Inspection on 19/05/05 for Lawrence Court Care Home

This inspection was carried out on 19th May 2005.

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.

Other inspections for this house

Lawrence Court Care Home 09/06/08

Lawrence Court Care Home 13/06/06

Lawrence Court Care Home 16/11/05

Lawrence Court Care Home 02/12/04

Lawrence Court Care Home 11/05/04

Lawrence Court Care Home 27/02/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Lawrence Court Nursing Home Allendale Road Byker Newcastle upon Tyne NE6 2SB Lead Inspector Irene Bowater Unannounced 19 May 2005 09:30 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. Lawrence Court Nursing Home B53-B03 S400 LawrenceCourt V222906 190504 Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Lawrence Court Nursing Home Address Allendale Road Byker Newcastle upon Tyne NE6 2SB 0191 276 0017 0191 276 0296 lawrence.court@fshc.co.uk Tamaris Healthcare (England) Ltd (wholly owned subsidiary of Four Seasons Health Care) Mr Robert Dawson CRH 46 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) Category(ies) of OP - Old Age (46) registration, with number of places Lawrence Court Nursing Home B53-B03 S400 LawrenceCourt V222906 190504 Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 2nd December 2004 Brief Description of the Service: Lawrence Court is a purpose built care home with nursinh located in Byker.It is situated on the same site as another care home owned by the same company. The home provides nursing care for 23 older pwrsons and the ground floor and provides social and personal care for 23 older persons on the first floor. The two floors are accessible via stairs and a passenger lift.There are two lounges and one dinning room on each floor and there are designated smoking lounges. All of the bedrooms are single ensuite and there are adapted bathing,showers, and toilet facilities throughout the home. The lower ground floor is not readily accessible to residents.This floor has the staff room,kitchens and laundry services. The home has an accessible garden area and there is ample car parking. The home is close to local shops and leisure facilities and is on a local bus route. Lawrence Court Nursing Home B53-B03 S400 LawrenceCourt V222906 190504 Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over one day. The home manager was available and assisted throughout the inspection. Ten residents, eight staff and two relatives were spoken to throughout the day. Part of the day was spent examining records and the majority of the time was spent touring the premises and spending time with the resident’s. What the service does well: What has improved since the last inspection? The staff team has become more aware of residents individual needs under the leadership and direction of the manager who was appointed in December 2004. The manager has progressed with many outstanding issues in the home, which include staff recruitment and training, sourcing the up to date records and monitoring the quality of the care and service in the home. Lawrence Court Nursing Home B53-B03 S400 LawrenceCourt V222906 190504 Stage4.doc Version 1.30 Page 6 Some progress has been made regarding the refurbishment and redecoration of the home and the general cleanliness of the communal areas and resident’s bedrooms have improved. The home has provided some specialist beds for residents and purchased new bed linen. The garden area to the front of the home has been landscaped which provides a pleasant outdoor seating area in the warmer months. Daily life for the residents is improving following successful recruitment of an activities person. Residents said the activities had improved and some residents have been out the local shops. Supervision for all staff has commenced with records available. What they could do better: The terms and conditions of residency (or contract) has not yet been given to residents who are self funding. This must be done so that resident’s know what their rights and obligations are for all aspects of the service. The care plans must be regularly up dated and reviewed according to the changing needs of the residents and the qualified nurses need to follow the requirements of the Nursing and Midwifery Council for record keeping. The teatime meals need reviewing and changes made in consultation with the residents. The residents were very vocal about how many times they has soup and sandwiches as an alternative for tea. The redecoration and refurbishment of the home needs to continue and outstanding requirements must be addressed to ensure the safety and well being of the residents. Training for staff in safe working practices and specialist training for them must be implemented to enable them to provide high quality care. The general housekeeping and cleanliness in the refuse area and the laundry needs to improve to ensure the company policies and other legal requirements are met. Lawrence Court Nursing Home B53-B03 S400 LawrenceCourt V222906 190504 Stage4.doc Version 1.30 Page 7 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. Lawrence Court Nursing Home B53-B03 S400 LawrenceCourt V222906 190504 Stage4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Lawrence Court Nursing Home B53-B03 S400 LawrenceCourt V222906 190504 Stage4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3. The home has amended the Service User Guide, which gives information about all aspects of the home. The Home has not yet produced a Statement of Terms and Conditions for residents who are self funding. Without this the rights and obligations of residents and the provider is not clear. The admission procedures are comprehensive and ensure that the staff can meet residents assessed needs. EVIDENCE: The home has amended the Guide that informs residents about all of the services provided for both nursing and personal care. The written contract or statement of terms and conditions with the home is still not yet available for residents who purchase their care privately. The home has detailed admission documents that are completed before residents are admitted to the home. Evidence was available to confirm that Lawrence Court Nursing Home B53-B03 S400 LawrenceCourt V222906 190504 Stage4.doc Version 1.30 Page 10 Care Managers and other professionals’ also complete assessments to ensure that residents individual care needs can be met. From this information the home formulates a care plan, which enable the staff to deliver the care required. Lawrence Court Nursing Home B53-B03 S400 LawrenceCourt V222906 190504 Stage4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 Progress has been made on improving the arrangements and documentation to ensure the health, social and personal care needs of residents are identified and met. The care plans are not consistently reviewed to provide staff with the detailed information they need to meet residents changing needs . The medication policies and procedures are comprehensive but the handwritten directions for dispensing medication is not followed. The staff have an understanding of residents needs and endeavour to promote their rights to privacy and dignity. EVIDENCE: All residents have a care plan, which is competed following the admission process. Some progress has been made since the last inspection in regard to the documentation, however all aspects of health, social and personal care needs are not always identified, recorded and planned for. Three of the care plans showed that residents with complex and changing nursing needs had not had their care reviewed for some time. Lawrence Court Nursing Home B53-B03 S400 LawrenceCourt V222906 190504 Stage4.doc Version 1.30 Page 12 There was evidence of risk assessments being competed for falls, dependency, pressure sore care and nutrition, however the plans were not always evaluated monthly nor are the plans updated to reflect changes in both nursing and social care needs. There was evidence from the care plans, discussion with the staff, relatives and residents to confirm that other professional are involved in individual residents care. These include visits from GP’s, chiropodist’s, opticians, diabetic nurse specialists and speech and language specialists. There are comprehensive policies for staff to follow to ensure the safe administration of medicines. Medicines are stored and administered from appropriate medicine trolleys, which are secured to the wall when not in use. Oxygen was securely stored and signage was available where it was stored and in use. The home has sight of all prescriptions and they retain a copy on the home file. There are systems in place to record all medicines received and disposed of in the home. A random audit found no discrepancies and clear recording on the Medicine Administration Record (M.A.R) Hand written prescriptions by staff did not have two signatures. The staff were observed to knock on doors before entering and they ensured that all personal care was carried out in privacy. Relatives spoken with said that they were satisfied that the staff ensured that their relatives privacy was respected at all times. The staff were knowledgeable regarding individual residents needs and the relationships were friendly and professional. Lawrence Court Nursing Home B53-B03 S400 LawrenceCourt V222906 190504 Stage4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15. Progress is being made in meeting resident’s social needs, including arrangements for outings and maintaining links with the local community. The home provides a balanced diet, however the choices available at tea times do not meet the resident’s expectations. EVIDENCE: The home has been successful at recruitment of a designated activities person. Although she has only been in post of a short time a programme of activities has been implemented for the residents. Activities have included video nights, bingo, floor skittles, dominoes and sing-a-long’s. The residents enjoyed the Easter egg painting competition and the VE party. The residents said that they are now able to go out on a one to one basis and enjoyed visiting the local shops and buying personal items. All activities undertaken are recorded in the activities file. Some residents said they did not want to join in any activities and these choices are also recorded and respected. Relatives said that they would like more information displayed regarding activities and events in the home. They also said that they had noted improvements in the daily lifestyle for their relatives in recent months. Lawrence Court Nursing Home B53-B03 S400 LawrenceCourt V222906 190504 Stage4.doc Version 1.30 Page 14 The residents and relatives spoken with confirmed that visitors are welcome at anytime and are able to visit in the communal areas or in the privacy of their own rooms. The home has a four-week menu, which offers choices for each meal. The care staff ascertains the residents choices and record their choices for the day on a menu sheet. The residents and staff spoken with were unsure what was for lunch. T here were no menu displayed in the upstairs dining room and the menu on display in the downstairs dining room was not readily available. The residents were offered 2 choices of main course and dessert. Hot and cold drinks were served throughout the meal and at mid morning and mid afternoon. The residents spoken with said “the food is nice”, “there is always plenty to eat”, and “the meals are good”. One resident was dissatisfied with the food provision and the manager was addressing this. The residents were united in their dissatisfaction with the soup and sandwich choices at teatime. Lawrence Court Nursing Home B53-B03 S400 LawrenceCourt V222906 190504 Stage4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 The complaints process within the home is currently satisfactory. The staff have knowledge of Adult Protection and would be able to use the procedures if necessary. EVIDENCE: The home has comprehensive policies and procedures in place, which give details of how and to whom to complain should a resident or their representatives wish to do so. Residents spoken with said they would be able to use the process if necessary. The records show that all concerns and complaints are taken seriously, are clearly recorded with actions and outcomes documented. There has been one complaint recorded since the last inspection. There are policies in place for the Protection of Vulnerable Adults. Copies of the Local Authorities Policies are available in the home. The staff are receiving internal training, which is ongoing to ensure they know what steps to take should there be a suspicion of any form of abuse. The manager confirmed that external training is being sourced for all staff. Lawrence Court Nursing Home B53-B03 S400 LawrenceCourt V222906 190504 Stage4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,26. The location and layout of the home is suitable for the residents who live there. The standard of the environment currently does not provided a clean, wellmaintained environment for the residents and there are potential hazards regarding safety and infection control. EVIDENCE: The location and layout of the home is suitable for the residents who live there. There has been some progress with the outstanding requirements from previous inspections and there is evidence of in house redecoration being completed. The small garden area to the front of the home has been prepared for the warmer months, which makes a pleasant seating area for the residents. New bedding and a dishwasher has been provided since the last inspection. Many of the bedrooms have been redecorated and have had new carpets. Lawrence Court Nursing Home B53-B03 S400 LawrenceCourt V222906 190504 Stage4.doc Version 1.30 Page 17 Two specialist beds were delivered from another home on the day of inspection and there are sufficient hoists and other adaptations available to meet the resident’s individual needs. All resident areas have an accessible call system. A random check of the water temperatures found that they were within satisfactory limits and bath thermometers are provided in all bathing areas. A number of other areas still require attention, in particular: One shower room has been out of use for a considerable time and the other bathrooms and shower facilities show signs of wear and tear and several of the areas are generally grimy. The flooring is split in one shower room, which allows water to pool on the floor, and the drain was full of debris. The flooring in most of the bathrooms and toilets was marked and staff said that the black marks and water stains could not be removed. The waste bins did not have lids in several of the bathrooms and toilets. The bedroom furniture is worn and shabby and several of the wardrobes, which are free standing, have items stored on top, which is a potential hazard. There were pockets of odour in several of the bedrooms. Many of the lounge chairs and occasional furniture are showing signs of wear and tear and are generally scuffed and stained. The carpet in the smoking lounge has numerous cigarette burns and other stains. The kitchenette units are grimy difficult and the doors do not fit. The grouting around the units is missing allowing water to seep behind and inside the units. The laundry area was busy and cluttered. with unnamed clothing and linen. The flooring in this area is in poor condition, the shelving, sink and on top of the machines were dusty and grimy. The walls and ceiling are in need of redecoration. On the lower ground floor there is a refuse store, which was full of broken, and unused furniture, bed rails and bumpers, continence aids, curtains and mattresses. Lawrence Court Nursing Home B53-B03 S400 LawrenceCourt V222906 190504 Stage4.doc Version 1.30 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 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) 27,29,30 The home is adequately staffed with qualified nurses and care staff given the current numbers of residents. The number of staff deployed should be constantly reviewed following assessment of dependency levels. The recruitment policies are now being implemented following the appointment of a manager. Some progress has been made regarding the provision of statutory and specialist training for all grades of staff. Further training for staff to gain care qualifications needs to be implemented. EVIDENCE: The home has changed the shift patterns and the staffing levels have reduced since the last inspection. The first floor unit provides social and personal care and is staffed by a senior carer over 24 hours and 2 carers from 8am to 8pm.Overnight there are 2 staff . The ground floor provides general nursing care and is staffed by 1 registered general nurse over 24 hours and 3 carers in the morning then 2 carers in the afternoon and evening. Overnight there is 1 qualified nurse and 1 carer. Lawrence Court Nursing Home B53-B03 S400 LawrenceCourt V222906 190504 Stage4.doc Version 1.30 Page 19 Since the last inspection the home has successfully recruited an activities person for 21 hours. This has resulted in an improvement in the daily life for the residents in the home. A new administrator is in post and the home has a maintenance person, domestics, cook, kitchen assistants and laundry staff. The home manager is currently working his notice and is due to leave in June. Since the last inspection the manager has started to review all the staff files to ensure the required 2 references, Criminal Record Bureau checks and proof of identity is available. Training files have been set up which contain basic information at present. The manager has improved the record keeping since coming into post in December 2004. There has been limited staff training and development for all grades of staff over a period of time. There was evidence that a training programme is being implemented for the year. This is to include Care of the Dying, and Palliative Care. Currently there is no NVQ training or moving and handling training. Lawrence Court Nursing Home B53-B03 S400 LawrenceCourt V222906 190504 Stage4.doc Version 1.30 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 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) 31,32,36,38 The home is currently being managed properly and there is leadership guidance given to staff to ensure residents receive consistent care. The staff receives suitable supervision and support from senior staff. There continues to be issues in the maintenance of the building and in the training of staff that pose potential hazards to health and safety. EVIDENCE: The Registered Manager has only been in post for 6 months. During this time the staff have said that they were now clear about what is expected of them and relatives said that improvements regarding the care and the services in the home have improved over this time. Lawrence Court Nursing Home B53-B03 S400 LawrenceCourt V222906 190504 Stage4.doc Version 1.30 Page 21 Staff supervision has commenced with records available. The sessions cover aspects of care practice and the ethos of the home. Statutory fire training is documented with dates, names and signatures recorded. Risk assessments are available for the safe use of bedrails. Generic risk assessments for the environment and fire have been completed since the last inspection. Accident recording is satisfactory with monthly analysis carried out. Contract maintenance certificates are available and up to date. The manager is aware of the shortfalls and lack of structured training in safe working practices and has a planned programme organised for the coming year. An internal audit of the kitchen has been carried out which identified poor cleaning and housekeeping practices in the kitchen. The manager is regularly monitoring this area. The evidence documented regarding the maintenance of the building in previous inspections has not been addressed. Lawrence Court Nursing Home B53-B03 S400 LawrenceCourt V222906 190504 Stage4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 1 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 2 2 1 3 2 2 x 2 STAFFING Standard No Score 27 3 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 3 x 2 3 3 x x x 3 x 2 Lawrence Court Nursing Home B53-B03 S400 LawrenceCourt V222906 190504 Stage4.doc Version 1.30 Page 23 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 OP 1 Regulation 5 Requirement The home must provide a statement of terms and conditions (or contract if self funding) Timescale of 2003 not met. The care plans must be reviewed at least monthly,updated to reflect changing needs and be signed and dated by the author. All handwritten transcriptions of medication directions require two signatures. The tea time menu requires reviewing to ensure residents preferences are taken into account. Progress with training for all staff on Protection of Vulnerable Adults,physical restraint and dealing with agression. Provide and implement a redecoration and refurbishment programme for the home. Replace worn,damaged furniture and lounge chairs. Replace damanged sink units in the dining rooms and regrout the tiles . Replace the smoking room carpet. Refurbish and repair the shower Timescale for action 31st July 2005 2. OP 7 13 31st July 2005. 31st Juky 2005. 31st July 2005. 30th September 2005. 1st September 2005 3. 4. OP 9 OP 15 12,13 12,16 5. OP18 12,13 6. OP19 13,23 7. OP 21 23 1st Page 24 Lawrence Court Nursing Home B53-B03 S400 LawrenceCourt V222906 190504 Stage4.doc Version 1.30 8. OP 24 16,23 9. OP26 12,13,16 10. OP 30 24 11. OP 38 13,16,23 room.Keep the door locked until repairs are affected. Deep clean or replace the flooring in the shower room opposite room 28. Assess all the bathroom and toilet floorings and where flooring cannot be cleaned or repaired it must be replaced. The worn bedroom furniture must be replaced.Wardrobes require fixing to the wall to prevent toppling accidents. The laundry flooring must be impermeable and the walls easily cleaned.The flooring requires replacing and the walls redecorating. All staff must receive training in safe working practices and specialist training to ensure residents assessed needs are met. All staff must have statutory training updated with records kept. Remove broken and unwanted equipement from the refuse area and maintain in a clean safe condition at all times. September 2005. 30th December 2005 30th December 2005. 30th December 2005. 31st July 2005. 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 OP 24 OP27 Good Practice Recommendations It is highly recommended that personal items are not stored on tops of wardrobes. It is highly recommended that staffing levels are monitored in accordance with the geography of the home,the dependency levles of the residents and the skill and the experience of the staff. B53-B03 S400 LawrenceCourt V222906 190504 Stage4.doc Version 1.30 Page 25 Lawrence Court Nursing Home Commission for Social Care Inspection Northumbria House Manor Walks Cramlington, Northumberland NE23 6UR 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 Lawrence Court Nursing Home B53-B03 S400 LawrenceCourt V222906 190504 Stage4.doc Version 1.30 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. 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