Inspection on 05/12/05 for Jaffray Nursing Home

This inspection was carried out on 5th December 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 17 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Jaffray Nursing Home 18/06/07

Jaffray Nursing Home 27/11/06

Jaffray Nursing Home 09/06/05

Jaffray Nursing Home 16/12/04

Jaffray Nursing Home 20/07/04

Jaffray Nursing Home 14/03/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Jaffray Nursing Home 19 - 31 Jaffray Crescent Erdington Birmingham West Midlands B24 8EG Lead Inspector Alison Ridge Unannounced Inspection 5th December 2005 10:00 Jaffray Nursing Home DS0000024859.V270677.R01.S.doc Version 5.0 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 Jaffray Nursing Home DS0000024859.V270677.R01.S.doc Version 5.0 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 Adults 18-65. 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. Jaffray Nursing Home DS0000024859.V270677.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Jaffray Nursing Home Address 19 - 31 Jaffray Crescent Erdington Birmingham West Midlands B24 8EG 0121 382 1383 0121 255 2356 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) Jaffray Care Society Sukhwinder Thandi Care Home 18 Category(ies) of Learning disability (18), Physical disability (18) registration, with number of places Jaffray Nursing Home DS0000024859.V270677.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 18 persons with a learning disability and physical disability. That the home can continue to accommodate three named services who are over 65. That Jaffray Nursing Home apply for variation on behalf of future service users who reach the age of 65. That details regarding how the specific care and social needs of people over the age of 65 will be met must be included in the service users plan. 9th June 2005 Date of last inspection Brief Description of the Service: Jaffray Nursing Home comprises of four bungalows. The home accommodates 18 people who have a learning disability, physical disability and additional nursing needs. The bungalows have level access throughout and are fully accessible to people without full mobility. Each bungalow is home to four or five people. Each service user has a single room, none of these have ensuite facilities, but all have a wash hand basin. Each bungalow has supported bathing facilities. The home has a range of hoists and mobility equipment. Each bungalow has a kitchen, dining room and lounge area. One bungalow has a conservatory. Jaffray Nursing Home DS0000024859.V270677.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors and an expert by experience Margaret Wyer undertook this unannounced inspection over the course of one day. During the visit time was spent talking with people who live in the home, staff on duty and observing the care and support people receive. Records about care and health and safety were assessed. The inspectors looked in all the communal areas of the home, and in some bedrooms when people said this was OK. Two of the people who live in this home and a relative/visitor completed a comment card. The inspection team suggest that this report be read alongside the report of the inspection undertaken in June 2005 to get a fuller picture of the service offered at Jaffray Nursing Home.4 The inspection team found that the home had improved in many areas since the last inspection. The inspection team extend their thanks to everyone who helped with this inspection. What the service does well: Jaffray nursing home is a very friendly and welcoming place. As visitors the inspection team were made to feel welcome and offered refreshments during their stay. The expert by experience also commented that,” Staff seemed to really care about the well being of people living here, this contributed to a nice atmosphere.” On one of the comment cards a person living at Jaffray had written, “ I am happy and comfortable, I like to live here.” The people who live at Jaffray that the inspection team met with all looked well cared for. They were wearing clothes that were in good condition. A relative commented, “I am very happy with the way my brother is looked after and cared for.” The bungalows that people live in are very well presented and maintained. They were all homely and tidy. The decorations up for Christmas made the bungalows look very festive. In all the bungalows there was a good stock of food. The food was of good quality, and very varied. The meals the inspection team saw were attractive and nutritious. Jaffray Nursing Home DS0000024859.V270677.R01.S.doc Version 5.0 Page 6 The people who live at Jaffray had been supported by staff to get ready for Christmas. They had organised special events to celebrate Christmas, and had supported people to buy presents. 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 Jaffray Nursing Home DS0000024859.V270677.R01.S.doc Version 5.0 Page 7 contacting your local CSCI office. Jaffray Nursing Home DS0000024859.V270677.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Jaffray Nursing Home DS0000024859.V270677.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): X Not assessed at this inspection. EVIDENCE: The home has a very stable service user group. There is one residential vacancy. These standards were not assessed at this inspection. Jaffray Nursing Home DS0000024859.V270677.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 and 9 Service users needs, wishes and risks are generally well assessed and documented, to ensure their needs are met in the way they prefer. Systems to ensure care documents are reviewed and developed after critical incidents must improve to ensure plans are developed to reduce the likelihood of a repeat incident. Care documents are generally not accessible to the service users. EVIDENCE: The plan of six service users was assessed in whole or part during this inspection. Staff at the home had developed extensive plans to underpin the needs of the people accommodated. All the plans sampled were very individual. Staff had kept the documents up to date. All the plans are stored in the room of the relevant service user, which is positive. Staff need to work on making these documents accessible to a greater extent. The exbyex said, “It is great people have their own care plans in their room, but if they are not in an accessible format. I don’t really see the point…people need to be central to all plans written about them and to have them in a way they person understand.” Jaffray Nursing Home DS0000024859.V270677.R01.S.doc Version 5.0 Page 11 Staff at Jaffray have had some training in Person Centred planning (PCP). The inspection team did not find that staff were really clear about what this was, or who would be having a PCP. The exbyex said, “I got the impression staff are not really aware about person centred planning and it’s tools. I would recommend staff have more training in this area as it is key to Valuing People.” Service users all have risk assessments to underpin risks they face and are exposed to. These were generally comprehensive, and control measures in place were reflective of the risk assessed. Staff had reviewed the documents regularly. The inspectors tracked the response of staff to critical incidents such as falls. In one instance a service user had fallen on two occasions. Staff had written, ”no changes” on the review despite these falls. Critical incidents must trigger a review of the risk assessment and subsequently the support plan if required. Jaffray Nursing Home DS0000024859.V270677.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16 and 17 The inspection team found a range of interesting and varied activities are offered. This included special events to celebrate Christmas. Service users are supported to stay in touch with people who are important to them. Service users are offered a range of nutritious, good quality foods. EVIDENCE: The opportunity for service users to undertake activities was assessed. The records of activities held in each home, and those held by the driver were looked at. These showed service users are offered a varied range of activities. It was pleasing to see this included opportunity for personal development, such as college courses or day placements, as well as leisure including eating out, going to places of interest, shopping and the theatre. Service users had been supported to plan a range of special activities for Christmas, which included meals out, theatre trips and a party. Therapeutic activities including aromatherapy and exercise to music is provided on a regular basis. Jaffray Nursing Home DS0000024859.V270677.R01.S.doc Version 5.0 Page 13 The inspection team spoke with some of the service users about their lifestyle. People reported being able and supported to do the things that makes them happy. The staff work from 8am until 8pm each day. Records did evidence that opportunities to go out in the evening are provided. The exbyex expressed concern that this limits people’s opportunities to go out in the evening. This is something CSCI inspectors have previously raised, and require to be kept under review. It was very positive to hear of the opportunities service users have to go on holiday. Service users reported in person and it was evident in daily notes that family contact is encouraged and maintained. It was pleasing to hear from service users and staff that family will be visiting over the Christmas period, and that service users have been supported to purchase presents and cards for people important to them. It was evident service users are consulted on key aspects of the homes operation. This includes choosing meals, activities and talking weekly about the coming week. The exbyex commented that, “It is good these meetings take place regularly but I would like to suggest people having a meeting without staff. Having someone from outside the home, like an advocate could help people be more open and honest about their feelings.” The food available in all the bungalows was plentiful and varied. Fresh fruit and vegetables were available in all the bungalows. It was pleasing to hear of the success one service user had achieved on a weight reducing diet. The menus showed a very varied diet had been planned. For one service user on bungalow 31 this had not been offered. In ten days the meals served included lasagne twice, fish pies on two consecutive days and pork on three days. It is recommended that this be reviewed, and greater variety offered. Members of the inspection team asked service users how food is chosen. The exbyex said,” In all bungalows people seem to be involved at some level with choosing meals.” She did raise concern at how people with more limited communication are involved in choice making, and stated, “It would be better if staff could find a way of finding out what the person would like to eat, rather than eating the choice of meals others agree on.” Some service users are fed enterally by tube. Evidence of review with the dietician, and care plans to underpin this were in place. Jaffray Nursing Home DS0000024859.V270677.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Service users are supported to undertake personal care to a high standard, and to wear clothes they choose and like. Most health care needs are well planned for and met. Some specific needs tracked need further development to ensure service users healthcare needs are fully addressed. Medication management is generally good, and systems showed service users had received the right medication at the right time. EVIDENCE: All the service users inspectors met with looked very well presented. On bungalow 19 service users were preparing to go out for a Christmas lunch. They had all been supported to choose attractive clothes and accessories. In all the bungalows service users had been supported to undertake personal care to a high standard. Everyone had personal supply of toiletries. The specific healthcare needs of service users were tracked. All of the files assessed generally contained detailed plans that provided staff with clear guidance on how to meet the detailed needs. Some specific issues were noted and include, • Staff record health care appointments on a matrix. These show most health care appointments are undertaken as required with the exception of chiropody and dentist appointments. Jaffray Nursing Home DS0000024859.V270677.R01.S.doc Version 5.0 Page 15 • • • • The work undertaken to plan one-service users mental health needs were assessed. Staff had undertaken some positive work, and made appropriate referrals. The plan needed to be further developed to provide a clear baseline of wellbeing, and indicators of change. The needs of one service user who had experienced some falls were assessed. The plan to underpin this had been reviewed. It did not evidence staff had looked at the possible cause of the falls, or taken action to develop the assessment or staff support to reduce the likelihood of this happening again. One service user who had experienced a significant change in needs was assessed. Inspectors identified that the plan of care for this person required significant development to underpin presenting needs. The provider already had this work in hand. Some people need support to evacuate their bowel on a regular basis. The records of this were tracked in one of the bungalows. Records of care and administration didn’t tally, and it is required this be reviewed to ensure people are getting all the support they need. It was pleasing to see the work undertaken with one service user to reduce her weight. This had been undertaken under the supervision of the dietician. The staff had supported service users to develop health action plans. This is positive, and in line with the Government white paper, “Valuing People.” Service users had been weighed on a regular basis. The medication was assessed in bungalows 19 and 29. The storage was all in good order. Audits of medicine not blister packed was correct. Most medicines were signed for. One medicine had not been signed for and this was being followed up with staff on duty. Protocols were not available for all as required (PRN) medicines. Where available these must be kept under review. Staff take copies of medication records out with them on activities in the event of a service user requiring medical treatment when away from the home. The copies available at the time of inspection did not reflect the current prescribed medicines. Staff must ensure these stay up to date. Jaffray Nursing Home DS0000024859.V270677.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): X Not assessed. EVIDENCE: Standards not assessed at this inspection. Jaffray Nursing Home DS0000024859.V270677.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Jaffray Nursing Home is attractive and homely. The home is generally well presented, with a few areas requiring attention to cleanliness. EVIDENCE: The Jaffray Nursing Home bungalows were all very well presented. There is a system of redecoration and refurbishment in place, which ensures the homes remain presented to a high standard. Since the last inspection new lounge furniture and curtains had been obtained, and some bedrooms had been redecorated and new flooring required. The only minor shortfall identified was the need to remove the dividing curtain rails in rooms that were previously shared. The bungalows were generally all very clean and tidy. Kitchen walls and cupboards in some bungalows required wiping down. It is required that food storage be reviewed, to ensure all dry goods are stored in an airtight way, and that fresh food that is frozen is dated. The fridge temperature records in bungalow 21 were not up to date. These must be undertaken and recorded daily. Hygienic facilities for hand washing must be provided in the laundry. Jaffray Nursing Home DS0000024859.V270677.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): X These standards were not assessed. EVIDENCE: During the visit members of the inspection team observed some very positive interactions between staff and service users. The exbyex said, “All the staff we met seemed very friendly towards us. People in the home seemed quite relaxed around the staff, which was reassuring.” Inspectors met with the service manager of the home at the end of the inspection. She reported that a review of staffing had resulted in an increase of the staffing establishment, which she believes will have a positive effect on the opportunities and support available to people. Jaffray Nursing Home DS0000024859.V270677.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 42 The management of Jaffray has improved, and it was evident better outcomes for service users were being achieved. The health and safety of service users, staff and visitors is well protected by robust systems to servicing and testing of appliances. EVIDENCE: The home has a manager who is registered with the CSCI. It appeared that the outcomes for service users in all bungalows had improved since the last inspection. The health and safety of service users, staff and visitors is generally very well protected by robust servicing and testing of equipment and fittings. All fire safety tests and routine tests of electrical, gas and lifting equipment had been undertaken. Jaffray has been active in improving safety systems by extending the emergency call systems. The staff must ensure the delivery temperature of hot water is tested at least monthly to ensure it is no greater that 43°c. Jaffray Nursing Home DS0000024859.V270677.R01.S.doc Version 5.0 Page 20 Staff must ensure that the filters of the tumble driers are cleaned after each load. These were very full at the time of inspection. Jaffray Nursing Home DS0000024859.V270677.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 2 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 2 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Jaffray Nursing Home Score 3 2 2 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X 2 X DS0000024859.V270677.R01.S.doc Version 5.0 Page 22 Yes Are there any outstanding requirements from 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. Standard Regulation 1. YA3 14 Requirement Evidence not available at inspection. Assessment must be undertaken of new service users. The home must evidence they can meet the individuals needs. Outstanding from the previous inspection. The contract must be further developed to include, - Elements of the Care management Care plan to be provided outside of the home All service users must be supported to develop and obtain a person centred plan. Staff must receive training and awareness regards this. Outstanding from the previous inspection. Residents risk assessments must be written, reviewed and updated where necessary. Risk assessments must then be subject to regular review and a record of this kept. HAS 1992 Outstanding from the previous inspection. Referrals made to Speech and Language Therapy. DS0000024859.V270677.R01.S.doc Version 5.0 Timescale for action 01/02/06 2. YA5 5(1) 01/02/06 3. YA6 12(3) 01/06/06 4. YA9 12 1 a,b 13 4a-c 09/01/06 5. YA11 12(1a-b, 2,3) 01/02/06 Jaffray Nursing Home Page 23 6 YA19 13(1) a) 7. YA19 13(1)(b) 8. YA19 12(1a-b) 9. YA19 12(1a-b) 10. YA20 13(2) 11. YA24 13(4c) 23(2a-b) 12. YA30 16(2)(j) 13. YA30 13(4)(c) 23(5) Service users must be offered opportunity to develop skills relevant to greater independence. Communication systems to support the spoken word must be provided as required by service users. Outstanding from the previous inspection. Nursing care must be reviewed to ensure service users health care needs are being fully met. Outstanding from the previous inspection. Service users must be supported to receive treatment from chiropody and dental services as required. Evidence of this must be maintained in the home. Outstanding from the previous inspection. Care plans must be updated and amended as service users needs change. Outstanding from the previous inspection. Mental health needs must be planned as required. Medication protocols must be available for all as required (PRN) medicines and show evidence of reviews. Outstanding from the previous inspection. Uneven paving slabs in the garden must be levelled to reduce the risk of residents and staff tripping. Outstanding from the previous inspection. Paper towels and liquid soap must be provided in all toilets and bathrooms and the laundry. Outstanding from the previous inspection. Food storage of dry good must be airtight Fridge and freezer temperatures must be taken and recorded daily. DS0000024859.V270677.R01.S.doc Version 5.0 01/02/06 01/02/06 01/02/06 01/02/06 01/02/06 01/03/06 09/01/06 09/01/06 Jaffray Nursing Home Page 24 14 YA30 23 18(2) 15. YA36 16 YA42 13(4)(c) 17 YA42 13(4)(c) Staff must ensure all areas of the home are maintained to a satisfactory level of cleanliness. Records not available at this inspection. Supervisions must be undertaken with all staff, at least six times each year. Staff must undertake routine testing of hot water delivery temperatures at outlets around the home. Staff must ensure fire risks such as excess debris in tumble drier filters are effectively managed. 09/01/06 01/02/06 09/01/06 09/01/06 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 2 3 4 5 Refer to Standard YA6 YA12 YA16 YA17 YA24 Good Practice Recommendations It is recommended that service users care documents be presented to them in a way they find accessible. It is recommended the opportunity for service users to undertake activities in the evenings be kept under review. It is recommended that the provision of an independent advocate be explored. It is recommended that ways of supporting service users with limited verbal communication skills to make choices regarding the choice of meals be developed. It is recommended that dividing curtain rails in the old shared rooms be removed. Jaffray Nursing Home DS0000024859.V270677.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Jaffray Nursing Home DS0000024859.V270677.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!