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Inspection on 27/02/07 for Laurel Court Nursing Home

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

This inspection was carried out on 27th February 2007.

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

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

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

The staffing was set at a level that met the needs of the residents. This showed that there were enough staff to make sure residents were kept safe and adequately supported. The home ensured they consulted with residents through house meetings, newsletters, satisfactory surveys and regular reviews. These different methods of communication ensured the views of residents and their families were sought and where necessary acted on. The home made sure the health of residents was monitored. This was done through the care planning system and holding regular care reviews. Information received through residents satisfactory surveys showed that overall residents felt they were well cared for, their privacy was respected, that food was nice and the home was nice to live in. These positive comments showed that residents were overall satisfied with the care and accommodation provided. One comment from a resident said " carers and staff cannot be faulted" Residents` spoken with said they were pleased with the improvements made to the home and enjoyed the meals they were offered.

What has improved since the last inspection?

Since the last inspection more staff had been trained in meeting the care needs of residents and how to ensure they were protected from abuse. This helped to keep residents` healthy and protect their welfare. The home was continuing to work on developing care plans. This meant that residents` care needs were known and staff members were able to provide consistent care that reflected residents` wishes, dignity and aspirations. The home was over half way through a redecoration / refurbishment programme. Where changes had been made the residents were seen to be benefiting from the overall improved accommodation. This meant residents lived in a homely environment that ensured their safety and provided additional comfort. The home had improved their monitoring / audit systems to ensure the care provided to residents was evaluated. By ensuring care was monitored meant that residents` health and safety was better safeguarded. The home was introducing a new dietary assessment called `Nutmeg`. This helped to ensure the meals provided to residents promoted their health, gave a nutritional balanced diet and offered more extensive choice.

What the care home could do better:

The home continued to have weaknesses in the care and management of medication despite implementing new assessments and training for staff. The continued weakness in medication had the potential to compromise the health of residents. The home needed to continue to develop their care plans to make sure they evidence all aspects of a residents care. By making these further improvements more person centre care approaches could be established.

CARE HOMES FOR OLDER PEOPLE Laurel Court Nursing Home 1a Candleford Road Off Palatine Road Didsbury Manchester M20 3JH Lead Inspector Michelle Moss Unannounced Inspection 27th February 2007 10:30 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 Laurel Court Nursing Home DS0000021556.V331511.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. Laurel Court Nursing Home DS0000021556.V331511.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Laurel Court Nursing Home Address 1a Candleford Road Off Palatine Road Didsbury Manchester M20 3JH 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) 0161 446 2844 0161 446 2873 Ashbourne Homes Limited Post Vacant Care Home 86 Category(ies) of Old age, not falling within any other category registration, with number (75), Physical disability (11) of places Laurel Court Nursing Home DS0000021556.V331511.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users requiring nursing care shall be 61. The service users requiring nursing care by reason of physical disability shall be accommodated on the lower ground floor. The service users requiring nursing care by reason of old age shall be accommodated on the second and third floors. The maximum number of service users requiring personal care only shall be 25, accommodated on the first floor. Registration is subject to compliance with the minimum nursing staffing levels indicated in the Notice of Variation of Conditions of Registration dated 8th March 2005. Personal care staffing levels will remain in line with those currently in place. One named service user requiring personal care is accommodated within a nursing unit. This place will revert to nursing care once this service user no longer requires this accommodation. 20th September 2006 3. 4. 5. 6. Date of last inspection Brief Description of the Service: Laurel Court is a care home providing nursing care, personal care and accommodation for 75 older people and nursing care for 11 adult service users who require care by reason of physical disability. The first floor is used to provide care only to older adults, and the second and third floors care with nursing to older adults. The home was opened in 1994 and is purpose built consisting of accommodation on four floors. The ground floor has been adapted to residents requiring care by reason of physical disability. The home has extensive gardens that were well maintained and readily accessible for residents. Ample car parking was available at the side and rear of the home. Each floor is served by two passenger lifts. The home is located in a residential area of Withington, South Manchester. Local amenities are available in Withington village and the area is served by an excellent bus network into the city centre. Fees are set in accordance to the assessed needs of individual residents and the service being referred to. Laurel Court Nursing Home DS0000021556.V331511.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector went to the home without telling anyone she was going to visit on the morning of Tuesday 27th February 2007. The inspector spent nearly 4hours visiting the home. During the visit to the home the inspector: • Met and talked with residents. • Looked at comments residents had made in a recent satisfactory survey. • Spoke with the staff on duty • Looked at some residents care plan records. • Looked at how medication was managed. • Looked around the home. • Watched how the residents and staff got a long together. There were some important things the inspector wanted to find out about the care given by the home. These were: • • • • How the health needs of residents were met. How the personal care needs of residents were met. How the staff helped to keep residents safe and promoted community involvement. How the home respected the residents’ rights, diversity and identity. What the service does well: The staffing was set at a level that met the needs of the residents. This showed that there were enough staff to make sure residents were kept safe and adequately supported. The home ensured they consulted with residents through house meetings, newsletters, satisfactory surveys and regular reviews. These different methods of communication ensured the views of residents and their families were sought and where necessary acted on. The home made sure the health of residents was monitored. This was done through the care planning system and holding regular care reviews. Information received through residents satisfactory surveys showed that overall residents felt they were well cared for, their privacy was respected, that food was nice and the home was nice to live in. These positive comments showed that residents were overall satisfied with the care and accommodation provided. One comment from a resident said “ carers and staff cannot be faulted” Laurel Court Nursing Home DS0000021556.V331511.R01.S.doc Version 5.2 Page 6 Residents’ spoken with said they were pleased with the improvements made to the home and enjoyed the meals they were offered. What has improved since the last inspection? 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. Laurel Court Nursing Home DS0000021556.V331511.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Laurel Court Nursing Home DS0000021556.V331511.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents only moved into the home after their assessments were assessed and confirmationby the home that they can meet the residents’ needs. EVIDENCE: The manager conducted a pre-admission assessment of prospective residents to ensure that the home could meet all their assessed needs. Following the assessment the normal practice was to telephone prospective residents to inform them whether the home was/was not able to meet their needs. Where necessary a letter was also provided. For residents who were referred through Care Management arrangements the home obtained a summary of the Care Management Assessment prior to admission. Laurel Court Nursing Home DS0000021556.V331511.R01.S.doc Version 5.2 Page 9 One newly admitted resident’s records were examined. The details recorded in the initial assessment provided overall a good picture of the needs of the resident. This included the level of care and support required. The home did not provide an intermediate care service. Laurel Court Nursing Home DS0000021556.V331511.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Overall the health, personal & social care needs of residents were set out in the care plan. Health needs were generally met and rights and privacy respected. However, the care and management of medication was not effective to ensure the health of residents was adequately safeguarded. EVIDENCE: At the home’s last inspection it had been noted that shortfalls in the recordings of care plans meant residents, needs were not always evident. Also, although risk assessments had been completed address such areas such as manual handling, nutrition and risk of falls. However, not all care plans examined at the time, reflected the outcome of the risk assessment and had the potential to place residents at risk. Since these findings, the home had spent considerable amount of time in improving the care plans. This included weekly auditing and random sampling of records. From examining two care plans and talking with staff, it was noted that overall improvements were evident with better links Laurel Court Nursing Home DS0000021556.V331511.R01.S.doc Version 5.2 Page 11 established between risks assessments and care plans. Further improvements could however be made to the plans. This extends to taking a more person centred approach, looking at how to promote independence, ensuring the plan provide a balance of strengths against needs. Also it needed to provide more overviews on residents likes and dislikes especially in areas of dietary needs. There were still occasions were inconsistency emerged that had the potential to compromise the care given and sustain independence. One example related to different remarks made in a care plan about the mobility of one resident. The confusion made it different to determine whether the resident should be hoisted or not. The details about the type of hoist to be used were unclear as well as the number of carers required. Care reviews were routinely carried out every 3 months. Details of the reviews were included in the care plan. Evidence that residents and families were consulted was seen. However, where needs had changed or concerns raised no action plan was devised to inform the care plan or staff on what should happen. A more proactive approach was needed to ensure consistency / improvement in care planning and review of care. From reading two care plans both had limited details about diversity and equality. Areas around cultural identity and religious need were not always clear. The link with diversity needed to be incorporated throughout the plan as part of the development of a more person centred approach. Areas such as aspirations, decision making and personal choice needed to be balanced against delivery of care. The last inspection identified weaknesses in the management of medication. Since that inspection the home was found to have taken action. New auditing checks were completed weekly, staff had received competency based training. This included being observed through the process of administering medication. Boots the contracted Chemist that provided the homes medication, had been asked to review medication stock levels and to advise the home on safe practices with medication. It was noted from examining the audits completed on medication that they recorded percentages on overall performances of the different floors. Although this was good practice, the records failed to indicate the action taken when shortfalls were noted. Also the home was not obtaining a data analysis that indicated if failures in administering related to specific staff members. From talking with the general manager and examining the forms used to measure staff competences it was noted that the home were not using any specific assessment tools that would sufficiently validate the process. Questions were raised during the inspection over the additional training and assessment criteria used by staff completing the assessments to ensure the assessments made could be adequately confirmed. Laurel Court Nursing Home DS0000021556.V331511.R01.S.doc Version 5.2 Page 12 For example, the forms used by the staff doing the assessments entered yes or no to areas such as administering medication. What was missing was the evidence to support the judgement. On a positive side, questionnaires were seen that had been completed by staff on safe administering of medication. Floors 1 & 2 were visited and medication on both floors examined. On floor 1 the MAR sheets were examined and overall provided a good audit trail on medication administered by staff. One missing signature was highlighted. The staff immediately went to the staff member responsible and obtained their signature. This raised some concerns in practice because no check was made against the actual medication first. Furthermore, there were a couple of residents who had not received their morning medication and the time was 1:30pm. Questions were raised about the home knowing sufficient information about the benefits of the medications and when they should be administered for the best effects. There was a risk that staff could become the prescriber by making such decisions. The home was recommended to look at introducing medication care plans that would provide greater understanding to the medication prescribed and links with medical conditions. On examining medication on the second floor some additional concerns over the administering of medication were found. There were several missing signatures in different residents records, Signing out of the medication was made where medication was not prescribed for that specific time. Tippex had been used. Signatures had been crossed out to the extent it was not possible to determine the initial signature. Where staff members were administering PRN medication such as pain relief, the time of administering the medication was not made. It was therefore difficult to determine if a minimum of a 4-hour gap was met. On checking blister packs, one resident’s medication was found to be still in for Saturday 24th Feb 2007, on checking the MAR sheet the medication had been signed out. The general manager was altered to this concern. During the examination of medication both the general manager and area manager were present. Both identified that urgent action was required to be taken by the organisation to address the shortfall found during the inspection in regards to medication. All these shortfalls in medication had the potential to compromise the health of residents. Following the site visit the area manager provided the Commission with an action plan that took immediate steps to address the shortfalls noted in medication. Laurel Court Nursing Home DS0000021556.V331511.R01.S.doc Version 5.2 Page 13 All residents were registered with local General Practitioners and had access to visiting healthcare professionals e.g., Dietician, Chiropody, Dentistry and Ophthalmology. This ensured residents were in receipt of appropriate health services necessary to support their health care needs. Questionnaires completed by residents showed that they were satisfied with the service. All indicated that areas such as respecting their privacy and dignity was overall a strength of the home. Laurel Court Nursing Home DS0000021556.V331511.R01.S.doc Version 5.2 Page 14 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 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A range of activities were offered, family contact actively sought and wholesome and appealing meals were offered to residents. EVIDENCE: The home had two designated activities coordinator posts, one part time and one full time. The part time post had been vacant since December 2006. However, a successful appointment had been made. Details regarding activities were displayed in the main entrance and on each individual unit. During the winter months, various activities had taken place, including a Bonfire party, Christmas fair, Christmas parties and other seasonal celebrations. Regular activities both formal and informal were offered to residents. Religious needs were met through the various planned activities organised by the home. The menu was displayed on the notice board. A new system called ‘Nutmeg’ was being introduced after the general and catering manager had attended a training course. The new system provided a data analysis on the nutritional Laurel Court Nursing Home DS0000021556.V331511.R01.S.doc Version 5.2 Page 15 values of the different foods. The system provided over 2000 menus that offered a balanced diet. The database provided information that would help health professionals to assess the nutritional status of a resident. Laurel Court Nursing Home DS0000021556.V331511.R01.S.doc Version 5.2 Page 16 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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had the systems and procedures in place that allowed people to express their complaints and concerns. Improvement in staff training offered better protection for the residents from risk of abuse. EVIDENCE: The home had a complaints policy and procedure that was displayed on the main notice board and in the Service Users’ Guide. The home had policies and procedures in place for the Protection of Vulnerable Adults and the manager had a copy of the ‘No Secrets’ guidance including the Manchester Multi Agency procedure. The general manager was found to be familiar with the procedures that ensured residents were safeguarded. However, at the last inspection it had been noted that a number of staff were not familiar with the procedures that should be followed where issues of protection were identified. Since the last inspection, some of the staff had received training. The home’s auditing of training indicated 88 of staff had received this essential training Laurel Court Nursing Home DS0000021556.V331511.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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The premises were generally clean and comfortable for the residents living there. EVIDENCE: The reception area of the home was warm and welcoming. There were seating areas available and refreshments available for visitors and residents. The premises were found to be generally clean and tidy. The home was half way through a redecoration programme. The improvements had been discussed with residents who confirmed they had been consulted about the selection of furnishing and decoration. Laurel Court Nursing Home DS0000021556.V331511.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): 27, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The number and deployment of staff available appeared sufficient to meet the residents’ assessed needs. EVIDENCE: On the day of the visit the home appeared to have an appropriate number of suitable staff on duty to meet the needs of the residents at the home. From examining a sample of resident / family surveys the main concern raised appeared to be staffing numbers. On checking the staffing levels it was confirmed that overall they were being sustained. The manager stated that the home had not needed to use agency staff as much as in the past. Bank staff members were still used but were more familiar with the home and the residents. Beside the care staff the home had numerous other staff employed that supported the running of the service. The support of the other personnel meant the hours allocated for care were purely designated care hours and not for undertaking other duties such as catering, cleaning and laundry services. Laurel Court Nursing Home DS0000021556.V331511.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems and procedures were in place, which safeguarded and protected residents’ financial interests and in the main the home was seen to promote the health, safety and welfare of the residents and staff. EVIDENCE: The manager was able to demonstrate a clear understanding of the aims and objectives of the home and how these were monitored. Regular questionnaires were distributed to residents and their families/friends and representatives to establish their views on the services provided by the home. A sample of the questionnaires were examined. The survey findings were not routinely brought together and published including what changes the home would make as a result of the findings. It was recommended this was done and provided to Laurel Court Nursing Home DS0000021556.V331511.R01.S.doc Version 5.2 Page 20 residents and families. The general manager was advised to ensure various formats for the information were offered. This included audiotapes, large print Braille etc. Evidence was seen that the systems in place safeguarded resident’s financial interests and secure facilities were provided for any money or valuables held on behalf of residents. The home employed a maintenance team whose responsibilities were to over see all the various aspects of the environment. This included health & safety. Laurel Court Nursing Home DS0000021556.V331511.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X x X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Laurel Court Nursing Home DS0000021556.V331511.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13 Requirement The Registered Person must make arrangements for the recording, handling, safekeeping and safe administration of medicines which are detailed below: All prescribed medication must be signed for by the person administrating them at the time of administration. All medication records must be accurate. All medication must be administered as prescribed. (not met in previous time scale 30/12/06) Timescale for action 30/03/07 Laurel Court Nursing Home DS0000021556.V331511.R01.S.doc Version 5.2 Page 23 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 OP7 Good Practice Recommendations It is recommended that the home look into introducing to the care plan nutritional screening plans and medication care plans. It is recommended that more details about meeting the diverse needs of residents including culture and religious needs are included in the care plan. It is recommended that continued development of care plans are made, the plans being person centered. This includes balancing independence, adding strengths as well as needs and problems. When reviews are carried out the home should form action plans that demonstrate action has been taken where areas of need or concern are raised. It is recommended that the home provide clear evidence that supports judgements made regarding the competency of staff who administer medication. It is recommended that staff completing competency training in medication have assessment tools that ensure the assessment can be validated. It recommended that the home make information for residents available in various visions E.g. audiotapes, large print, Baillie. It is recommended that the survey results are published and made available to residents and families, including the action, if any, taken. 2 OP7 3 4 5 6 7 OP7 OP9 OP9 OP33 OP33 Laurel Court Nursing Home DS0000021556.V331511.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North West Regional Office 11th Floor West Point 501 Chester Road Old Trafford M16 9HU 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 Laurel Court Nursing Home DS0000021556.V331511.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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