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Inspection on 17/10/07 for Larchwood Nursing & Residential Home

Also see our care home review for Larchwood Nursing & Residential Home for more information

This inspection was carried out on 17th October 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

What has improved since the last inspection?

What the care home could do better:

CARE HOMES FOR OLDER PEOPLE Larchwood Nursing & Residential Home 133 Yarmouth Road Thorpe St. Andrew Norwich Norfolk NR7 0RF Lead Inspector Maggie Prettyman Unannounced Inspection 17th October 2007 09:15 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 Larchwood Nursing & Residential Home DS0000015652.V353333.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. Larchwood Nursing & Residential Home DS0000015652.V353333.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Larchwood Nursing & Residential Home Address 133 Yarmouth Road Thorpe St. Andrew Norwich Norfolk NR7 0RF 01603 437358 01603 702046 larchwood@bondcare.co.uk 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) Bondcare (Larchwood) Limited Position Vacant Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48), Physical disability (48) of places Larchwood Nursing & Residential Home DS0000015652.V353333.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Up to forty-eight (48) Older People may be accommodated in the category OP. Up to forty-eight (48) Service Users who have a physical disability may be accommodated in the category PD, who are aged 55 years or over. No more than 48 Service Users may be accommodated. One person with dementia whose name is held on CSCI records may be accommodated. Once this person is no longer resident, the registration reverts to 48 older people. 11th April 2007 Date of last inspection Brief Description of the Service: Larchwood Nursing and Residential Home is owned by Bondcare Ltd and is situated on the outskirts of Norwich, within Thorpe St Andrew. The home lies within easy access of a large supermarket, post office and small local shops. It is a two-storey building with access to the first floor by shaft lift and stairs. The home can accommodate up to 48 older people, 25 with nursing needs and 23 with residential needs. The service has 36 single and 6 shared bedrooms. All the bedrooms have en-suite toilets and washbasins. There is an enclosed patio area with seating and with raised flowerbeds that are accessible to wheelchair users. The home has car-parking facilities at the rear of the premises. The home informed CSCI of its charges in March 2007 and charges the following for care provision: from £281 to £539.80 per week. Residents are expected to pay extra for hairdressing, chiropody, newspapers and personal items. Larchwood Nursing & Residential Home DS0000015652.V353333.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out using information from previous inspections, information from the providers, the residents and their relatives as well as others who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the home and current judgements for each outcome group. This inspection took place over 8 hours during which many of the people living at the home were individually consulted and observed. Visitors to the home were also consulted about their experiences. Two staff were interviewed and others observed and spoken to as they conducted their duties. Care, medication and maintenance records were inspected and a tour of the premises was undertaken. Prior to the inspection 22 confidential questionnaires were received from residents and their relatives and the manager helpfully completed an annual quality assurance assessment as required by the Commission. What the service does well: What has improved since the last inspection? Larchwood Nursing & Residential Home DS0000015652.V353333.R01.S.doc Version 5.2 Page 6 There have been many significant changes and much improvement since the last inspection, meaning that the rating of this home has been improved in a number of areas. Examples of this positive change are as follows; • • • • • • • • • • • • • • • • • • The statement of purpose has been updated Care plans are more detailed and are audited Better health care records are being kept Staff are allocated time to read care plans Pressure area audits are undertaken Life history work is being undertaken A key worker system has been introduced Nutritional screening has been introduced Care practice is improving Accountability sheets are in place for many aspects of care delivery People feel that their privacy and dignity is respected Activities provided by the home have been expanded and improved Residents and relatives meetings are being held The kitchen has been refurbished and better standards of food hygiene are in place Many areas of the home have been redecorated and a new bath has been installed Staff training has been improved Staff appraisal and supervision is being implemented People living at the home are pleased with the new manager and her commitment to improving the service offered by the home. What they could do better: Larchwood has been through a troubled time, and the new manager and her team are working hard to address its difficulties. The overall rating of the home has improved, but some areas still need to be addressed and the changes need to be sustained. Three requirements and thirteen good practice recommendations have been made at the end of this report as follows; Requirements • • • Work on pressure area management must be continued The person administering the medication must not be disturbed Staff must be thoroughly vetted prior to their appointment Larchwood Nursing & Residential Home DS0000015652.V353333.R01.S.doc Version 5.2 Page 7 Recommendations • • • • • • • • • • • • • The contract should be signed by the resident when possible The needs assessment form should be improved and expanded People should be involved in the writing and development of their care plans Peoples chosen rising time should be respected, and people should be encouraged to spend time socially if they wish People should be consulted more about their choice of activities People should be given more autonomy and choice in their daily lives Care should be taken that food is presented in an appetising and appealing way Mealtimes should become a more social event Maintenance records should be kept to their previous good standard The home should work to ensure that staff have the opportunity to gain NVQ qualification English language training should be given to those staff that would benefit from it The manager of the home should register with the Commission as soon as is practicable Care should be taken that all wheelchairs in use have footrests in place. 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. Larchwood Nursing & Residential Home DS0000015652.V353333.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 Larchwood Nursing & Residential Home DS0000015652.V353333.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): Standards 1, 2, 3 and 6 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have the information that they need about the service to decide whether it will meet their needs. They have their need assessed, and a contract which clearly tells them about the service they will receive. EVIDENCE: Examination of the Service user guide and Statement of purpose demonstrated that they meet the requirements of the standards. The statement of purpose has been recently updated, and further work is planned for the service user guide. Larchwood Nursing & Residential Home DS0000015652.V353333.R01.S.doc Version 5.2 Page 10 Contracts detailing the service provided to individuals were seen in all personal files inspected. Further comprehensive detail about the homes services is placed in each person’s room. It was noted that the contract only has the facility for the relative of the person living at the home to sign. People living at the home should have the opportunity to sign the contract for themselves. A recommendation has been made in this respect. People who live at the home confirmed that they had been visited before they came to the home to have their needs assessed. Evidence of written needs assessment was seen in each personal file inspected. The format of the needs assessment is limited in space and could be further expanded. The home plans further work to expand and develop its needs assessment form. A recommendation has been made in this respect. The home does not provide intermediate care. Larchwood Nursing & Residential Home DS0000015652.V353333.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): Standards 7, 8, 9 and 10 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs but could be further improved. EVIDENCE: Service user plans were found to be in place. The home has worked hard since the last inspection to improve the information available to staff and to ensure that accountability records are in place, kept up to date and audited. Records also demonstrated that staff have been allocated time to read care plans, and that they have understood the needs of individuals. An agency nurse on duty confirmed that the paperwork available enabled her to access up to date information about people living at the home. Care plans could be further improved by involving the person concerned fully in their development. A recommendation has been made in this respect. Larchwood Nursing & Residential Home DS0000015652.V353333.R01.S.doc Version 5.2 Page 12 The home has worked hard since the last inspection to improve the health care service that it offers to its residents. Records of visits by health care professionals are kept. The home is being included in a new health support project with the health authority called “Telehealth” that will monitor and review peoples vital health signs remotely. The issues relating to pressure area management are being addressed by way of improved understanding of nutritional needs, better standards of equipment and training for staff. It is expected that once this work is completed, these issues will be fully resolved. A requirement has been made in this respect. The system of medication used by the home was inspected and the morning medication round observed. Records were found to be accurate and a good system of audit is now in place. The round observed was seen conducted in a conscientious manner. Unfortunately the person conducting the round was subjected to several interruptions during their work, which led to delay in the administration of some medication. This meant that some people were left waiting for pain relief, and could mean that subsequent dosage is delivered without a suitable time interval. A requirement has been made in this respect. The home has given staff training in understanding principles of privacy and dignity since the last inspection. During the inspection staff were observed to be cheerful and polite to people living at the home. Several residents were interviewed in private, all of whom confirmed that they feel well treated. Some visiting relatives were also interviewed and said that they observe people living at the home to be treated with respect at all times. The home is to be commended for the care that is taken of people’s personal clothing. People said that their clothes always come back to them in excellent condition and that items do not get mislaid or lost. This service is much valued and appreciated by the homes residents. Larchwood Nursing & Residential Home DS0000015652.V353333.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): Standards 12, 13, 14 and 15 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Although much work has been undertaken to improve the lifestyle of people living at the home, this could still be further improved and people could be given more autonomy and choice. EVIDENCE: Flexible rising times are not always offered, and at least one person living at the home remains in bed longer than they wish in the mornings. It also appeared that some people are being left at bed rest or alone in their rooms, when they could be offered the choice to rise for part of their day, or to spend time in communal areas. A recommendation has been made in this respect. Larchwood Nursing & Residential Home DS0000015652.V353333.R01.S.doc Version 5.2 Page 14 A programme of activities is in place at the home. These provide enjoyable entertainment and stimulation for some of its residents. Activities are put on notice boards in the home, but a list is not given to people individually. As many people spend their days in their rooms, they rely on being told about activities verbally by staff. Discussion with people living at the home demonstrated that the activities in place are not to everyone’s taste, and that people should be consulted more about what they wish to do, so that the types of activities offered can be expanded and individualised. Work is in progress to collate life histories and personal preferences, and this will assist in this process. A recommendation has been made in this respect. Residents commented how much they value individual interaction with staff and how much they had enjoyed an outing undertaken earlier in the year. Discussion with residents and their visitors demonstrated that the home works hard to welcome and support people coming to see people living at the home. People confirmed that they can visit at any time and that staff respect the privacy of personal visits and do not interrupt unless necessary. The home has recently instituted monthly meetings for residents and relatives to enable discussion to take place about how well the home is meeting people’s needs. One resident commented that a suggestion made at one meeting was immediately instituted. This is a constructive step towards consultation and choice. People commented that they were able to bring their personal belongings with them when they moved in, and how much they valued this. The home still needs to work to give people more autonomy and choice, examples of change needed are; • People signing their own contracts • People being involved in their own care planning • More lifestyle flexibility and choice of daily activity and routine • More direct involvement in the day-to-day running of the home, for example choice of dishes on the menu and types of activity available. A recommendation has been made in this respect. The home has made many improvements in the kitchen area since the last inspection. Most residents said that they like the food that is provided, and evidence of choice was observed. One person commented that the food that day looked bland lacked texture and was uninspiring. They said that the taste was acceptable. The meal presented was seen to lack colour and defined pieces of meat. A recommendation has been made in this respect. As commented in the previous report, most people are still eating in their own rooms and staff are not on hand in dining rooms to facilitate conversation and make the meal a more social occasion. A recommendation has been made in this respect. Larchwood Nursing & Residential Home DS0000015652.V353333.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): Standards 16 and 18 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home continues to receive complaints about some aspects of its service, with particular reference to the attitude and care practice of specific staff. The home is working hard to address these issues. EVIDENCE: The home has received a number of complaints about individual staff practice since the last inspection. To its credit, these have been appropriately reported and investigated, and disciplinary action taken in respect of staff concerned. The home has not always reported the outcome of its investigations to the complainant or the Commission and could improve its practice in this respect. It is of important note that complaints have been about individual, isolated staff practice, and that the vast majority of people working at the home are kind and caring in their duties. Staff training in Adult Protection has been updated, and staff interviewed during the inspection demonstrated an understanding of issues and confidence in whistle blowing procedures. The home is clearly in the process of establishing safe and sound practice and it is hoped that this period of challenge and positive practice will result in a significant decrease in incidents of this nature. Larchwood Nursing & Residential Home DS0000015652.V353333.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a comfortable and well-maintained environment, which is clean and fresh in all areas. Larchwood Nursing & Residential Home DS0000015652.V353333.R01.S.doc Version 5.2 Page 17 EVIDENCE: A tour of the premises demonstrated that it is well decorated and maintained and that it meets individual and collective needs in a comfortable and homely way. Many areas of the home have been tastefully redecorated and a new bath has been installed. A leak in the roof is proving difficult to repair and the home should continue to try to resolve this problem. The garden is accessible and has raised beds and an organic vegetable patch. Safety records were inspected and have been meticulously kept until recently. The call system is not checked weekly and other records have lapsed. A recommendation has been made in this respect. The home is clean and fresh throughout. The laundress reported that items are brought appropriately sorted. Bed linens are laundered externally and table linen is kept separate from clothing. There are very limited laundry facilities in terms of space, but staff manage well, and an excellent and well-organised service is provided. During the inspection it became clear that a sluice is not in use and is used for general storage. The home would benefit from reinstating this facility. Issues raised by the Environmental Health officer in respect of the kitchen area have been addressed and rectified. Larchwood Nursing & Residential Home DS0000015652.V353333.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28 29 and 30 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained and in sufficient numbers to support the people currently living there. EVIDENCE: General observation of practice during the inspection demonstrated that sufficient staff were on duty to meet the current numbers of people living at the home. It is important to remember that the home is not currently fully occupied, and that increases in resident numbers would mean that the staffing numbers would have to be reviewed. The rota was inspected, and the home is to be commended for using agency staff rather than allowing shortfall to occur. Currently the home is just short of the expected levels of NVQ qualification. Some staff are in the process of NVQ training, but there are currently problems with the process. A recommendation has been made in this respect. Larchwood Nursing & Residential Home DS0000015652.V353333.R01.S.doc Version 5.2 Page 19 A selection of staff files was inspected. Older files failed to meet the vetting requirements of the standards. More recent files were of a better standard, but improvements are still needed to ensure that all staff are properly checked prior to employment. A requirement has been made in this respect. Evidence of staff training was seen in staff files and confirmed in discussion with people on duty. Staff feel well supported by the training offered to them and it covers areas in excess of statutory requirements. Feedback from residents and relatives suggests that English language skills could be further improved for some staff. English language training has been given in the past at the home. Staff spoken to said that they would welcome further training in this area. A recommendation has been made in this respect. Larchwood Nursing & Residential Home DS0000015652.V353333.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 36 and 38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has a new manager who has made significant improvements to its management and care practice. EVIDENCE: The homes new manager was not present during the inspection, but her hard work and commitment to change was demonstrated in all aspects of the standards inspected. She has been assisted in the change process by a Social Care Consultancy and it is to be hoped that the changes that she has worked hard to implement will be sustained once the contract with the Consulatnt has reached an end. Larchwood Nursing & Residential Home DS0000015652.V353333.R01.S.doc Version 5.2 Page 21 Improved recording, audit and practice was found in each group of standards and she is to be commended for this development and change. She has yet to be registered by the commission. A recommendation has been made in this respect. A quality assurance survey is in progress, and a report has yet to be written. However it is clear that this process is progressing, and that the eventual report will benefit residents and inform the development of the home. Money held on behalf of people living at the home was checked and found to be accurately recorded and regularly audited. Staff records demonstrated that appraisals have taken place and that a system of supervision is being introduced. Records of mandatory health and safety training for staff were seen. Domestic staff were seen using cleaning products appropriately, chemicals were not left unattended and all storage areas were locked. COSHH assessments are in place. Records of routine servicing of fire, gas and electrical systems were seen. Risk assessments are in place in resident’s individual files. Some wheelchairs were found with missing footrests. A recommendation has been made in this respect Larchwood Nursing & Residential Home DS0000015652.V353333.R01.S.doc Version 5.2 Page 22 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 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Larchwood Nursing & Residential Home DS0000015652.V353333.R01.S.doc Version 5.2 Page 23 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. 1 Standard OP8 Regulation 12. 1 (a) Requirement Work commenced to resolve pressure area management issues must be continued until this issue is resolved so that people are protected from unnecessary breakdown in tissue viability. The person responsible for administrating medicines must not be interrupted in the course of their duties so that medicines are administered safely and in good time. A policy and procedure for the recruitment and vetting of staff must be written and adhered to so that all staff employed in the home are thoroughly vetted and checked prior to employment. Timescale for action 31/12/07 2 OP9 13. 2 30/11/07 3 OP29 19 30/11/07 Larchwood Nursing & Residential Home DS0000015652.V353333.R01.S.doc Version 5.2 Page 24 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 OP2 OP3 Good Practice Recommendations The contract should include the option for the resident to sign their own contract so that people’s rights and responsibilities are respected. The needs assessment form should be expanded to contain more information and to give more room for recording to ensure that a comprehensive assessment is always undertaken. People living at the home should be more involved in their own care planning so that their individual wishes are always understood. People’s wishes with regard to rising time should be respected, and those able to, should be encouraged to spend time out of bed and in communal areas if they wish. People should have more individual consultation about their choice of daily activity, and offered individual support to ensure that the lifestyle of the home meets their needs. People should be given more autonomy and choice to ensure that they can influence the way that the home is run. Care must be taken that the presentation and texture of food ensures that it is appealing and appetising The home should work to make mealtimes a more social and enjoyable event. The previous good standard of maintenance recording should be reinstated so that people can be sure that all equipment in the home is in working order. The home must ensure that NVQ training continues to be offered to staff. Staff should be offered further English language training where necessary to ensure good communication with residents. The homes manager should complete her registration with the Commission All wheelchairs in use should have their footrests attached and used to ensure the safety of the person transported. 3 4 5 6 7 8 9 10 11 12 13 OP7 OP12 OP12 OP14 OP15 OP15 OP19 OP28 OP30 OP31 OP38 Larchwood Nursing & Residential Home DS0000015652.V353333.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Larchwood Nursing & Residential Home DS0000015652.V353333.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!