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Inspection on 09/06/05 for Lansbury Court Nursing Home

Also see our care home review for Lansbury Court Nursing Home for more information

This inspection was carried out on 9th June 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.

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

Lansbury Court offers a very comfortable, clean and well maintained home. It is well furnished and efforts are made to make the home inviting to visitors, for example, drinks facilities, music and seating are pleasantly arranged in the main entrance area. Residents are encouraged to bring items from home with them when they come to live in the Home. Therefore many bedrooms reflect the taste of the residents living there. The Registered Manager demonstrates a sharp awareness of the need to protect the residents from harm. She is quick to involve the adult protection team if any abuse is suspected.

What has improved since the last inspection?

The Registered Provider has employed a specialist to give advice about how to look after people with dementia and how to adapt the Home to help residents keep their independence. The dementia care unit has had some improvements made to help the residents recognise their own bedrooms, toilets and bathrooms.

What the care home could do better:

It is important that staff know how to meet the needs of the people they look after. Although there has been some training for staff about dementia it does not seem to have given staff the right information about how to deal with people with the level of dementia that the residents in the Home have. This is also relevant when planning activities for people with dementia. Currently, activities do not fully meet the needs of the people living at the Home. The garden area offers a safe place for residents to be outside. Currently the area is not developed to offer a pleasant and interesting area for residents and their visitors to sit have a drink and enjoy some flowers and fresh air.

CARE HOMES FOR OLDER PEOPLE Lansbury Court Nursing Home Parkhouse Avenue Castletown Sunderland SR5 3DF Lead Inspector Sharon McDowell Unannounced Thursday, 9 June 2005 : 09:30 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. Lansbury Court Nursing Home B52-B02 S18199 Lansbury Court V219721 8 Jun 05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Lansbury Court Nursing Home Address Parkhouse Avenue, Castletown, Sunderland SR5 3DF 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) 0191 549 3950 0191 549 3955 Highfield Care Management Ltd Mrs Noreen Johnson PC Care home with nursing 56 Category(ies) of 56 x OP; 19 x DE(E) registration, with number of places Lansbury Court Nursing Home B52-B02 S18199 Lansbury Court V219721 8 Jun 05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 16th December 2004 Brief Description of the Service: Lansbury Court is registered to provide personal and general nursing care for up to thirty-seven older persons and has a separate nineteen-bed unit for personal care to older persons with dementia. The Home is a purpose built single storey building. Single room accommodation is provided, some with en-suite facilities. There is adequate communal living space with good access to all areas of the home. It is built in a quadrangle shape with a central enclosed paved area and is surrounded by grassed areas. There is ample car parking to the rear of the property. There is easy access to local amenities and the Home is situated on a public transport route. Lansbury Court Nursing Home B52-B02 S18199 Lansbury Court V219721 8 Jun 05 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors, Mrs S McDowell and Mrs K Tucker, conducted this unannounced inspection. It lasted six hours during which time the inspectors reviewed documentation, including residents care plans, staff training and personnel records. The Registered Manager was not available during the inspection as she was on holiday. The inspectors ate lunch with the residents and met with residents and staff to discuss care provided in the Home. A total of twelve residents and seven staff were spoken with. What the service does well: What has improved since the last inspection? The Registered Provider has employed a specialist to give advice about how to look after people with dementia and how to adapt the Home to help residents keep their independence. The dementia care unit has had some improvements made to help the residents recognise their own bedrooms, toilets and bathrooms. Lansbury Court Nursing Home B52-B02 S18199 Lansbury Court V219721 8 Jun 05 Stage 4.doc Version 1.30 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. Lansbury Court Nursing Home B52-B02 S18199 Lansbury Court V219721 8 Jun 05 Stage 4.doc Version 1.30 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 Lansbury Court Nursing Home B52-B02 S18199 Lansbury Court V219721 8 Jun 05 Stage 4.doc Version 1.30 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) 3 & 5 Sufficient information is available about the needs of potential residents to enable staff to complete a care plan. Therefore enabling staff to meet the residents needs. However, the dementia care assessment tool does provide the same level of information and means staff are not able to identify the specific care needs of residents with dementia. EVIDENCE: The prospective resident and relatives are encouraged to visit the Home to help them make a choice about where they want to live. This is documented in the statement of purpose and service user guide. Some residents chose the Home because it was near to their family therefore easier for visiting. Completed care manager and initial assessment documentation including social profile, pressure area care, moving and handling, nutrition, continence and falls risk assessments is available demonstrating the Home assesses whether it can meet the needs of people looking for accommodation. Lansbury Court Nursing Home B52-B02 S18199 Lansbury Court V219721 8 Jun 05 Stage 4.doc Version 1.30 Page 9 Dementia Care Unit The assessment form is based on a nursing model suitable for people who have general nursing needs. This tool does not show how staff meet the needs of people with dementia. There is no evidence of life history documentation to reflect how this might affect the person with dementia and their behaviours although staff collectively had a good range of knowledge about the residents. Staff have completed courses on dementia to raise awareness of the needs of people with this condition. Lansbury Court Nursing Home B52-B02 S18199 Lansbury Court V219721 8 Jun 05 Stage 4.doc Version 1.30 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 Care plans mainly focus on meeting health needs of the resident. Therefore the social and personal care needs are not fully promoted limiting residents from leading a fulfilled lifestyle. Nursing staff ensure that appropriate health care professionals are involved in residents care. Therefore the healthcare needs of the residents are met. Dementia Care Unit Lack of awareness about the role of staff in relation to health care needs means staff are not acting promptly to ensure service users needs are met. EVIDENCE: Care plans demonstrate that health and social care staff are involved with the care of the residents and outline where Dotors, District Nurses, Tissue Viability nurses and social workers make visits to the Home. Which means residents have access to appropriate health care professionals. Appropriate assessments are completed; including, pressure area risk, moving and handling, nutrition, continence and falls risk assessments, which means residents care needs are appropriately assessed and care plans can be developed to ensure their needs are met. Lansbury Court Nursing Home B52-B02 S18199 Lansbury Court V219721 8 Jun 05 Stage 4.doc Version 1.30 Page 11 The manager submits monthly reports to the company head office regarding any residents with pressure areas. This enable the Registered Provider to monitor any particular issues related to pressure area care in the Home and to take action if concerned, for example, if there were to be a large number of residents with pressure area needs this might identify a training need or equipment problem. Individual care plans focus on problems the resident might have, for example, nutrition, personal hygiene, continence but none identify positive outcomes the resident might want to achieve, for example, going to the cinema, theatre or shops, keeping in touch with family who live away from the area, maintaining or learning a new skill. Dementia Care Unit Care plans do not reflect people’s mental health or dementia care needs. Some service users showed signs of frustration but care plans did not show how staff help people with their anxieties. Also, care plans do not reflect the specific individual needs of each service user and how staff should support them. Daily records were informative, describing people’s progress or changing needs, but this is not reflected in care plans. Risk assessments did not meet the needs people with dementia. Risk-taking strategies were discussed with staff. Residents have retained a wide range of skills however staff are not encouraging people to continue to use these skills. Some of the approaches staff adopted tended to patronise people and led to service users becoming annoyed about their views and needs not being listened to or acted on. One person on the dementia care unit complained that they were constipated and had been for days. They said staff had been told but nothing was done. They again asked staff and were dismissed. When this was discussed with staff they said that they did not have laxatives, as a homely medicine and felt people often said things that were not fully accurate. Staff were instructed to contact the GP. One person was in pain but the strong painkiller they had previously been prescribed was discontinued and staff thought this meant he could not have anything other than Paracetamol. The staff seemed to feel they had to sort out people’s healthcare needs and should not seek advice from the nurses on general unit or other professionals. At times the amount of medication received was not recorded. Also there were gaps in the recording of medication given out. Some service users had not been prompted or assisted to wash after meal. Staff wanted to promote peoples’ independence in this area but were not considering the resident’s level of ability or insight. Lansbury Court Nursing Home B52-B02 S18199 Lansbury Court V219721 8 Jun 05 Stage 4.doc Version 1.30 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 & 15 Visitors are encouraged to come to the Home therefore residents are able to keep in touch with friends and family. Positive relationships are evident between residents, visitors and staff, which mean residents, live in a pleasant atmosphere at the Home. A variety of meals are provided for residents, which means the nutritional needs of the residents are met. However, the furniture provided makes it difficult for some residents to eat their meal with dignity. Dementia Care Unit Staff actively encourage people to be engaged in meaningful activity but do not always provide relevant activities to meet the needs of the individual. EVIDENCE: Several residents and visitors made positive comments on the approach of staff, such as ‘the girls are good’ and ‘staff are really nice’. Visitors are encouraged to come to the Home throughout the day therefore residents can have their family and friends to visit when they wish. Residents stated they were able to go about the Home as they please. They could choose to eat their meals in their rooms or to join other residents in the dining area. Bedrooms were reflective of the individual tastes of the person Lansbury Court Nursing Home B52-B02 S18199 Lansbury Court V219721 8 Jun 05 Stage 4.doc Version 1.30 Page 13 living there, as residents are encouraged to bring personal possessions from home when they come to live at Lansbury Court. Some people had their own telephones, small fridges and kettles, items of furniture and many pictures and family photographs therefore keeping some familiar and memorable items and ways of remaining independent, being able to make a drink and to make private phone calls from their room. The Home employs an activities organiser who helps individuals and groups of residents to join in social events. Several residents spent time in their bedrooms and said they were not interested in social activities. Many enjoyed watching their television, reading and doing crosswords. These people tended to be the more independent residents whilst those needing more help were sat in the main lounge. During lunch residents were served their meal by staff that asked what they would like to eat. Cold drinks were available on the table for residents to help themselves. Residents in wheelchairs were not able to get their chairs under the table therefore had to stretch to reach their plate, often dropping food from their fork or spoon. Positive comments were made about the food, such as, ‘the food is good’, ‘you get plenty to eat’. One person said they would like more variety as they like their food spiced up. They had their own condiments in their room to add to meals. Suggestions were made about the cook keeping a separate portion of food and possibly using marinades and spices if appropriate, for example, if there is pork on the menu a separate piece is put aside for that particular resident. Dementia Care Unit Staff encourage residents to join in social activities. Residents were reading books and newspapers, chatting and watching music videos. Some people said the same music video was often repeated. Staff were aware of the importance of meaningful occupation and how feeling valued contributes to people’s sense of well-being. Many people on this unit were very able. However, at times activities are not tailored to demonstrate their level of ability. Many residents were aware of their memory loss and the impression was gained that they would like a supportive forum to discuss their feelings about this loss. Staff on the dementia care unit are caring and supportive towards residents. However staff assume that people are less able than they are. Thus, at times people are not given challenging experiences. Limitation and restrictions on resident’s freedom are not recorded Lansbury Court Nursing Home B52-B02 S18199 Lansbury Court V219721 8 Jun 05 Stage 4.doc Version 1.30 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) 18 Staff have very good knowledge and understanding of Protection of Vulnerable Adults procedures therefore residents and relatives can be assured correct action will be taken in the event of alleged abuse. EVIDENCE: Regulation 37 notices are submitted to the Commission for Social Care Inspection when a significant event affecting the residents has occurred. During the inspection a Protection of Vulnerable Adults meeting was conducted with representatives from relevant organisations present. The Registered Manager has alerted the Protection of Vulnerable Adults team previously when concerned about aspects of care demonstrating knowledge of the process and required action. Staff have attended training in Protection of Vulnerable Adults either with the Tyne and Wear Care Alliance or as part of NVQ training. The Home has a policy, procedure and local organisation procedures for staff to follow in the event of alleged harm to residents. Lansbury Court Nursing Home B52-B02 S18199 Lansbury Court V219721 8 Jun 05 Stage 4.doc Version 1.30 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 & 26 Overall the Home provides a clean, comfortable, pleasant and well-maintained environment for the residents to live in. Whilst the garden area offers a safe outdoor space for residents it is not developed sufficiently to make this a pleasant area for residents and visitors to use. EVIDENCE: The home is well maintained. The décor and furnishing is of a good standard. Residents bring items from home to personalise their own rooms and a number of bedrooms are regularly redecorated. A large enclosed garden is available for residents to sit in and walk around. This area is currently limited to a central shrub feature and grassed areas. Much of the garden furniture was not in a position for residents to use as seats were propped up against tables, covered over and umbrellas were down. There were no flowers planted to promote a pleasant area to sit and enjoy the fresh air. Lansbury Court Nursing Home B52-B02 S18199 Lansbury Court V219721 8 Jun 05 Stage 4.doc Version 1.30 Page 16 Dementia Care Unit The dementia care unit is being developed to meet the needs of the service users. A specialist in dementia care employed by Southern Cross Healthcare is to visit Lansbury Court and provide information on how to further develop the unit, including the garden area. Lansbury Court Nursing Home B52-B02 S18199 Lansbury Court V219721 8 Jun 05 Stage 4.doc Version 1.30 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) 29 & 30 Recruitment processes are robust and ensure the residents are cared for by staff that are deemed to be suitable for working with older persons. Staff training is varied and relevant to the work they perform therefore the needs of residents are attended to by knowledgeable and skilled staff. However records of training do not always provide evidence of the training staff have attended. Dementia Unit Although staff have completed specialist training in dementia there is concern that the training was not delivered at the correct level and may limit their knowledge of how to care for people with dementia adequately. It may also prevent service users from having their needs met. EVIDENCE: Staff personnel files demonstrate that Criminal Record Bureau and Protection of Vulnerable Adults checks, references and interview processes are implemented when recruiting staff to work in the Home. Staff confirmed they are offered a variety of training opportunities. Some have completed NVQ Level 2 in Care and some are currently doing the NVQ Level 3 in Care. Other courses either attended or are currently being completed are, palliative care, pressure ulcer update and statutory training in fire safety, moving and handling, risk assessment, food hygiene and first aid. Some of the staff have been selected for a committee to talk to other care homes about how they work with pressure area care in Lansbury Court as they have worked Lansbury Court Nursing Home B52-B02 S18199 Lansbury Court V219721 8 Jun 05 Stage 4.doc Version 1.30 Page 18 alongside the local Primary Care Trust Tissue Viability nurse to promote good practice in the Home. Monthly training statistics are sent to the Registered Provider head office for monitoring of training in the Home. A training needs analysis was available for 2004 and a training matrix for 2003/2004. There was no matrix for 2004/2005 therefore it was difficult to assess the overall training of staff. Training attendance sheets are available with names of staff that have attended. One of the sheets did not have the subject of training entered and a fire safety questionnaire had a scoring system to identify if staff required further training, which was not completed therefore the person responsible for this would not know if the staff member had sufficient knowledge. Dementia Care Unit Staff have completed a distance-learning course about caring for people with dementia. Staff said at times the information booklets were hard to understand. Therefore they completed the workbooks without referring to the booklets. The training provided is aimed at work with people who have moderate to severe memory loss. The residents living in the dementia care unit have less severe levels of dementia. Therefore the training provided has not informed staff about working with this group of people. Several service users on the dementia care unit expressed frustration at being at the home. Records showed that these people could be prone to outbursts of anger. The approaches staff adopted often exacerbated situations and provoked upset. Lansbury Court Nursing Home B52-B02 S18199 Lansbury Court V219721 8 Jun 05 Stage 4.doc Version 1.30 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) 38 These outcomes were not reviewed during this inspection. However the information below was noted and thought to be significant for action to be taken by the Home. Dementia Care Unit Measures taken in hot weather are insufficient to safeguard service users from being adversely affected by the heat. EVIDENCE: Dementia Care Unit Temperatures on the dementia care unit often exceeded 30°c and no air conditioning units are available. A fan was used in the dining room but this did not reduce the heat. Some service users did not drink sufficient amounts of fluid to ensure they remained hydrated. Staff did not actively promote the drinking of fluids during the day. The manager does not have a copy of the Lansbury Court Nursing Home B52-B02 S18199 Lansbury Court V219721 8 Jun 05 Stage 4.doc Version 1.30 Page 20 guidance around actions to take during a heat wave and therefore staff have not been made aware of this. Lansbury Court Nursing Home B52-B02 S18199 Lansbury Court V219721 8 Jun 05 Stage 4.doc Version 1.30 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 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 3 2 x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x x x x x x 2 Lansbury Court Nursing Home B52-B02 S18199 Lansbury Court V219721 8 Jun 05 Stage 4.doc Version 1.30 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 OP3 Regulation 14(2) Requirement Suitable assessment tools are required, which provide the appropriate information for the care of people with dementia. (Previous timescale not met). Care plans need to reflect positive outcomes for residents and not just be problems based. Activities for residents with dementia must be relevant to the individuals needs. Advocacy information must be available to residents and visitors. (Previous timescale not met). Residents must be advised of their right to access personal records. Residents with wheelchairs must be provided with furniture at mealtimes that enables them to eat their meal comfortably and with dignity. Staff must receive training about the needs of people with demetia relevant to the residents accommodated at the Home. The must obtain a copy of the guidence for looking after residents during hot weather and the guidence must be Timescale for action 30/9/05 2. 3. 4. OP7 Op12 OP14 15(1) 16(2)(n) 12 31/10/05 30/9/05 31/8/05 5. 6. OP14 OP15 15(1) (2) 12(4)(a) 30/9/05 30/9/05 7. OP30 18(1)(a) 31/10/05 8. Op38 12(1)(a) 31/8/05 Lansbury Court Nursing Home B52-B02 S18199 Lansbury Court V219721 8 Jun 05 Stage 4.doc Version 1.30 Page 23 implemented. 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 OP20 Op30 Good Practice Recommendations The garden area should be developed to encourage residents to use the outdoor space. A training matrix should be implemented to provide a useful tool for demonstrating staff training attended. Lansbury Court Nursing Home B52-B02 S18199 Lansbury Court V219721 8 Jun 05 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Baltic House Port of Tyne South Shields NE34 9PT 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 Lansbury Court Nursing Home B52-B02 S18199 Lansbury Court V219721 8 Jun 05 Stage 4.doc Version 1.30 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. 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. 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