Inspection on 24/11/05 for Hyde Nursing Home

This inspection was carried out on 24th November 2005.

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

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

Other inspections for this house

Hyde Nursing Home 26/09/07

Hyde Nursing Home 26/06/06

Hyde Nursing Home 13/05/05

Hyde Nursing Home 07/12/04

Hyde Nursing Home 15/06/04

Hyde Nursing Home 16/07/03

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

CARE HOMES FOR OLDER PEOPLE Hyde Nursing Home Grange Road South Gee Cross Hyde Tameside SK14 5NY Lead Inspector Mrs Fiona Bryan Unannounced Inspection 24th November 2005 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 Hyde Nursing Home DS0000025436.V263264.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. Hyde Nursing Home DS0000025436.V263264.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hyde Nursing Home Address Grange Road South Gee Cross Hyde Tameside SK14 5NY 0161 367 9467 0161 368 7707 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) Tameside Care Limited Care Home 100 Category(ies) of Dementia - over 65 years of age (25), Physical registration, with number disability (75), Physical disability over 65 years of places of age (50), Terminally ill (1) Hyde Nursing Home DS0000025436.V263264.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. No service user may be admitted into the establishment who is under the age of 55 years. No more than 10 service users may be admitted into the home who just require personal care. A minimum of 4 first level registered nurses must be on duty throughout the 24 hour period. The manager must be supernumerary to the above staffing requirements. 13th May 2005 Date of last inspection Brief Description of the Service: Hyde Nursing Home is a purpose built home, owned and operated by Tameside Care Limited providing accommodation for up to 100 service users requiring nursing care. The home is a two-storey building, divided into four separate courts: Newton, Flowery Field, Godley and Werneth. Each court has a maximum of 25 beds, 15 on one floor and ten on the other. The courts link into a central area known as The Pavilion. Godley, Newton and Flowery Field Courts provide accommodation for service users who require general nursing care. Werneth Court provides accommodation for 25 service users with dementia who require specialised nursing care. All bedrooms are single with en-suite facilities. Each of the four courts has two dining rooms, two quiet rooms, two lounges and four bathrooms. Passenger and wheelchair lifts provide access to both floors. The Pavilion overlooks the Mary Secole gardens and is the central core of the home, serving as the social and recreational focal point, equipped with a hairdressing salon and shop. The home is built on the site of Hyde Hospital. Public transport is within easy access, providing links to all towns within Tameside. Hyde Nursing Home DS0000025436.V263264.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 conducted by two inspectors and was the second inspection for the year. During the visit the inspectors spent time talking to residents, relatives and staff. Three residents were looked at in detail, looking at their experience of the home from their admission to the present day. A selection of documents were examined including residents’ care files and medicine records, staff duty rotas and training records, complaints and accident records and staff personnel files. Comments cards were left at the home. Two residents had responded at the time of writing this report. One resident was positive about the home and stated that they felt well cared for. The other resident did not feel the home provided suitable activities and only sometimes liked the food. Four relatives responded who expressed mixed views about the home. One relative stated that staff were very friendly to residents and visitors and that there had been a big improvement in her relative’s health since being admitted to the home. Two other relatives were mainly positive about the service but did not always feel that there were enough staff on duty. One relative did not feel that the staff were very welcoming and stated that communication between staff and relatives was sometimes poor. Prior to this inspection comments cards were sent to GP’s who visit residents in the home. Two responded, both of whom stated that the home did not always communicate clearly with them and there was not always a senior member of staff available to confer with. Both GP’s also felt that staff did not always demonstrate a clear understanding of the care needs of residents and both stated that they were not happy with the overall care provided to the residents they visited. Since the last inspection concerns about staffing levels at the home have been raised with the CSCI on a number of occasions. As a result of this the home has been providing weekly information about the number of staff working at the home since July 2005 and several meetings have been held with the registered provider to agree acceptable levels of staffing. What the service does well: Although the environment was not formally inspected during this visit, it was observed that the home was clean, tidy and welcoming. Newton Court has been refurbished to a high standard and residents and staff were pleased with the results. Hyde Nursing Home DS0000025436.V263264.R01.S.doc Version 5.1 Page 6 The Pavilion area provides a large communal space for residents to meet together and the home is particularly good at arranging larger scale events such as parties and entertainment nights. Plans had been made for a “Stars in Their Eyes” evening that week, which residents were looking forward to. Residents said permanent staff treated them well. Many of the care staff have completed a National Vocational Qualification. What has improved since the last inspection? What they could do better: Pre-admission assessments had been undertaken prior to all residents entering the home. However, whilst information about residents’ personal and health care needs was more detailed than previously, there was less information about residents’ social care needs. Few residents had social care plans in place and whilst some improvements have been made to the range of activities provided, opportunities are not very specific to individual residents’ interests and needs. Improved assessment and care planning to identify how staff can meet residents’ social care needs would enhance the degree of social stimulation for some residents. Work is still required to ensure that care plans are developed to address all the residents’ needs. More care needs to be taken to make sure that residents’ needs are documented clearly so that all staff know what they need to do to look after and monitor the residents properly and to demonstrate that advice and instructions given by other health care professionals has been followed. Residents are treated kindly and their privacy is upheld but poor standards in maintaining residents’ hygiene and personal appearance and institutional practices such as “lining up” the residents to take them to the toilet reduces their dignity and self-esteem. Hyde Nursing Home DS0000025436.V263264.R01.S.doc Version 5.1 Page 7 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. Hyde Nursing Home DS0000025436.V263264.R01.S.doc Version 5.1 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 Hyde Nursing Home DS0000025436.V263264.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 4 The pre admission assessment process requires more rigour to ensure that the social care needs of residents are identified so that residents can be assured their needs can be met. EVIDENCE: Examination of a number of residents’ care files indicated that care assessments and individual care plans from Tameside Social Services had been obtained. The relative of one resident who was quite new to the home stated that they had been visited in hospital prior to their admission to the home and staff confirmed that it was usually the manager who undertook pre-admission assessments. Assessments were generally detailed regarding the residents’ physical and mental health needs but less information was available regarding their family contacts and social history and interests. One resident arrived at the home whilst the inspection was in progress and it was observed that staff greeted her warmly and had ensured that the resident’s room was prepared with the necessary equipment. Hyde Nursing Home DS0000025436.V263264.R01.S.doc Version 5.1 Page 10 One resident said she felt staff understood her needs well and were aware of her preferred daily routine. Staff, when questioned were knowledgeable about residents’ needs. Care staff said they read the care plans and discussed the care needs of new residents with the nurses. Hyde Nursing Home DS0000025436.V263264.R01.S.doc Version 5.1 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Care plans did not always give full details regarding the needs of residents, leading to a risk that residents’ health care needs may not be met. The home’s policies and procedures for dealing with medicines were generally satisfactory. Residents are treated kindly and their privacy is upheld but poor standards in maintaining residents’ hygiene and personal appearance and institutional practices reduces their dignity and self-esteem. EVIDENCE: Examination of a selection of residents’ care files indicated that some care plans did not give all the necessary information to ensure that care was properly delivered to the residents. For example one resident had a care plan to address the fact that they were being fed enterally, but the plan did not specify whether the resident was able to eat or drink anything orally and did not state what type of oral hygiene was required, although there was evidence that appropriate care was actually being given. Hyde Nursing Home DS0000025436.V263264.R01.S.doc Version 5.1 Page 12 Care plans were sometimes vague, for example one resident at risk nutritionally had a care plan which stated that their food and fluid intake should be monitored but had no details as to how this should be done or what would constitute an acceptable dietary and fluid intake. The majority of care files examined contained no care plans to address the social care of residents. Residents had been seen by GP’s, tissue viability nurses, chiropodists, speech and language therapists and opticians. Some residents had attended hospital outpatient appointments. Residents had been offered flu vaccinations. Information regarding pressure mattresses was not accurate. One care plan stated that an air mattress was being used for one resident. The specific type of mattress should be detailed together with the pump setting – the pump setting was in fact set too high. Other care plans contained no information about what measures were being taken for residents at risk of pressure sores. The daily record for one resident indicated that a dressing was required to her leg. No care plan had been developed and there was no record of the progress of treatment and any improvement or deterioration of the wound. It was not always apparent if instructions given by other health care professionals had been carried out, for example the tissue viability nurse had requested that a check be made on a resident’s blood sugar and the GP contacted if it was raised but there was no evidence that this was done. Examination of a selection of residents’ medication administration records were satisfactory. Service users are identified prior to medication administration by the use of photographs attached to the medication administration records. Staff members with responsibility for medication administration can be identified by the means of a staff signature sheet. On occasions where a variable dose of medication was prescribed, for example, one or two tablets to be taken, the actual dose administered was recorded. Some containers of eye drops had not been labelled with the date of opening of the container. This practice ensures that the item can be discarded 28 days after this date to prevent bacterial contamination. One relative said staff were very patient and “lovely” with the residents. One resident said most of the staff were very nice. Some institutional practices, such as “lining up” residents to queue for the toilets prior to meals were observed, which have the capacity to diminish the autonomy and dignity of residents. The manager also witnessed this process and told the staff concerned that it was not appropriate. Hyde Nursing Home DS0000025436.V263264.R01.S.doc Version 5.1 Page 13 Some of the residents were noted to have long, dirty fingernails and some female residents had facial hair. Several residents on Flowery Fields Court appeared dishevelled and apathetic. Staff interaction with residents was limited. Staff took residents into the privacy of their own rooms or the bathrooms to carry out personal care, however residents’ dignity was not always being upheld when their appearance was not maintained to an acceptable standard. Hyde Nursing Home DS0000025436.V263264.R01.S.doc Version 5.1 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 Further consultation is needed to ensure that the home satisfies all of the residents’ social and recreational needs. EVIDENCE: A new activities organiser was appointed in 2005 who, it was reported goes to each Court every day and chats with the residents. Approximately ten residents each day meet in the Pavillion to participate in activities, which vary from table top games and arts and crafts to bingo and music. Birthday parties are held for residents and preparations were being made for a “Stars in Their Eyes” evening the following week, which many of the residents were looking forward to. The activities organiser had not received any training about providing activities for older people and people with dementia and would benefit from this. The nurse in charge on Werneth Court had attended training to enable her to lead a structured programme for a group of residents with dementia each week. These SONAS sessions consisted of an eight-week course involving music, singing, poetry and stimulation of the senses with residents being invited to taste different foodstuffs and smell different scents. Throughout the programme the residents’ participation and involvement in the sessions is Hyde Nursing Home DS0000025436.V263264.R01.S.doc Version 5.1 Page 15 monitored and recorded to assess if their concentration and recognition of parts of the programme improves. Two relatives said they felt the provision of activities had improved slightly over recent months. However, for residents who prefer to stay on their own Courts, social stimulation and leisure pursuits seemed limited and there were no care plans to address this aspect of their care in the majority of care files examined. One resident said they would like to be able to go out of the home more. Hyde Nursing Home DS0000025436.V263264.R01.S.doc Version 5.1 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The home has a satisfactory complaints procedure in place. Staff require further training to ensure that residents are protected from abuse. EVIDENCE: The complaints procedure was displayed in the Pavillion. Details of the timescales by which complainants can expect a response and contact details for the CSCI were provided. The complaints procedure is also displayed on each of the four Courts but contained out of date information about who to contact in the company. One relative said she had been given a copy of the home’s service user guide with the complaints procedure. Another relative said she would speak with the nurse in charge but had not had to make any complaints. A record was maintained of complaints received, which indicated that six complaints had been dealt with in June 2005, three in August 2005 and one in September 2005. The record included details of how the complaints had been investigated and the outcome. Since the last inspection one complaint was referred to the CSCI from Social Services. The complainant had concerns regarding wound care practices and staffing levels. This complaint was forwarded to the registered person who responded directly to the complainant. Hyde Nursing Home DS0000025436.V263264.R01.S.doc Version 5.1 Page 17 Carers said they would report suspected abuse to the nurse in charge and training in this topic was provided to carers who had undertaken NVQ training. However all staff should receive training in the local protection of vulnerable adult policies and procedures and the prevention of abuse. Hyde Nursing Home DS0000025436.V263264.R01.S.doc Version 5.1 Page 18 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): None of the standards in this section were assessed. EVIDENCE: Hyde Nursing Home DS0000025436.V263264.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Staffing levels are satisfactory the majority of the time. The home meets the standards for the percentage of care staff who have completed NVQ training. Recruitment procedures are followed but more rigour is needed in checking the authenticity of references and the validity of curriculum vitae. An ongoing training programme is in place. EVIDENCE: One relative said she felt there were enough staff. However, two relatives said there had been staff shortages, especially at weekends and that the resident they visited got quite anxious when agency staff that she did not know came into her room at night. Other residents also said that there were not enough staff in the evenings and they often had to wait to go to bed. One member of staff said on occasions shifts were changed at short notice and staff were not informed – as copies of the staff duty rotas are only kept in the administration offices and not on separate units this could cause problems with staff not arriving for duty as they were not aware their duty had been altered. Since the last inspection concerns regarding staffing levels at the home have been raised by a number of different sources. As a result of this the home has been supplying information about the numbers of staff working at the home to Hyde Nursing Home DS0000025436.V263264.R01.S.doc Version 5.1 Page 20 the CSCI on a weekly basis. Sufficient staff were on duty on the day of the inspection and recent information would suggest that levels have improved slightly since the last inspection. Forty of the sixty-two permanent care staff hold a National Vocational Qualification in care. This figure represent more than 50 of the care staff and therefore exceeds the target to meet this standard. Three staff personnel files examined. One employee had not provided a reference from her most recent employer and her employment history could not be properly verified, as the dates of her previous positions were not provided. However, this employee had worked at the home for some time and the manager stated that recruitment procedures had improved since then. The last employee to be appointed had started work on 9/11/05 and a PovaFirst had been obtained on 3/11/05. Two references were available on file, with one being from the employees’ most recent line manager. A training matrix indicated that the majority of staff had undertaken mandatory training in health and safety topics. In addition some staff had received training in oral care, wound care and dementia care. One carer said that she was due to attend training in deaf awareness in January 2006. One staff member said she had been told that if she identified any training opportunities for herself she would be funded to undertake it. Hyde Nursing Home DS0000025436.V263264.R01.S.doc Version 5.1 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 and 35 Residents have some opportunities to voice their opinions about how the home is run but the home needs to demonstrate how these views inform the home’s development. Residents’ finances are dealt with appropriately. EVIDENCE: Management meetings are held monthly and the minutes are sent to the CSCI. Minutes were available of residents/ relatives meetings held in August and September 2005 on each of the Courts. In most cases it was not recorded if the issues that had been raised at the meetings had been addressed. This information would be useful to track the effectiveness of the meetings and the influence residents have in decision-making. Hyde Nursing Home DS0000025436.V263264.R01.S.doc Version 5.1 Page 22 Staff had not had any recent staff meetings and seemed to be feeling somewhat disengaged from any processes the home has for seeking and valuing their opinion about how the home should continue to move forward and improve its services for residents. As previously stated, some of the current practices in the home do not promote residents’ autonomy. The home does not handle any personal money for the residents but invoices either their family or the representative who deals with their finances such as a solicitor, at the end of each month, for any sundry expenses, such as hairdressing bills or newspapers. Hyde Nursing Home DS0000025436.V263264.R01.S.doc Version 5.1 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 X 2 2 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 X X X X X X X X STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 X X X Hyde Nursing Home DS0000025436.V263264.R01.S.doc Version 5.1 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 OP3OP4 Regulation 14 Requirement The registered person must ensure that pre-admission assessments include information relating to residents’ social care needs. The registered person must ensure that each residents care plan sets out in detail the action which needs to be taken to ensure that all aspects of the health, personal and social care needs of the resident are met. (Timescale of 31/7/05 not met). The registered person must ensure that residents’ personal hygiene is maintained. The registered person must ensure that the incidence of pressure sores and the treatment provided to residents and its outcome is maintained in the resident’s care plan. The registered person must ensure that treatment and advice from other health care professionals is carried out and recorded in the residents’ care plans. The registered person must DS0000025436.V263264.R01.S.doc Timescale for action 31/01/06 2 OP7 15 28/02/06 3 4 OP8 OP8 12 17 31/01/06 31/01/06 5 OP8 13 31/01/06 6 OP10 12 31/01/06 Page 25 Hyde Nursing Home Version 5.1 7 OP12 18 8 OP12 16 9 OP18 13 10 OP29 19 ensure that residents are not subject to institutional practices. The registered person must ensure that the activities organiser receives training in the provision of activities for older people and people with dementia. The registered person must ensure that staff consult with residents and develop personcentred care plans to address their social care needs. The registered person must ensure that all staff receive training in the prevention of abuse and local adult protection policies. The registered person must ensure that the authenticity of references and the validity of CV’s is verified. 31/03/06 31/03/06 30/06/06 31/03/06 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 OP8 Good Practice Recommendations The registered person should ensure that care plans include specific details about the type of pressure mattresses being used and the pump settings if applicable so that staff can ensure they are working properly. The registered person should ensure that all eye drops and eye ointments are labelled with the date of opening of the container, and discarded 28 days after this date. The registered person should record any changes made as a result of residents’ suggestions/opinions at residents’ meetings so it can be demonstrated that their views are taken into account. 2. 3 OP9 OP33 Hyde Nursing Home DS0000025436.V263264.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 Hyde Nursing Home DS0000025436.V263264.R01.S.doc Version 5.1 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. 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