Inspection on 09/08/05 for Kallar Lodge

This inspection was carried out on 9th August 2005.

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

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

Other inspections for this house

Kallar Lodge 21/06/06

Kallar Lodge 31/10/05

Kallar Lodge 15/02/05

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

CARE HOMES FOR OLDER PEOPLE Lake Rise 75 Gregory Road Chadwell Heath Romford, Essex RM6 5RU Lead Inspector Harbinder Ghir Unannounced 9 August 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lake Rise G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Lake Rise Address 75 Gregory Road, Chadwell Heath, Romford, Essex, RM6 5RU Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208 270 6750 London Borough of Barking & Dagenham Ms Carol Ann Darkins CRH - Care Home 37 Category(ies) of OP - Old Age 37 registration, with number of places Lake Rise G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th February 2005 Brief Description of the Service: Lake Rise Residential home offers 24-hour residential care to 37 people over the age of 65 years. The home also provides intermediate care. The accommodation is split between 3 floors and has a passenger lift. The accommodation is linked to the remaining sheltered accommodation complex which has been a cause of concern, as the homes lift is shared with the tenants of the sheltered accommodation complex who have access to the residential home to use it. The first and second floor each have their own communal lounge and kitchen area. In addition to these communal areas there is a large lounge on the ground floor which is used for social events and as a private visitors room. All rooms are single with an ensuite toilet and washbasin. All rooms are spacious, airy and bright and have TV points and a call system in place. The rear garden is with disabled access to the grounds and there are car parking facilities at the front of the property. The home is located within a residential area close to local services and facilities which are easily accessible by car and public transport as is the M25 and A12. Lake Rise G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission was represented by Harbinder Ghir, Regulatory Inspector who was in Lake Rise from 10.00 a.m. until 4.00 pm. During that time some residents and staff agreed to speak with the Inspector. The home and some records were inspected. What the service does well: What has improved since the last inspection? What they could do better: Lake Rise G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 Page 6 A number of residents have developed dementia whilst at the home. The registered provider and manager need to discuss with the Commission for Social Care Inspection for the categories for whom the home is registered in relation to the residents noted to have dementia. Staff supervision needs to be made a high priority for the home, as staff are not being supervised 6 times a year, resulting in staff not being aware of developments within the home concerning the welfare of residents. Training records must be kept up to date to reflect the current training needs of all staff. Ways to minimise the risks of infection needs to be revisited by the manager. Menus and a list of activities need to be readily available to residents throughout the home. More activity hours are required and detailed records need to be maintained of all activities taken place and of all those who participated. A daily log of food intake for all residents needs to be maintained by the home to monitor their nutritional intake. Care plans must be devised for all new residents upon admission and they must be informed in writing that the home is able to meet their needs. Care plans also need to be compiled as one complete working file to avoid the duplication and fragmentation of information. The recording of daily logs needs to be more detailed and comprehensive. 7 requirements made at the last inspection have been restated, as they were not complied with. Failure to comply by the new timescale will result in the commission considering enforcement action to secure compliance. 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. Lake Rise G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Lake Rise G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3, 4,5, 6. The home’s Statement of Purpose and Service User Guide need to be updated to include the information required by the regulations. Trial visits are offered and pre -admission assessments are completed prior to admission to ensure identified needs can be met by the home. Service users who are assessed and referred solely for intermediate care are helped to maximise their independence and return home. EVIDENCE: The Statement of Purpose was seen, which provided detailed information about the service. However, the document needs to be updated to provide information on how it can meet the needs of residents who have developed dementia at the home. The registered provider and manager need to discuss with the Commission for Social Care Inspection for the categories for whom the home is registered in relation to the residents noted to have dementia. The Service User Guide had information missing required by the regulations and needed updating. A copy of both documents is given to all residents prior to admission and is readily available within the home. The last inspection report Lake Rise G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 Page 9 was not readily available and could not be located during the inspection. All residents receive a written contract of terms and conditions, which was very comprehensive. The home has a good pre-admission assessment form. However, the home does not confirm in writing to all new residents that the home is able to meet their needs. The senior carer confirmed that trial visits to the home and overnight stays are encouraged and are an opportunity for potential residents and their family to identify how appropriate the home is for them in meeting their needs. Intermediate care is well run and established within the home and has a specialised staff team consisting of a physiotherapist, occupational therapist and care members of staff. Accommodation provided was appropriate to the service’s aims and adequately met the needs of its residents. One resident spoken to informed that the scheme has been very beneficial to her, giving her the opportunity to get back on her feet and has enjoyed her stay and plans to return home. Another resident spoken to informed that the physiotherapist sees her more unless everyday and has found the therapy very useful. Lake Rise G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 10, 11 The care planning system is clear and consistent to provide staff with the information they need to meet residents’ needs. The recording of daily entries was very brief and did not provide the reader with comprehensive information of residents’ individual care and support needs provided by the home on a daily basis. Personal care is offered in a way that protects residents’ privacy, dignity and promotes their independence. The home has made limited progress on establishing residents’ wishes in the event of death. EVIDENCE: Four care plans were viewed. Care plans included a detailed plan of residents’ daily routine, personal, physical, emotional, mental and healthcare needs. The needs of those residents with dementia were recognised and met, but the home failed to meet their social needs, which will be discussed in the next section. Staff informed that the psycho-geriatrician reviews those with dementia. Risk assessments were clear and identified clear methods to reduce or prevent risk. Healthcare is monitored and prompt referrals are made to external healthcare professionals when required. Care plans and risk Lake Rise G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 Page 11 assessments viewed had not been reviewed monthly. This was an area for concern as residents’ needs or care plans were not updated monthly or amended accordingly. The daily log recording by staff did not reflect the individual care and support provided by the home on a daily basis. The recording was very brief and generalised. It was observed that newly admitted residents do not have a care plan in place and staff informed that this would be completed after the 4 four weekly review. One file viewed where a resident was admitted in February was not reviewed until May. Only a pre-admission report is made. Care plans must be produced for all new residents on admittance to ensure their needs are identified and are being met. Personal support takes account of individual preferences and residents’ choice of dress and appearance is respected and personal care is provided in private. Privacy was maintained through lockable toilet and bathroom doors. Residents’ rooms were lockable and they had had the choice to lock their rooms and keep the key on them. Residents could meet with visitors any time of the day. The home has a private visitors room. All residents have a designated key worker. On speaking to various residents they were all aware of who their key worker was. The homes procedures in the event of death are very detailed and service user lead. The home has not yet identified all residents’ personal wishes in the event of death. I was informed by the senior carer that the manager is in the process of doing this. Lake Rise G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15. Limited social activities are organised and residents need to better informed of what was being organised for them. The home is not meeting the social needs of those with dementia. The meals in the home are good offering both choice and variety and catering for special diets. The menu is not accessible to all residents. Residents choice and control over their lives within the home needs to be better promoted. EVIDENCE: Staff take responsibility for organising activities throughout the home and entertainers are invited as when and available. There is no set timetable for activities. The home provides a church service every other Sunday. The home does not arrange regular day trips and the last trip arranged was in July this year, which was the first day trip out since 2003. A brief log is kept of what activities have been completed during the day but not of any residents that may have participated. On speaking to residents, one replied that there is not enough entertainment or activities provided and they are very often bored. Another stated that they do not go out into the garden enough, as staff do not Lake Rise G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 Page 13 have enough time take them out. No specific activities were provided to meet the needs of those with dementia. It was advised that a daily timetable of weekly activities is devised, including activities to meet the needs of those with dementia and that this is displayed within the home or communicated to residents in ways which is appropriate to their needs, to ensure residents are informed of what is being arranged in the home. Residents spoken to informed that their relatives and family can visit any time and they often meet family in their room or in the private visitors room. Residents spoken to said the routines of daily living were tailored to their individual preference as far as was practicable, although one resident stated that she didn’t think she could have a lie in as breakfast was served at 9pm and they all had to be seated by this time, as the night staff had to get them up in the morning. Another resident informed that everyone was in bed by 10pm and also didn’t think she could go to bed late if she wished. Residents had access to their daily records if they wished. Menus seen demonstrated choice and variety. Special diets were well catered for. One resident stated that meals are good and they have good size portions but is never aware of what they are having until it is served. Another resident informed that the lunchtime meal is very good but didn’t like what was served for tea each day and had never informed the cook. She stated that she didn’t think the cook would prepare anything else if she asked. A record of individual nutritional intake is not kept. It was advised that the menu is accessible to all residents. It was advised that the home also keeps a record of what each resident has had to eat and what amount of portion he or she has eaten, and for this information to be recorded in the daily log in order to monitor their nutritional intake. Lake Rise G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The complaints process in the home is clear but needs to be updated to comply with requirements of the regulations. EVIDENCE: The home uses the complaints procedure set out by the London Borough of Barking and Dagenham. The procedure is displayed throughout the home and is given to all residents. However, the procedure fails to identify details of the Commission for Social Care Inspection and needs to be updated. Residents spoken to informed that minor dissatisfactions were dealt with promptly before they became complaints. Lake Rise G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25, 26. Residents benefited from living in warm, clean personal and communal accommodation. The welfare of residents’ and staff is put at high risk due to access areas, which are shared with the sheltered accommodation complex. Residents were also put at some risk due to infection control issues. EVIDENCE: The premises were comfortable, airy, clean and free from offensive odours. Furnishings and fittings were domestic and unobtrusive. The home’s communal lounges and dining rooms were homely and comfortably furnished. However, all communal bathrooms need to undergo a redecoration programme. The overall condition of bathroom floors and fittings were in need of repair and all communal bathrooms throughout the home lacked basic hand washing equipment increasing the risk of infection. Lake Rise G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 Page 16 The gardens are well maintained and are equipped with suitable furniture. The home has a lift, a ramp leading to the garden and adequate aids and equipment were provided throughout the home. Residents are at risk at the home due to the lift being shared with the sheltered accommodation complex. This has allowed unauthorised people to gain access into the home. Service user rooms were decorated and furnished according to the wishes of the occupant. All rooms are lockable which staff can override in an emergency. All service users have a key to their rooms. The home has a sluicing facility located in the laundry, which was clean. Lake Rise G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28, 29, 30 There is a good match of well- qualified staff offering consistency of care within the home. However, staff morale was low with some members of staff. Recruitment policies have been consistently followed resulting in residents receiving care from staff that have been appropriately vetted. EVIDENCE: Lake Rise G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 Page 18 The home has a ratio of 50 and above of NVQ trained staff. The home has combination of permanent and agency members of staff. Some members of staff spoken to informed that they were not happy with the home using agency staff which did not offer consistency of services to its residents. Agency staff were used due to staff shortages as well as to provide cover for over established hours where extra staff are required to cover additional hours to meet the needs of residents. Members of staff spoken with were low in morale and did not feel their views were acted upon in team meetings. Staff were observed to respect residents and were accessible and approachable. Various residents spoken to stated that the staff were very approachable and friendly. Staff received a comprehensive induction programme. Staff training was organised but was not well monitored by the manager, as records of staff training were not kept up to date. Four staff files were inspected and indicated residents were protected through the use of robust staff recruitment processes. Lake Rise G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,36. The systems for Service User consultation are good with evidence that Service User views are sought. Staff supervision needs to be a high priority for the home, as staff are not being supervised regularly. EVIDENCE: Staff records seen identified members of staff had not been supervised regularly. The senior care team informed they were aware of the lack supervision staff were receiving. It was highlighted that all members of staff must be supervised at least 6 times a year. The minutes of regular resident meetings were viewed which indicated the home was acknowledging resident views and wishes and action was being taken to rectify any issues raised. The management team also sends out surveys to relatives and residents once a year. The results of the surveys highlighted the need for more activities. This request by relatives had not been acted upon. No reason was given for this. Lake Rise G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 Page 20 Lake Rise G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 2 2 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 2 14 2 15 2 COMPLAINTS AND PROTECTION 2 3 3 3 3 2 3 2 STAFFING Standard No Score 27 x 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x x x 2 x x 2 x x Lake Rise G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 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. 1. Standard 1 Regulation 5 (1) (a) to (f) Requirement The Satement of Purpose and Service Users Guide must contain all the information required in relation to this Regulation. Both documents must specify how they can meet the needs of residents with dementia and what service user groups the home caters for. Timescale not met on 30/04/05. This requirement is restated. The registration application must specify the service user groups which the home can admit. Timescale not met on 31/03/05. This requirement is restated. The manager must confirm to new service users, in writing, that it can meet their needs. Timescale not met on 31/03/05. This requirement is restated. The Manager Designate must discuss with the Commission for Social Care Inspection the categories of registration and how the home can meet the needs of the service users in those categories. The registered person must ensure that monthly care plan reviews are completed. These Timescale for action 30/10/05 2. 1 4(1) (c) Schedule 1 (6) & (8) 14 (1) (d) 30/09/05 3. 3 30/09/05 4. 4 4(1) (c) Schedule 1 (6) 30/09/05 5. 7 15(2) 30/09/05 Lake Rise G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 Page 23 are to be signed and dated. 6. 7. 8. 7 8 15 Schedule 3 (1) (b) 15 (2) 17 (1) (a) All new service users must have a care plan devised upon admission. The registered person must ensure that monthly risk reviews are completed and must review individuals risk assessment when any changes occur in care needs. These are to be signed and dated. The registered person must ensure that care staff demonstrate how individuals lifestyle, wishes and choices have been made by recording appropriately in the daily report log. The service users wishes concerning the arrangements after death are discussed and carried out. The home must demonstrate that it is able to provide for the needs of service users with dementia in relation to activities and daily living if they remain living in the home. The complaints procedure to be updated in accordance with the regulations. The health, safety and welfare of service users and staff must be paramount, therefore, the home must not be accessible via the sheltered housing accommodation. Timescale not met on 30/06/05. This requirement is restated. The health, safety and welfare of service users must be paramount, therefore the lift must be in use for the residential home only and not the sheltered housing flats. Timescale not met on 30/06/05. This requirement is 30/09/05 30/09/05 30/09/05 9. 10 & 37 15 & 17 (1) (a) Schedule 3.3 (q) 30/09/05 10. 11 12 (2) 31/10/05 11. 12 4 (1) (c) Schedule 1 (6) & (8) 16 (2) (m) & (n) 22 (7) (a) 12,13,16, 21,23 30/09/05 12. 13. 16 19 30/09/05 31/12/05 14. 19 12,13,16, 21,23 31/12/05 Lake Rise G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 Page 24 restated. 15. 16. 17. 19 24 26 23 (1)(2) (a) 16 (2) (c) 16 (2) (J) The homes communal bathrooms undergo a redecoration programme. The carpet in room 48 is replaced. All bathrooms are provided with paper towels, liquid soap, swing pedal bins to reduce the risk of infection. A report of all quality care surveys with residents and relatives must be provided to service users and to the Commission for Social Care Inspection when complete. Timescale not met on 30/06/05. This requirement is restated. The registered person shall ensure that persons working at care home are appropriately supervised. In that: staff are supervised at least 6 times a year. All water tempertures to be checked and logged before each resident is bathed where the bath does not have a pre-set valve fitted. 31/12/05 30/09/05 30/10/05 18. 33 24 31/12/05 19. 36 18 (2) 30/09/05 20. 25 13 (3) (4) (a) (c) 30/09/05 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. Lake Rise Refer to Standard 7 7 12 15 Good Practice Recommendations It is recommended that the care plan document is used as one live working document. It is recommended that the food intake of all residents is recorded to monitor nutrional intake. It is recommended that more hours are designated to social activities and day trips and the weekly rota of activities is available to residents throughout the home. It is recommended daily menus are readily available for G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 Page 25 5. 30 residents and relatives to view within the home. All staff training records are kept up to date. Lake Rise G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection Ferguson House 113 Cranbrook Road Ilford, Essex IG1 4PU 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 Lake Rise G55-G05 S40415 Lake Rise V244242 090805 Stage 4.doc Version 1.40 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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