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Inspection on 17/05/07 for Langwith Lodge Care Home

Also see our care home review for Langwith Lodge Care Home for more information

This inspection was carried out on 17th May 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Service users health, personal and social care needs are well set out in individual care plans and the monitoring and documentation in relation toservice users nutritional needs has been improved to ensure their needs are fully and appropriately met. Service users say the home can meet their needs, which are assessed and reviewed. The practice of the management of medicines in the home protects service users safety. Service users are treated with respect and their right to privacy is upheld. Service users live in a safe, comfortable, clean and well-maintained environment. Service users needs appear to be met by the numbers and skills mix of staff. Service users and staff said they were aware of how to make complaints and are confident that they would be dealt with. The activity provision appears to satisfy service users social, religious and recreational interests and needs and they can maintain contact with family and friends and the local community as they wish. Service users are helped to exercise choice and control over their lives and are provided with a nutritious diet and are happy with the food provided.

What has improved since the last inspection?

Improvements have been made in respect of health and safety and infection control, which ensure that service users and staff are fully protected. The home was visited by the Health Protection Agency in April 2007 and had confirmed with the home that they are satisfied with the action taken to improve infection control within the home. There was noted improvement in practice in monitoring and addressing the changing needs of service users and the implementation of new or revised care plans, particularly in relation to nutritional needs and risk of falls. Medication management was assessed, focusing on the areas needing improvement at the last visit and a recent audit by the Community Pharmacist had taken place. Medication management and practice was assessed as satisfactory. Recruitment procedures were examined and were satisfactory.

What the care home could do better:

Thirteen good practice recommendations have been made.

CARE HOMES FOR OLDER PEOPLE Langwith Lodge Care Home The Park Nether Langwith Mansfield Nottinghamshire NG20 9ES Lead Inspector Jayne Hilton Key Unannounced Inspection 17th May 2007 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Langwith Lodge Care Home DS0000008742.V337190.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. Langwith Lodge Care Home DS0000008742.V337190.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Langwith Lodge Care Home Address The Park Nether Langwith Mansfield Nottinghamshire NG20 9ES 01623 742 204 01623 744 611 awlangwithlodge@btconnect.com www.yourhealth.ltd.uk Your Health Ltd 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) Post vacant Care Home 54 Category(ies) of Dementia (12), Old age, not falling within any registration, with number other category (42) of places Langwith Lodge Care Home DS0000008742.V337190.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd December 2006 Brief Description of the Service: Langwith Lodge is an adapted large country house, set in its own private grounds overlooking a lake within a scenic rural setting. The home is owned by Your Health Ltd. There are two units, the main house and the Horton Suite, which adjoins the main house. Lift Access is provided to the first and second floors, for those who cannot manage the stairs. The home provides 24-hour care and support for 54 older people and service users with dementia. Information was provided by the acting manager on 22-12-06 on the range of fees charged; these are between £314-£380 service users pay extra for newspapers, hairdressing and chiropody. A copy of the last inspection report was displayed in the home. Langwith Lodge Care Home DS0000008742.V337190.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This inspection took place over 6 daytime hours. The main method of inspection used was called ‘case tracking.’ This involves selecting two residents and looking at the quality of the care they receive by talking to them, examining their care files and discussing how support is offered to them by staff members. Many of the people who live at this home have a very limited ability to understand and communicate. Therefore many judgements in this report are from observation and reading residents’ records and documents. The residents who were “case tracked” were not able to help by giving an opinion about the care provided. Two residents were spoken with during the inspection and one relative. Two members of staff, the acting manager, were spoken with as part of this inspection, documents were read and medication inspected to form an opinion about the quality of the care provided to residents. A new acting manager has been in post from October 2006. Prior to the inspection survey questionnaires were returned by, residents and relatives. Also a questionnaire was completed by the provider and returned before the inspection report was finalised. Information gathered from all of these sources has been included within the report. What the service does well: Service users health, personal and social care needs are well set out in individual care plans and the monitoring and documentation in relation to Langwith Lodge Care Home DS0000008742.V337190.R01.S.doc Version 5.2 Page 6 service users nutritional needs has been improved to ensure their needs are fully and appropriately met. Service users say the home can meet their needs, which are assessed and reviewed. The practice of the management of medicines in the home protects service users safety. Service users are treated with respect and their right to privacy is upheld. Service users live in a safe, comfortable, clean and well-maintained environment. Service users needs appear to be met by the numbers and skills mix of staff. Service users and staff said they were aware of how to make complaints and are confident that they would be dealt with. The activity provision appears to satisfy service users social, religious and recreational interests and needs and they can maintain contact with family and friends and the local community as they wish. Service users are helped to exercise choice and control over their lives and are provided with a nutritious diet and are happy with the food provided. What has improved since the last inspection? Improvements have been made in respect of health and safety and infection control, which ensure that service users and staff are fully protected. The home was visited by the Health Protection Agency in April 2007 and had confirmed with the home that they are satisfied with the action taken to improve infection control within the home. There was noted improvement in practice in monitoring and addressing the changing needs of service users and the implementation of new or revised care plans, particularly in relation to nutritional needs and risk of falls. Medication management was assessed, focusing on the areas needing improvement at the last visit and a recent audit by the Community Pharmacist had taken place. Medication management and practice was assessed as satisfactory. Langwith Lodge Care Home DS0000008742.V337190.R01.S.doc Version 5.2 Page 7 Recruitment procedures were examined and were satisfactory. 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. Langwith Lodge Care Home DS0000008742.V337190.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Langwith Lodge Care Home DS0000008742.V337190.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have the information they need about the home and their needs are assessed and reviewed. The home does not provide an intermediate care service. EVIDENCE: Service users are issued with a service users guide and contract. A copy of the last inspection report was displayed in the home but there was not any information displayed which informed service users or visitors how they could access copies of inspection reports and this is recommended so people have information they need about the home. Langwith Lodge Care Home DS0000008742.V337190.R01.S.doc Version 5.2 Page 10 Service users benefit from a fairly comprehensive assessment, which offers service users the opportunity to express preferences and which is reviewed approximately six monthly. The date of when the service users moved to the home was not clearly indicated on all of the care plans examined. Extended Community Care assessments were seen where applicable. The assessment documents include service users preferences for make up, perfume/ aftershave, expressing sexuality, number of pillows, keys for bedroom, religious needs and worshipping. The cultural and diversity needs of service users need to be expanded upon however. As the home provides care for people with Dementia it is expected that the individual’s capacity for consent would be addressed within the assessment and care plan process. All of the service users spoken with confirmed that they were happy with the service provided and that their needs were met. The service user spoken with individually praised the staff and the facilities highly. One service user said “ I like living here, the staff are marvellous and it is just paradise” The home specialises in the provision of care for people with dementia and staff, were observed to treat service users with patience and respect when communicating with them. Langwith Lodge Care Home DS0000008742.V337190.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are treated with respect and their right to privacy is upheld, their health, personal and social care needs are well set out in individual care plans and this ensure their needs are appropriately met, the management of medicines in the home further protects service users safety and welfare. EVIDENCE: Care plans related to the assessment of needs and offered instruction to staff of how the needs of the service user would be met. There was noted improvement in practice in monitoring and addressing the changing needs of service users and the implementation of new or revised care plans, particularly in relation to nutritional needs and risk of falls. There was evidence of nutritional assessments within the assessment documentation and appropriate care plans weight records and referral to the Langwith Lodge Care Home DS0000008742.V337190.R01.S.doc Version 5.2 Page 12 dietician. However it is recommended that a nutritional screening tool be included within the system and that the dietician be consulted about how best to record the dietary intake of individuals to ensure appropriate nutritional values of food are monitored. Risk assessments were in place for pressure sores, manual handling, agitation and risk of falls and specific needs such as use of denture soak, were, noted to be in place and appropriately reviewed. It is recommended that personal care charts are implemented or specific reference is made in daily records for care of hair and nails and shaving that can be monitored and evaluated. Healthcare checks such as Chiropody, dentist, hearing checks are now included within the care plan structure and records. Service users and relative’s spoken with, confirmed prompt and appropriate action to meet their healthcare needs. Medication management was assessed, focusing on the areas needing improvement at the last visit and a recent audit by the Community Pharmacist had taken place. Medication management and practice was assessed as satisfactory. Service users spoken with confirmed that staff treated them with respect and that their privacy and dignity was upheld, that mail is given unopened, that staff knock before entering rooms, during personal care etc. Staff spoke with were able to demonstrate how they maintain and respect service users privacy and dignity. Observation of staff practice on the day supported this. Langwith Lodge Care Home DS0000008742.V337190.R01.S.doc Version 5.2 Page 13 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): 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 activity provision meets service users social, religious and recreational interests and needs and they can maintain contact with family and friends and the local community as they wish. Service users are helped to exercise choice and control over their lives and are provided with a nutritious diet. EVIDENCE: The social and recreational needs of service users are recorded within the assessment process and records are usually kept of service users participation. Each service users plan contained an activity programme which included music to movement, co-ordination therapy, hymns and `prayers, quiz, board games, bingo, nostalgia hour, 1:1 chats, crosswords, craft hour and day trips according to the weather. One service user said, “ We could do with more activities” Langwith Lodge Care Home DS0000008742.V337190.R01.S.doc Version 5.2 Page 14 It is recommended that staff be more innovative in relation to the provision of daily activities for service users other than what is provided by the activities person on those days she is employed at the home. This will ensure the well being of service users is promoted. On speaking with staff members about equality and diversity issues it was demonstrated that although training was clearly needed that equality and diversity was respected and that any such specific needs would be promoted. Service users and staff confirmed that visitors were welcome at any reasonable time. One relative spoken with at this inspection confirmed she is made welcome. Staff demonstrated through discussion how they promote service users independence, choices and decisions within their daily routines, such as what to wear etc. Service users confirmed that they could get up and go to bed when they choose and all had made choices of the meals. Records were seen of service users choice options. The menu displayed appeared varied and nutritious and service users spoken with said the food was very nice. Comments received by a service user were “When several residents mentioned we didn’t think much of frozen chips or frozen Yorkshire pudding home cooked were immediately available” Observation of staff practice in assisting service users with eating was appropriate. It is recommended that staff be more innovative with ways to encourage service users with Dementia to enjoy their food and undertake training in nutritional values of food. Langwith Lodge Care Home DS0000008742.V337190.R01.S.doc Version 5.2 Page 15 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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and staff are aware of how to make complaints and are confident that they would be dealt with. Service users are protected by policies in place and staff training and confirmed that they felt safe. EVIDENCE: The complaints policy is included in the service user guide and service users confirmed that they felt able to raise any concerns or complaints should they have any. Complaints records were viewed; two complaints were recorded since the previous inspection, one of these directly related to the service provided by the home and was about cleaning standards. It is recommended to re visit complainants to see if complaints are still fully resolved. There was a policy for protection of service users from abuse. Staff records highlighted that all staff have undertaken training in abuse awareness. Staff spoken with were able to demonstrate that they would report any concerns in relation to The Protection Of Vulnerable Adults. Langwith Lodge Care Home DS0000008742.V337190.R01.S.doc Version 5.2 Page 16 Langwith Lodge Care Home DS0000008742.V337190.R01.S.doc Version 5.2 Page 17 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): 19, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a safe, comfortable, clean and well-maintained environment. EVIDENCE: The home was visited by the Health Protection Agency in April 2007 and had confirmed with the home that they are satisfied with the action taken to improve infection control within the home. A Tour of premises was undertaken at this inspection. The home appeared comfortable and well equipped. A number of bedrooms were viewed and found to be well equipped, personalised and safe. Langwith Lodge Care Home DS0000008742.V337190.R01.S.doc Version 5.2 Page 18 All areas of the home smelled fresh and appeared clean and safe. Liquid soaps and paper towels were seen around the home and staff wore protective aprons and gloves as necessary. Infection control policies are in place and staff trained in this topic. There were noticeably improved practices in the promotion of infection control and general cleanliness standards in the home. A Relative commented that it would be nice to have a conservatory on the end of the building, for service users to sit, which overlooked the lake. Langwith Lodge Care Home DS0000008742.V337190.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users needs are met by the numbers and skills mix of staff, however management hours require addressing. Robust recruitment practices ensure service users safety is protected. EVIDENCE: The rotas were examined. It was reported that thirty six service users were in residence on the day of the inspection. Four staff were rotered for daytime shifts and three at night with one member of staff on call. Catering and domestic hours were assessed to be satisfactory. An additional staff member would be beneficial to service users in relation to one to one time with staff. The manager does not work supernumery full time. In order for the manager to undertake and fulfil her responsibilities under the Care Standards Act 2000 it is strongly recommended that she work full time supernumery. Recruitment procedures were examined and were satisfactory. Langwith Lodge Care Home DS0000008742.V337190.R01.S.doc Version 5.2 Page 20 Staff members confirmed that they had undertaken training in the following, Food Hygiene, Fire Safety, Manual Handling, NVQ2 and Medicines Management, Health and safety, First Aid, Vulnerable Adults and Infection Control as records indicated. The cook has recently undertaken the intermediate level food hygiene training and has reported to the manager that this had been beneficial for the home. Equality and diversity training should be provided for all staff. Training records confirmed sixteen staff have achieved or are currently studying NVQ2 and three staff have achieved NVQ3 and all remaining staff registered apart from three. It is strongly recommended that training be provided for staff in dealing with challenging behaviour, diabetes care, nutrition and other topics in relation to service users specific needs. Langwith Lodge Care Home DS0000008742.V337190.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 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 home is run in the best interests of service users with a new acting manager in post who is yet to be registered with the Commission for Social care Inspection. Improvements have been made in respect of health and safety and infection control, which ensure that service users and staff are fully protected. EVIDENCE: The acting manager has been in post now for six months she was previously the deputy manager at the home and is currently undertaking the Registered Managers award. The acting manager reported that she is currently making an Langwith Lodge Care Home DS0000008742.V337190.R01.S.doc Version 5.2 Page 22 application to be registered with the Commission for Social Care Inspection. This must now be undertaken without further delay. Staff spoken with reported that changes have been made to improve the systems and practices in the home. Staff and service users spoken with reported that the manager was excellent, very approachable and staff stated that they were confident in the manager’s abilities to lead the team. There was some evidence available of quality monitoring in the home for example provider visits under regulation 26 and service user surveys. There was also evidence of service user/relatives meetings recently held. Minutes of these were viewed. No dates were seen for the service user surveys and the acting manager was not sure about how evaluation and feedback will be reported back to service users. This issue was identified at the previous inspection. Service users finances are kept in safe these were viewed and found to be satisfactory, however it is recommended that procedures be reviewed to ensure that where staff obtain shopping for individual service users that there is a process of checks/audits in place to protect both service users and staff. Records were seen for one to one supervision meetings held in the home. Improvements have been made in respect of health and safety and infection control. All aspects of health and safety examined were satisfactory including a sample of service records and electrical and gas safety certificates. Service users and their relatives are confident that the home provides a safe service. Langwith Lodge Care Home DS0000008742.V337190.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 4 3 X 3 3 X 3 Langwith Lodge Care Home DS0000008742.V337190.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP1 Good Practice Recommendations Inform service users and relatives/representatives how they can obtain a copy of the inspection reports on the home. 2. OP3 Include capacity to consent within the assessment documentation. Attention to dates and full completion on assessments is needed. 3. OP8 Ensure weight records have an action section and are used in the evaluation and monitoring of service users nutritional needs. DS0000008742.V337190.R01.S.doc Version 5.2 Page 25 Langwith Lodge Care Home 4. 5 OP8 OP8 Implement personal care charts, which include hair and nail care and shaving. It is recommended that a nutritional screening tool be included within the system and that the dietician be consulted about how best to record the dietary intake of individuals to ensure appropriate nutritional values of food are monitored. It is recommended that staff be more innovative in relation to the provision of daily activities for service users other than what is provided by the activities person on those days she is employed at the home. This will ensure the well being of service users is promoted. It is recommended that staff be more innovative with ways to encourage service users with Dementia to enjoy their food and undertake training in nutritional values of food. An additional staff member would be beneficial to service users in relation to one to one time with staff. The manager does not work supernumery full time. In order for the manager to undertake and fulfil her responsibilities under the Care Standards Act 2000 it is strongly recommended that she work full time supernumery. Provide training for care staff in nutrition, diabetes, challenging behaviour, equality and diversity and other specific needs of service users and provide intermediate level of food hygiene training for the cook. The acting manager must submit an application to e registered without further delay. No dates were seen for the service user surveys and the acting manager was not sure about how evaluation and feedback will be reported back to service users. This issue was identified at the previous inspection. It is recommended that this be addressed. It is recommended that procedures be reviewed to ensure that where staff obtain shopping for individual service users that there is a process of checks/audits in place to protect both service users and staff. 6 OP12 7 8 9 OP15 OP27 OP27 10. OP30 11. 12 OP31 OP33 13 OP35 Langwith Lodge Care Home DS0000008742.V337190.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Langwith Lodge Care Home DS0000008742.V337190.R01.S.doc Version 5.2 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. 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!