home D53 - D02 S3267 Hurst Manor V235959 060705 Stage 4.doc Version 1.40 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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