Inspection on 24/05/06 for Ivydene Nursing Home

This inspection was carried out on 24th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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.

Other inspections for this house

Ivydene Nursing Home 10/12/08

Ivydene Nursing Home 12/12/06

Ivydene Nursing Home 17/01/06

Ivydene Nursing Home 12/10/05

Ivydene Nursing Home 09/02/05

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Ivydene Care Home Staniforth Drive Ivybridge Plymouth Devon PL21 0UJ Lead Inspector Fiona Cartlidge Unannounced Inspection 09:50 24th May 2006 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 Ivydene Care Home DS0000061638.V292739.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. Ivydene Care Home DS0000061638.V292739.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ivydene Care Home Address Staniforth Drive Ivybridge Plymouth Devon PL21 0UJ 01752 894888 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) Sanctuary Care Limited Vacancy Care Home 57 Category(ies) of Old age, not falling within any other category registration, with number (20), Physical disability over 65 years of age of places (57), Terminally ill over 65 years of age (5) Ivydene Care Home DS0000061638.V292739.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Physical Disability over 65 years of age (PD(e)) 37 Both Terminally Ill over 65 years of age (TI(e)) 5 Both Old age not falling within any other category (OP) 20 Both One Service User under the age of 65 years (named elsewhere) Date of last inspection Brief Description of the Service: Ivydene is a purpose built care home, situated in the town of Ivybridge, providing nursing and/or personal care for up to 57 persons over the age of 65 years of age of either gender. The home is designed to care for persons suffering with varying degrees pf physical disability/frailty or illness. The accommodation is located on 2 floors with 2 passenger lifts providing access to the 1st floor. All the bedrooms have the benefit of en-suite WC and wash hand basin. 7 bedrooms are dedicated to persons receiving short term nursing care funded by the NHS. Ivydene has large communal areas including dining room and large lounge and 2 smaller lounges. There is a pleasant patio area with flower- beds; the town centre is a short distance away. Ivydene was first registered in 1994. Ivydene Care Home DS0000061638.V292739.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 5hours and 40 minutes and was unannounced. A partial tour of the home took place when some bedrooms and all communal living rooms were viewed. Personal records of care of 5 residents and personnel records of 4 members of staff were inspected. The inspector spoke with 18 residents, 2 staff members the deputy manager and administrator. Written feedback was received from 5 residents and 3 care workers. The homes senior staff had also submitted answers to a preinspection questionnaire supplied by the Commission. What the service does well: What has improved since the last inspection? Each resident has a complete documented plan of care, which provides information to the staff on how their individual needs should be met; this provides a consistent approach to the care that is given. An accessible system has been made available in communal rooms for immobile residents to be able to summon assistance when staff are not in attendance. Ivydene Care Home DS0000061638.V292739.R01.S.doc Version 5.2 Page 6 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. Ivydene Care Home DS0000061638.V292739.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ivydene Care Home DS0000061638.V292739.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Not all service users have a written contract/statement of terms and conditions with the home. The contract issued by the provider to self- funding clients is of a good standard. The admission process is safe. Service users admitted for intermediate care are helped to maximise their independence and return home. EVIDENCE: The inspector looked at contracts provided for 3 recently admitted residents. Observation of these records and discussion with the homes administrator provided this evidence: All Service users are provided with a contract however for service users who have had their care commissioned for them through health or social services the contract is provided by the commissioning authority and is in fact a third party agreement and does not set out clearly the residents individual rights and the homes service specific terms and Ivydene Care Home DS0000061638.V292739.R01.S.doc Version 5.2 Page 9 conditions of business for that individual. The contract issued by the provider to self- funding clients is of a good standard. Of the 5 residents who provided feedback via surveys provided by the Commission for Social Care Inspection (CSCI), 4 indicated they had received a contract and 1 that they had not. The inspector examined the personal records held on behalf of 4 recently admitted residents and the information obtained for a previously admitted long term resident. These documents provided evidence that a good level of information about people’s conditions and needs is received to enable the nurses in the home to make a professional judgement about if/how each person’s needs will be met. When possible i.e. if the person being admitted is geographically accessible, the manager visits the person in their existing setting to perform a full needs assessment in addition to receiving documentation from other social and health care professionals. The home admits some people for short- term rehabilitative care, bedrooms for these residents are situated on the 1st floor of the building and all have en suite WC/wash hand basins. There is no dedicated communal space for these residents or kitchenette for their use or for assessment purposes. Records provided evidence of Care plans designed to encouraging and enabling. Continual assessment of need and ability provides information on which multidisciplinary discharge decisions/plans are made. Ivydene Care Home DS0000061638.V292739.R01.S.doc Version 5.2 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 the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Resident’s needs are set out in an individual plan of care. The registered person promotes and maintains residents’ health and ensures access to health care services to meet assessed needs. The homes medication system does not fully protect the medical welfare of residents. Residents are treated with respect and their right to privacy is upheld. EVIDENCE: The inspector examined the personal records held on behalf of 5 residents; in all of these documented assessments were seen and provided information about skin integrity, moving and handling, safety - including risk of falls, and information about social needs. This information generates the plans of care, which provides the basis for the care to be delivered. In the case of one resident there was no documentary evidence that their care plan had been reviewed for a period of approximately 7 weeks, this poses a risk that changes Ivydene Care Home DS0000061638.V292739.R01.S.doc Version 5.2 Page 11 in need may not be identified and therefore a plan to meet them not developed, which poses a risk that some people with changing needs may not have all of their needs met. Records are maintained for all visits to the home by social or health care professionals, all residents are registered with a GP. Records provided evidence that visits are made by General Practitioners, district and specialist nurses, chiropodists, occupational therapists, physiotherapists and dentist’s. Records of outpatient appointments show that visits to community and hospital health resources are enabled. 5 residents provided written feedback, 2 confirmed they always receive the medical support they need, 2 indicated they usually receive the medical support they need, 1 indicated they fell that they sometimes received the medical support they need. The commission received written feedback about this home from 6 General Practitioners all indicate that they receive appropriate referrals about residents from the staff in the home and 5 of the 6 rated the homes management of health and personal care as excellent with the 6th indicating it was good to excellent. The medication system is managed by registered nurses; the inspector looked at storage and recording – some of the controlled drug stock was checked against records and found to be correct. The home uses a monitored dosage system, which is well organised and easily audited and administered from purpose built trolleys directly to the residents on a 1:1 basis The inspector found there were gaps in the administration records, this poses a risk to residents because there is no documentary way to assess if the medication has been given or not. Disposal of unused medication is safe, currently only one nurse signs to indicate which/how much medication is placed in the purpose built receptacle for removal and destruction by a licensed contractor. Residents told the inspector that the staff respect their privacy and dignity, the inspector observed that when personal care was being provided this was done behind closed doors, the staff spoke to residents in a polite manner and were witnessed to knock on the doors to private accommodation before entering. Ivydene Care Home DS0000061638.V292739.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. Great effort is made by the home to provide an activities programme and social interaction/stimulation for residents. Residents are able to maintain contact with family and friends and exercise choice and control over their lives. Residents receive a wholesome appealing diet but sometimes there is limited choice. EVIDENCE: This home employs a person dedicated to organising and providing social activities to meet the needs of those living in the home. During this visit the inspector saw that some residents were socialising in the lounges or watching television others were spending time in their rooms, reading, listening to music or watching television. In the afternoon a group activity was held in one of the lounges the activity was mentally stimulating and appeared lively and well received. A monthly news - letter is distributed to residents to provide information about the group social activities available, those in May included sessions titled poets corner, tranquil moments, handicrafts and knitting circle, bingo, Ivydene Care Home DS0000061638.V292739.R01.S.doc Version 5.2 Page 13 bookworm club, Ivydene Olympics, Board games, recreational movement to music, down memory lane quiz, coffee morning including a film slide of ‘a tour round Dartmoor’, exercise classes, poets corner, bingo, knitting circle and gardening club. In addition to the organised group activities residents are encouraged to maintain their own hobbies and interests; the inspector was told by one resident that they enjoyed spending time knitting and crocheting another how much they enjoyed reading and another confirmed they have continued with their model making of aircraft. Residents were aware of the group activities advertised in the monthly diary and confirmed they can pick and chose which ones to attend. 4 residents provided written feedback via a survey. When asked –‘Are there activities arranged by the home you can take part in? 3 indicated ‘usually’ and 1 ‘sometimes’. Feedback about the meals served in the home was varied. During the inspection lunch was served, options available were meat pie with vegetables and potatoes or cauliflower cheese also served with vegetables and potatoes. A number of residents told the inspector they had enjoyed their meal and several said they had not, one resident said they had asked for a salad but had been told they must eat the pie. This situation was discussed among the resident, inspector and deputy manager all agreed that as long as the resident was aware that eating salad often may not provide all the nutrients required for sustained health, it was for the resident themselves to chose the food they eat and this should not be dictated by staff within the home. Residents told the inspector they would like an option of a hot and cold dessert, on the day of this inspection residents were offered cold mousse or jelly with cream. Residents were seen not to be offered alternatives when they declined both desserts and discussion ensued where residents said they would have like to have had a final option of cheese and biscuits when they did not like either of the alternative meals offered. Residents told the inspector that they did not see the cook very often to discuss their meal preferences and that when they had been given the opportunity to comment at a ‘residents’ meeting they felt the cook had been negative and unresponsive when they had tried to communicate their wishes. A number of staff confirmed they were aware of dissatisfaction about some meals, but were reluctant to bring this to the attention of staff in the catering department because of the negative response they thought they might receive. The people living in the home told the inspector they were happy with the visiting arrangements, visitors said they feel welcomed into the home and are able to visit their relative/friend in private or socially. Ivydene Care Home DS0000061638.V292739.R01.S.doc Version 5.2 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 the following standard(s): Quality in this outcome area is adequate, this judgement has been made using available evidence including a visit to this service. Residents and their relatives/friends know how to make a complaint. Verbal Complaints are listened to but not always taken seriously and acted on. People are safe living in this home. EVIDENCE: Residents spoken with at the time of the inspection told the inspector they knew who to speak to if they were dissatisfied with the care or services provided. The Complaints procedure was found displayed in the entrance hall, in the statement of purpose and in the contract. Of the five residents whom provided written feedback 3 indicated they ‘usually’ know how to make a complaint and the other 2 that they ‘always’ know how to make a complaint. Discussion with the deputy manager and information seen in a residents daily record provided evidence that verbal complaints are not always recorded, this poses a risk that dissatisfaction continues and possible required changes to practise are not actioned. The inspector read the homes policy and procedure relating to responding to allegations or incidence of abuse or neglect and found it to be written in plain English and informative with a useful appendix providing specific contact details of agencies to be notified. The staff training matrix and feedback from staff and all 3 of the staff who provided written feedback to the Commission, confirmed their awareness of adult protection procedures. Ivydene Care Home DS0000061638.V292739.R01.S.doc Version 5.2 Page 15 Ivydene Care Home DS0000061638.V292739.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The environment is safe and adequately maintained. The home is clean and hygienic. EVIDENCE: A tour of the home provided evidence that the providers maintain an attractively presented environment for residents and staff that is well maintained. Maintenance and associated records provided to the Commission indicate that Fire equipment, Moving and handling equipment (including passenger lifts) and gas and electrical installations are checked and serviced regularly. Resident’s rooms contained personal items of furniture and ornaments and pictures. All of those spoken to said they liked their rooms, some particularly commented positively about the fact they have there own en suite WC. Ivydene Care Home DS0000061638.V292739.R01.S.doc Version 5.2 Page 17 The home appeared well equipped to meet the needs of those residents identified with moving and handling risks and disabilities that affect their capability to bathe. The gardens are safe and accessible and a new gazebo is in place consultation about wheelchair access into the gazebo is ongoing with the manufacturer. A redecoration and refurbishment programme is in place and the inspector noted that carpets in some bedrooms had been replaced since the last inspection. Specialist mattresses were seen in place for those residents requiring them, as were height adjustable beds. On the day of inspection interviews were being performed as part of the recruitment process for an ‘in house’ maintenance person. The communal areas of the home were fresh and clean in their appearance; Hand washing facilities are available throughout the home as were protective gloves. Ivydene Care Home DS0000061638.V292739.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): 27,28,29,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are usually sufficient numbers of staff with appropriate skills and knowledge to meet the needs of residents in this home. The homes recruitment practise does protect residents from being placed at risk of harm or abuse. EVIDENCE: The inspector examined the personnel records held within the home for 4 members of staff, the records contained evidence that all required checks had been performed to ensure the prospective staff are suitable to work within a registered care setting. In addition other evidence of good practise included record of recruitment interviews, performance reviews and 1:1 supervision sessions. Three care staff returned surveys provided to them from the Commission (CSCI) Information from these surveys indicates that all staff receive a written contract of employment, job description, induction training, feel supported and receive funding and time to receive relevant training. A clearly displayed training matrix provided evidence of on going training and a commitment to National Vocational Training. Information supplied along with that on the matrix shows that more than 50 of the staff have obtained a national Vocational Qualification at level 2 or above. Ivydene Care Home DS0000061638.V292739.R01.S.doc Version 5.2 Page 19 5 surveys were returned to the Commission from Residents at the home. When asked ‘Do you always receive the care and support you need?’ all 5 confirmed that they ‘usually’ do. When asked ‘do the staff act on what you say?’ 4 confirmed ‘usually and 1 ‘sometimes’. When asked ‘Are the staff available when you need them?’ 3 indicated ‘usually and 2 ‘sometimes’. One written comment received indicates that some residents have to wait to have their call bell answered and sometimes are late being assisted into bed’. Another written comment received was ‘not enough staff for all the patients, but the staff here are very good’. The residents spoken to on the day of the field trip said there was usually enough staff on duty; all the residents spoken to said their needs were being met. Residents described staff as hard working, kind and respectful. Ivydene Care Home DS0000061638.V292739.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38, Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registered manager for this home has retired recruitment processes are underway in the mean time the deputising arrangements have provided a safe system of management. Personal money held in the home on behalf of residents is secure. The registered provider shows a responsible attitude toward promoting and protecting the health, safety and welfare of residents and staff. EVIDENCE: Comments received from residents and staff during the field trip confirmed that the previous manager who has now retired was well respected and is now missed, however they confirmed the deputy manager has filled the void well in her absence. A new manager has been recruited and the Commission is Ivydene Care Home DS0000061638.V292739.R01.S.doc Version 5.2 Page 21 awaiting confirmation of their start date. The inspector witnessed meaningful interaction by the deputy manager with staff and residents. The inspector examined the records and storage of personal money held in the home on behalf of residents. A random selection of actual balances were checked against the documentation and found to be correct. Best practise systems are in place for the protection of both residents and staff. Internal auditing processes are in place, an external company manager visits the home on a monthly basis and performs a systems audit as well as feedback from residents and staff the results of which are reported to the manager to ensure a plan is made to address any short falls. The Commission receives a copy of this report. The provider generally demonstrates a responsible attitude towards health and safety pre-inspection information given to the Commission by the provider indicates that services and equipment are routinely maintained and serviced by people trained to do so, many fire doors that were open were being held by ‘safe’ hold open devices and notices were displayed throughout the home. Risks to residents are individually assessed and documented with an agreed plan in place to minimise risk where possible. Requirements and recommendations communicated from previous inspections are acted upon. Most recently a remote control call system has been made available for use in the communal rooms to enable residents to summon assistance when they require it. Ivydene Care Home DS0000061638.V292739.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 2 4 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 4 3 X 3 Ivydene Care Home DS0000061638.V292739.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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(2) Requirement The registered person must ensure the health and well being of service users through the correct recording of medication administration in the care home. The registered person must for the purpose of care to service users, and making proper provision for their health and welfare, so far as practicable ascertain and take into account their wishes and feelings. This requirement relates to residents being allowed to make an informed choice about what they chose to eat. The registered person must ensure there are sufficient staff on duty at all times to allow residents to make decisions about when they rise and retire and ensure their needs are met in a timely fashion. The registered person must notify the Commission of when the date of appointment of the manager is to take place. Timescale for action 14/06/06 2. OP14 12(3) 14/06/06 3 OP27 18(1)(a) 01/08/06 4 OP31 8 01/07/08 Ivydene Care Home DS0000061638.V292739.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard OP2 OP7 OP15 OP16 Good Practice Recommendations To ensure equity of service all service users should be provided with a written contract/statement of terms and conditions with the home. To ensure the changing needs of residents are recognised and a plan to meet them is in place, all care plans should be reviewed at, at least monthly intervals. The registered person should ensure that the alternatives made available at meal times suit the needs and wishes of all service users. The registered person should ensure that procedures are followed to ensure that service users and their relatives and friends are confident that verbal complaints will be taken as seriously and acted upon in the same way as written complaints. Ivydene Care Home DS0000061638.V292739.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. 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