Inspection on 05/07/07 for Ladymead Nursing Home

This inspection was carried out on 5th July 2007.

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

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

Other inspections for this house

Ladymead Nursing Home 19/10/09

Ladymead Nursing Home 27/06/08

Ladymead Nursing Home 22/08/06

Ladymead Nursing Home 03/03/06

Ladymead Nursing Home 16/08/05

Ladymead Nursing Home 16/02/05

Ladymead Nursing Home 19/11/04

Ladymead Nursing Home 19/02/04

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 Ladymead Nursing Home Moormead Road Wroughton Swindon Wiltshire SN4 9BY Lead Inspector Karen Mandle Unannounced Inspection 09:45 5th July 2007 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 DS0000015924.V334262.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. DS0000015924.V334262.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ladymead Nursing Home Address Moormead Road Wroughton Swindon Wiltshire SN4 9BY 01793 845063 01793 845068 ladymead@fshc.co.uk www.fshc.co.uk Laudcare Ltd (a wholly owned subsidiary of Four Seasons Health Care Ltd) Mrs Anne Rouse Care Home 40 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) Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (4), Terminally ill (4), of places Terminally ill over 65 years of age (4) DS0000015924.V334262.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No more than 4 service users with a terminal illness may be accommodated at any one time The minimum staffing levels set out in the Notice of Staffing issued by Wiltshire Health Authority and dated 27 January 2000 must be met at all times 22nd August 2006 Date of last inspection Brief Description of the Service: Ladymead is a purpose-built home in the village of Wroughton, on the outskirts of Swindon. The home provides accommodation on two floors and has single and double rooms, with en-suite facilities. There are lounge and dining areas on both floors and a passenger lift is available. The home has a garden, which is level and well maintained. Shops and local amenities are within a short walking or driving distance. The home is registered to accommodate up to 40 older people requiring nursing care, which may include up to four persons requiring nursing care due to terminal illness and four requiring nursing care due to physical disability. Current fees are from £650 per week. The home is part of the Four Seasons Healthcare Group. The registered manager is Mrs. Anne Rouse. Nursing staff are on duty at all times, supported by care assistants. Activity, administrative, domestic, laundry, catering and maintenance services are also available in the home. DS0000015924.V334262.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place July 5th 2007, commencing at 9.45am and was completed by 3.50pm.The inspection was carried out by two inspectors, Karen Mandle and Pauline Lintern. The manager Mrs Anne Rouse was available to assist with the inspection. The inspectors were able to freely tour the building, visit with many of the service users and observe the staff interacting and caring for service users. Prior to the site visit-taking place, surveys were sent to the home to gain the opinions from the service users and relatives regarding the service provided at Ladymead. The surveys returned generally provided positive comments about the service, apart from two, which made comments about staffing levels needing to be increased. The inspectors visited with many of the service users during the first day of the inspection to gain their personal views of the service they received. The care records of seven service users were closely reviewed, as was the medication procedure. Other various records were reviewed, such as staff records, including training records and health and safety records. The fees range from £650.00 to £700.00 per week. One requirement remains outstanding from the previous inspection and six further requirements have been made following this inspection. Three good practice recommendations were made. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. What the service does well: What has improved since the last inspection? The manager conducts a full pre-admission assessment for all service users. Service users receiving palliative care now have their wishes concerning terminal care set out in a care plan. All staff had been provided with manual handling training. The system to ensure that all staff receive formal and regular supervision has much improved. Environmental risk assessments are now reviewed annually. Nineteen profile beds had recently been purchased. DS0000015924.V334262.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. The summary of this inspection report can be made available in other formats on request. DS0000015924.V334262.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 DS0000015924.V334262.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3. Standard 6 does not apply to this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are fully assessed prior to admissions taking place, ensuring that the home can meet their personal and social care needs. A record of the assessment is maintained. The home is not registered for intermediate care. EVIDENCE: All prospective service users are assessed by the manager, Anne Rouse, prior to admission ensuring that through the assessment process, the home is able to meet the nursing and personal care needs of the service user. Three preadmission assessments were seen which provided information relating to longterm care needs and current needs. A record of the assessment is kept on the service users’ file and used towards implementing a care plan. Two service users confirmed that they had chosen to live at Ladymead by saying, “ I came here because I already knew the home” and “I came here for respite care and then decided to move here as it was getting more difficult for DS0000015924.V334262.R01.S.doc Version 5.2 Page 9 me in my own home”. Other service users implied that they had been too poorly to decide for themselves therefore their families had made the decision for them to live at Ladymead. Ladymead is not registered to provide intermediate care therefore Standard 6 is not applicable. DS0000015924.V334262.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Each service user is provided with a care plan but some assessments were not provided to ensure that all health care needs are being met. The care plans are reviewed monthly. Health care needs are monitored. The medication procedure was safe. Service users are treated with respect and supported with personal care. EVIDENCE: The care records of seven service users were reviewed. The care plans provided information relating to the support needs of the service users, health care needs and social background. Risk assessments had been completed which included nutritional, manual handling, pressure area and falls assessments. Evidence was seen of monthly reviews taking place. However continence assessments could improve by providing evidence of clinical indicators being identified to support the use of catheters. DS0000015924.V334262.R01.S.doc Version 5.2 Page 11 Eleven out of sixteen service users living on the 1st floor were being nursed in bed on the day of the inspection. By reviewing the daily care charts of these service user’s, it was evident that this was not unusual. Evidence was not recorded in the care records for the reason for this. A service user said, “ I would rather be out of bed but the chair is not comfortable”. Another service user said, “I have to stay in bed because of my legs”. A service user also said, “When there is no one about I have to stay in bed”. Care records did not provide clear assessments regarding service users needing to be nursed in bed. As required from the previous inspection, care plans are now in place reflecting service users wishes regarding end of life decisions. The health care needs of the service users are monitored with appropriate action taken when health care needs change. A GP visit takes place weekly and on request from the nursing team. A GP spoke with the inspectors and reported that the home manages tissue viability issues very well and had been successful in healing some poor pressure sores. Tissue viability needs were well addressed with appropriate pressure relieving equipment in place, in line with the outcome of the risk assessment. However it was observed that an additional sheet folded in half was being used, to reposition service users. A slide sheet should be used for this procedure. The use of an extra sheet with an air mattress could reduce the effectiveness of the mattress. Service users with higher care needs had frequent care charts in place. Service users who were able to comment on the care and support provided gave positive comments such as “The staff are caring and look after me here and get the doctor here if I need one” and “My health has improved since living here”. Five of the service users being nursed in bed did not have a call bell available to them. Comment cards received from seven service users all stated they were satisfied with the overall care provided. A relative who visits the home regularly said, “I am satisfied with the care here”. The medication procedure was safe. The qualified nurses are responsible for the administering of all medications. The medications were stored correctly, as were the controlled medicines. The administration of medication was observed and was safe. The disposal of medications was in line with current legislation. The medication administration records were up to date. It is recommended as safe practice that a handwritten medication order be countersigned by two members of staff, ensuring accuracy of the order. Personal care was provided behind closed doors either in the privacy of the service users’ bedroom or bathroom. The staff knocked on bedroom doors before entering. Service users were well groomed with personal care needs being met. A service user said “I don’t like going in the bath as it is uncomfortable, but they wash me every day and keep me clean”. DS0000015924.V334262.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The activities provided meet the social needs of the service users. Service users are supported to retain links with family and friends. Some service users are provided with choice and control over their lives. Service users were satisfied with the standard and quality of the food. EVIDENCE: A range of activities is provided daily such as exercise classes, quizzes, and games such as ‘play your cards right’. The activities co-ordinator is employed for 29 hours per week. A service user said, “I really enjoy the activities but not much goes on when Julie is not here”. One to one visits were also observed taking place for those service users not wishing to participate with group activities. Service users were also observed enjoying reading, watching TV and receiving visitors. A service user reported, “Julie is planning to take me to town as I like shopping”. A record is kept of all activities and who attended and each service user had an individual activities plan. Religious services are held monthly in the home and a minister will visit those who request Holy Communion. DS0000015924.V334262.R01.S.doc Version 5.2 Page 13 Service users are supported by the home to maintain links with family and friends. The visitors signing in book showed visits taking place throughout the day. A service user confirmed “My family can visit me here whenever they like”. The comment cards received from two relatives indicated that they were made welcome when visiting the home and were kept informed of important matters. Through observation and speaking with service users, it was evident that some service users had more control over their lives than others. A service user informed the inspector, “I do go to bed early but that is my choice and there is no rush in the mornings to get up”. However as previously stated under Standard 7 of this report, it did not appear to be the choice of all service user’s who were being nursed in bed, to be in bed. The home provides a separate dining room on each floor. Only six service users were observed having lunch in the dining room on the ground and two in the first floor dining room. The remaining service users ate in their bedrooms. A service user said, “ I choose to have meals in my room so I’m near the toilet, which I prefer”. Service users needing assistance were observed being supported on a one to one basis. The menus were varied and a choice of nutritious meals was available. The main hot meal of the day was observed during the inspection and appeared well cooked and nicely presented. Service users were asked if they were happy with the food, the responses were; “The food here is good”, “Oh yes the food is generally very good”, “You always get a choice and they ask you the day before what you would like” and “The cook is very nice lady and gives us what we want”. Nutritional needs are monitored through assessments and monthly weighing. Service users who had weight loss were weighed weekly and provided with nutritional supplement drinks. DS0000015924.V334262.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A complaints policy and procedure are in place, which is openly displayed. The staff had received training in abuse awareness. The employment procedures are robust and protect the service users. EVIDENCE: A complaints policy and procedure are in place. The complaints policy is openly displayed in the home. A record of complaints is maintained along with the outcome of the complaint and what action (if required) was taken by the home. Whilst visiting with service users, the issue of what they would do if they had a concern or complaint about any areas of the service provided by the home was raised. Three service users said, “I would speak to Ann”. Another said, “I would speak to my daughter first”. Relatives reported that their father had been provided with information on how to raise a concern when he was first admitted. They confirmed that they could access Four Seasons web site if they needed. The staff had received training in abuse awareness. All staff had been issued with a copy of the “No Secrets” document, which they had to sign for. The manager and head of care were fully aware of how to implement the local vulnerable adults procedure. The employment procedures are robust and protect service users as much as possible. DS0000015924.V334262.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 22, 24 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally well maintained apart from the main corridors where the carpet is worn and the walls are damaged. Ample communal space is provided and two separate dining rooms. The bedrooms are homely and personalised. The home was clean and infection control practices were satisfactory apart from some equipment items being stored incorrectly. EVIDENCE: The home is purpose built. Communal space and dining rooms are provided on the ground and 1st floor, all of which are laid out in a domestic style and are accessible for wheelchair users. The garden is well maintained with a pleasant patio area. Maintenance records indicated that the building and equipment were regularly serviced and maintained. The main corridors on both floors should be refurbished, as the carpet is worn and stained and the walls are damaged. DS0000015924.V334262.R01.S.doc Version 5.2 Page 16 Whilst visiting service users in their bedrooms it was observed that five service users did not have access to their call bells whilst in bed. Therefore they were not able to call the staff for assistance. A service user reported, “They come as soon as they can but sometimes they are busy and come and turn the alarm off and say how long they will be”. It was also said “The night care is good they come quickly when you call them” and “They are very good when I call the bleep, they do come but not straight away”. A written comment on a survey was that “Sometimes when I ring my buzzer I wait quite sometime before I get some assistance”. It is recommended that the home review the current call bell system in place and consider implementing a system, which logs who called and time addressed. As required from the last two inspections, profile beds are now in place for the majority of service users. Many of the assisted bathrooms were being used for the storage of hoists, commodes and wheelchairs. If the baths were in use, these items would then be stored in the corridor posing a fire risk. The bedrooms visited were generally well furnished and personalised. However not all bedrooms provided a suitable armchair, which supported the needs of the service users. It will be recommended that a review take place of the specialist chairs that are available in the home with an aim of providing comfortable seating, especially for those service users who are currently staying in bed much of the time. Service users were satisfied with the bedrooms, with comments received like “My room is cosy, I like it” and “They clean my room for me”. The bedrooms had en-suite facilities, however many en-suites were being used for storage of clean dressings, catheters and medical equipment used for performing catheterisation. This is not a clean storage area and could pose a risk of cross infection, these items should be stored elsewhere. Also in the ensuite were clinical waste bags with used items in them. The home was clean through out with no offensive odours noted. DS0000015924.V334262.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels enable service users to receive the support and care they need the majority of time. An induction programme is provided for new staff and an on going training programme is provided for all the staff. The home’s recruitment procedures are robust and protect the service users. EVIDENCE: The majority of service users felt there were enough staff provided but at busy times of the day, such as the morning they did sometimes have to wait some length of time before care could be provided. Two of the comment cards received made reference to the benefits of increasing staffing levels to provide more one to one care, especially when service users are being provided with palliative care. The home should review staffing levels in line with the care needs of the service users. Domestic and kitchen staff was also provided. The recruitment files of four members of staff were reviewed. All files contained two references, application form, contract of employment and appropriate police checks. Recruitment procedures are robust and protect the service users. A review of the training files took place, which indicated that all mandatory training had been provided. The home was also working closely with Prospect DS0000015924.V334262.R01.S.doc Version 5.2 Page 18 Hospice, which were providing training in pain control, communication, and spiritual care and wound care. The home provides a 12-week induction programme for all new staff. They are also provided with a copy of the “New Employee Handbook”. Five members of staff had obtained NVQ 2 and three had just commenced. A member of staff said “I think the training is fine here”. DS0000015924.V334262.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is qualified and competent to run the home. Quality assurance systems are in place, apart from unannounced visits taking place by the providers. Health and safety systems are in place providing a safe environment for service users to live in. EVIDENCE: The manager, Mrs Ann Rouse, is a registered nurse. Mrs Rouse has been the homes’ manager since November 1997. Mrs Rouse has achieved the Registered Manager award. A service user said, “ Ann visits me everyday which I like”. DS0000015924.V334262.R01.S.doc Version 5.2 Page 20 Quality assurance systems are in place in the form of an annual questionnaire which had been sent out to families from head office on the 23/05/07, which is designed to gain the views of service users and families. Relatives meetings are now held but it was reported that attendance was low. The last unannounced visit by a representative of Four Seasons was conducted in February 2007. These visits should be carried out monthly. Supervision records indicated that staff had received regular formal supervision, which was fully documented. Two members of staff had received supervision every other month and one had received it less frequently. However this is a good improvement from the previous inspection. Accidents are recorded, providing information of how the accident occurred and what action was taken by the home. The manager regularly audits the accident record. Electrical equipment is tested annually and the servicing of the hoists and passenger lift takes place annually. The home had purchased 19 profiling/variable beds as required from the previous inspection. A service user informed the inspector “I have just got my new bed and it is very comfortable”. Environmental risk assessments had been completed and recently reviewed. The fire log indicated that all appropriate fire checks had been made and staff had received fire training. Radiators are covered and hot water temperatures are controlled and checked. DS0000015924.V334262.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X 2 X 3 X 2 STAFFING Standard No Score 27 2 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X X 3 X 3 DS0000015924.V334262.R01.S.doc Version 5.2 Page 22 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 OP7 Regulation 14(2a) Requirement Service users care needs will be assessed and documented, as to the reason for being nursed in bed and the assessment will be kept under review. The records for service users who have a urinary catheter will state the clinical indicator for the use of catheters. All service users will have access to a call bell at all times. The en-suite facilities will not be used for storage areas for clean dressing and clean catheter care equipment. The registered provider is required to ensure that a representative of the Company carries out monthlyunannounced visits. This requirement was identified at the inspection of 22nd August 2007. The last unannounced visit by a representative of the company took place in February 2007. Equipment such as commodes, wheelchairs and hoist will not be DS0000015924.V334262.R01.S.doc Timescale for action 30/09/07 2. OP8 12(1a) 30/09/07 3. 4. OP22 OP26 12 13(3) 27/08/07 30/09/07 5. OP33 26 (2,3,4) 27/08/07 6. OP19 23(2L) 30/09/07 Version 5.2 Page 23 7. OP19 23(2D) stored in the assisted bathrooms. The corridors will be refurbished to enhance the living environment for service users. 01/10/07 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. Refer to Standard OP9 OP22 Good Practice Recommendations Two qualified members of staff should countersign handwritten medication order. A review should take place of the armchairs provided to ensure that the chairs suit the physical needs of the service users, providing service users with an opportunity to spend time out of bed. It is recommended that a review of staff practice and staffing levels be undertaken. 3. OP27 DS0000015924.V334262.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000015924.V334262.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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