Inspection on 28/04/05 for Linden Manor Care Home

This inspection was carried out on 28th April 2005.

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

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

Other inspections for this house

Linden Manor Care Home 14/01/09

Linden Manor Care Home 14/02/07

Linden Manor Care Home 11/11/04

Linden Manor Care Home 15/07/04

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

CARE HOMES FOR OLDER PEOPLE Linden Manor Care Home 159 Midland Road Wellingborough Northants NN8 1NF Lead Inspector Kathy Jones Unannounced 28 April 2005 09:15 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. Linden Manor Care Home D C51 C08 S50670 Linden Manor Care Home V222699 280405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Linden Manor Care Home Address 159 Midland Road Wellingborough Northants NN8 1NF 01933 270266 01933 229141 lindenmanor@regalcarehomes.com Regal Care Homes Ltd 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) Vacant Care Home Only (CRH) 28 Category(ies) of Older People (28) registration, with number Dementia - over 65 (DE(E)) (28) of places Linden Manor Care Home D C51 C08 S50670 Linden Manor Care Home V222699 280405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 To include one named person aged 56 years and above with a Dementia related condition. Date of last inspection 11 November 2004 Brief Description of the Service: Linden Manor is a care home providing personal care and accomodation for 28 older people the majority of who have a dementia related condition. Linden Manor has been registered as a care home for a number of years and is now owned by Regal Care Homes Ltd. The home has been registered with Regal Care Homes since 31 October 2003. The Home is situated close to Wellingborough town centre with shops and other local amenities. The home is set within its own grounds with gardens which at the time of inspection required some maintenance work. There are two communal lounges which have some dining space and a long conservatory area which was being used by Service Users and Staff who smoke. Bedrooms are located on the ground floor, first floor and second floor of the building. There is a passenger lift available. Linden Manor Care Home D C51 C08 S50670 Linden Manor Care Home V222699 280405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over the morning and afternoon of a weekday with a break over the lunch period. A second unannounced inspection visit was carried out a few days later in response to a complaint the details of which are contained in this report. The first inspection visit involved review of records relating to the assessment and planning of care needs, complaint records and a limited tour of the premises. Discussions with Service Users and observations of the daily routines and care provided were made. Inspectors had a brief discussion with the Deputy Manager and a Staff member to discuss the care provided. No Comment cards were received from Service Users and only two from relatives/visitors prior to the inspection. Inspector’s conversations with Service Users identified that the majority are unable to answer complex questions due to their dementia. however those able to express a view were generally satisfied with the care provided. A temporary Manager at the home had completed a pre-inspection questionnaire, which provided the Inspector with some information to inform the inspection. Additional information regarding confirmation of maintenance checks and staff recruitment has been requested and will be checked on receipt. What the service does well: Service Users able to express a view were generally satisfied with the care provided and said that Staff treated them well. Staff had assisted a Service User to her room to enable her to see a visitor in private and the visitor commented that nothing seemed too much trouble for Staff. Service Users were happy with the meals provided and additional research undertaken regarding special diets. Complaints are responded to appropriately with remedial action taken where necessary. Staff were keeping the home clean and tidy. Linden Manor Care Home D C51 C08 S50670 Linden Manor Care Home V222699 280405 Stage 4.doc Version 1.30 Page 6 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. Linden Manor Care Home D C51 C08 S50670 Linden Manor Care Home V222699 280405 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Linden Manor Care Home D C51 C08 S50670 Linden Manor Care Home V222699 280405 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3. The home does not provide intermediate care therefore standard 6 is not applicable. The admissions process does not provide assurance that Service Users needs can be fully and safely met. EVIDENCE: Records’ relating to the admission process for a recently admitted Service User identified that the pre-admission documentation had not been fully completed with areas such as medical history and personal and social history left blank. An assessment of needs carried out by a care manager from Social Care and Health had been obtained and the home had carried out some assessments of their own on admission. There were some discrepancies in the two assessments and no evidence that the home had queried or checked the information. For example the care management assessment had identified that the Service User had a physical and sensory disability whereas the home identified the Service User as having dementia. The homes assessment for Linden Manor Care Home D C51 C08 S50670 Linden Manor Care Home V222699 280405 Stage 4.doc Version 1.30 Page 9 another Service User identified that they had depression “at times” however there was no evidence of how and when this diagnosis had been made. Without the correct information the home is unable to ensure that the Service User could be admitted within the homes category of registration and that they are able to meet their needs. The Service User was described as having a history of falls however the home made an assessment on admission of a low risk of falls. The lack of information regarding medical conditions and acknowledgment of the risk of falls has the potential to put the Service User at risk. Assessment information for a married couple did not contain any information regarding their relationship and although they are accommodated in single bedrooms, there was no evidence that they had been offered the opportunity to share a room or to have any private space. Linden Manor Care Home D C51 C08 S50670 Linden Manor Care Home V222699 280405 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 and 10 The shortfalls in planning of care, instruction and guidance to staff have the potential to put Service Users at risk of not having their needs including health care needs met. The absence of locks on toilet doors demonstrates a lack of respect for Service Users privacy and dignity. EVIDENCE: Two feedback cards were received from relatives/visitors and they confirm that they are satisfied with the overall care provided. Individual plans of care are in place for Service Users however the plans do not cover all areas of care need identified through the assessment. Examples of areas not covered include management of falls, depression, agitation, depression and management of reflux. Failure to plan and provide proper instructions to Staff regarding these care needs has the potential to cause increased distress and risk to Service Users. Where care plans are in place some of these contain very general information rather than identifying the needs of the individual. For example a dietary care Linden Manor Care Home D C51 C08 S50670 Linden Manor Care Home V222699 280405 Stage 4.doc Version 1.30 Page 11 plan for one Service User stated, “to eat what is liked”. A member of staff said that this Service User was very poorly and taking only fluid with some liquid food supplements. Staff advised that a record had been introduced to monitor the amount of food and fluid taken by a Service User who was poorly. The care plan had not been revised to reflect this change. Review of the food and fluid record identified up to fifteen and a half hour gaps between food and fluids offered. The record did not always detail what had been taken or the quantity. Records showed that General Practitioners and District Nurses are contacted to visit Service Users who are poorly and Staff confirmed that District Nurses are involved with pressure area care. A pressure area assessment and care plan was seen to be in place for one Service User however this did not detail where the pressure sores were located, how often the District Nurse was visiting or any actions required of Staff. A Service User being cared for in bed was seen to be clean and comfortable. A recently admitted Service User who was described by the hospital as being prone to falls and had fallen since in the home, was seen to be walking around the home, at times without a stick. A Staff member described him as ‘very mobile’. Records stated that he needed help at times with mobility but did not indicate what type of help or mention the need for the stick, which may increase the risk of falls. Opportunities for physical movement and exercise appeared limited to those who are independently mobile. The encouragement of physical activity does not form part of the care plan. Many Service users were seen to spend their day in the same chair with many of them being served meals on a small table in front of them and having little opportunity for physical movement creating the risk of unnecessary reduction in their level of mobility. A sample check of records showed that accidents are recorded however there were no details of any checks to monitor the condition of the Service User for injuries, which may become apparent at a later time. Some bathrooms and toilets were without suitable locks and in some cases had no lock, which results in a lack of privacy and dignity for service users. Not all residents knock before entering, and not all residents would hear a knock or respond to someone calling. Linden Manor Care Home D C51 C08 S50670 Linden Manor Care Home V222699 280405 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,15 Care appears to be taken to meet individual needs in respect of special diets however Service Users needs in relation to social activities and stimulation are not being met. EVIDENCE: No social or leisure activities or stimulation were observed in the home during the inspection visit resulting in many Service Users sleeping for large parts of the day. There were a few magazines available in one lounge. Televisions were on in both lounges, but no one appeared to be watching them and two Service Users indicated that this is common practice. Staff said that they aimed to provide activities in the afternoons, but inspectors observed that there was not enough Staff to do this and meet Service Users basic care needs. Menus are planned over a 3 week period. On some days a choice of main course was listed, but these options are not always cooked if all service users preferred one particular choice (as on the day we visited). Service Users spoken to confirmed that they enjoyed the food and that portions were sufficient. Linden Manor Care Home D C51 C08 S50670 Linden Manor Care Home V222699 280405 Stage 4.doc Version 1.30 Page 13 Special dietary needs are catered for and the cook had carried out some research through the Internet to provide a suitable gluten free diet for a Service User. Menus had been drawn up using gluten free recipes and the cook bakes special bread and checks ingredients carefully to ensure all food given is suitable. Linden Manor Care Home D C51 C08 S50670 Linden Manor Care Home V222699 280405 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Complaints are responded to appropriately with remedial action taken where necessary. EVIDENCE: A record of complaints held in the home indicates that any concerns raised by Service Users and their families are investigated and a resolution sought. The outcome of the complaint has been recorded except for one instance and the inspector has requested this information following the inspection. Comment cards received from two relatives/visitors and discussion with a visitor during the inspection confirmed that they are aware of the homes complaints procedure. The Commission for Social Care Inspection received a complaint prior to completion of the inspection process and an additional unannounced visit was carried out to investigate the concerns. The complaint included: -1) Staff sitting smoking together and smoke drifting into the lounge where service users are, 2) A Staff member on a mobile phone swearing in front of Service Users, 3) Staff didn’t know where the District Nurse records were for a Service User making it difficult to provide the correct treatment, 4) Staff had a lack of knowledge of individual Service Users. Parts 1 and 3 were founded, 2 partially founded and 4 was not proven. The Acting Manager has provided written details of the action taken to address these areas of concern prior to the production of this report. Linden Manor Care Home D C51 C08 S50670 Linden Manor Care Home V222699 280405 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 21,22,26 Re-decoration currently underway is improving the appearance of the home, however the environment continued to be poor due to the condition of the furnishings and fittings, the lack of privacy in toilets and bathrooms and the smoky atmosphere. EVIDENCE: The home is situated within a short distance of the town centre of Wellingborough and is set within its own grounds with some car parking to the front of the building. A limited tour of the premises was carried out. This demonstrated that the home was clean and tidy. A Service User spoken to confirmed that there is a good standard of cleanliness in the home. However an open bin with incontinence pads was seen in a downstairs bathroom, which is not hygienic or pleasant for anyone using the toilet. Linden Manor Care Home D C51 C08 S50670 Linden Manor Care Home V222699 280405 Stage 4.doc Version 1.30 Page 16 The environment was in poor condition when the current owners purchased the home in October 2003 and various timescales have been discussed with The Commission for Social Care Inspection for the refurbishment of the home. At the time of this inspection the internal painting was being carried out and measurements being taken for carpets and curtains. Timescales for the fitting of carpets and curtains and replacement of furniture, which are in poor condition, were not available. There were not enough places for all residents to eat at a dining table so several residents were served their meals on a small table in front of them. A Service User was overheard saying that she hoped to get a place at the table indicating that this was not always out of choice. The home is a large three storey building with a passenger lift. At the time of the inspection the external décor was in a very poor condition with paint peeling from the window frames. The grounds were overgrown and patio area unkempt. There are two communal lounges with some dining tables and a long conservatory type area. At the time of the inspection the conservatory area was being used by some Service Users and Staff as a smoking area. Smoke was drifting into the lounge used by none smokers and potentially also to the bedrooms located at the opposite end of the conservatory. Since the inspection the Inspector has been informed that Staff no longer smoke in the building Some bathrooms and toilets were without suitable locks and in some cases had no lock. Bolts were present on the inside of some doors which if used creates the risk of Staff not being able to get in if a Service User fell or was taken ill. Some bedrooms were found to have locks which if locked with a key from the outside could not be released from the inside. The Acting Manager has now confirmed that these locks have been removed. One of the baths was in very poor condition with enamel being very corroded. The bath is an ordinary domestic bath with no aids or adaptations making it unsuitable for the needs of the Service Users, this was the only bath located on that floor of the home. A member of Staff advised that a shower, which had a broken frame, was also unsuitable for the needs of Service Users. Linden Manor Care Home D C51 C08 S50670 Linden Manor Care Home V222699 280405 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 Staffing levels and Staff training are insufficient to provide adequate and safe care for Service Users. EVIDENCE: Comment cards received from two relatives/visitors stated that they were satisfied that there are sufficient staff in the home. At the time of the inspection there were 26 Service users in the home with a high proportion having dementia. Staff told Inspectors that 5-6 needed two carers for assistance, 1 was very poorly and being cared for in bed and 5-6 were prone to wandering. At the time of inspection Staffing levels were considered insufficient to meet these needs. On return from lunch on the first inspection visit inspectors found that two Staff were having a lunch break leaving only one member of Staff looking after 26 Service Users. The Staff rota identifies that at times there are only two care staff on duty in the building, given that some Service Users require two Staff for assistance this leaves no staff available to monitor and supervise other Service Users. The potential for risk was highlighted on the second inspection visit when a Service User appeared unaware of the lighted cigarette in his hand and the ash that had fallen into his lap. Staff were also unaware of the potential for a serious accident to occur. Service Users confirmed that Staff treat them well and a visitor commented that Staff were always helpful and nothing seemed to be too much trouble. Linden Manor Care Home D C51 C08 S50670 Linden Manor Care Home V222699 280405 Stage 4.doc Version 1.30 Page 18 The pre-inspection questionnaire submitted includes information about staff training and identifies that only one member of staff has completed a National Vocational Qualification (NVQ). This figure falls far short of the recommended ratio to provide at least 50 of staff who have achieved NVQ level 2 by 2005. A Staff member spoken to acknowledged the importance of training in meeting the needs of Older People and hoped that a course would be arranged. The dementia care training undertaken by staff at present is less than half a days training which is insufficient to give staff a good understanding of how to meet the needs of Service Users with dementia. Linden Manor Care Home D C51 C08 S50670 Linden Manor Care Home V222699 280405 Stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,38 The home needs strong leadership and management to ensure the home is able to meet the needs and protect the health and safety of Service Users who live there. EVIDENCE: A new Manager had been appointed just prior to this inspection. As the application for registration of the Manager is being processed by the Commission for Social Care Inspection the Manager is referred to as the Acting Manager in this report. The home has been without a Registered Manager for some time however Senior Staff with some support from temporary Managers have worked hard to establish care planning systems and maintain the care provided to Service Users. The continuing shortfalls highlight the need for strong leadership and management to ensure that Staff receive the correct guidance, training and support to provide appropriate care and reduce risk for Service Users. Linden Manor Care Home D C51 C08 S50670 Linden Manor Care Home V222699 280405 Stage 4.doc Version 1.30 Page 20 The Pre-inspection questionnaire confirms that relevant safety checks have been carried out which include checks on fire safety equipment, central heating system and the lift. There was no information about legionella checks or checks on electrical wiring. The Acting Manager has confirmed that she has now arranged for these checks to be done. Areas of risk have been highlighted in this report for example the need for staff supervision where vulnerable Service Users are smoking and the assessment and management of Service Users who are at risk of falls. The findings indicate the need for a full review of practices to ensure that the health and safety of Service Users is properly protected. Linden Manor Care Home D C51 C08 S50670 Linden Manor Care Home V222699 280405 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 2 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 2 COMPLAINTS AND PROTECTION 2 x 2 2 x x x 2 STAFFING Standard No Score 27 1 28 2 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 2 x x x x x x 2 Linden Manor Care Home D C51 C08 S50670 Linden Manor Care Home V222699 280405 Stage 4.doc Version 1.30 Page 22 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 3 Regulation 12 (1) (a & b), 14 (1) 12 (1) (a & b) Requirement Timescale for action 15.06.05 2. 7,8 3. 8 4. 10 5. 12 6. 19,20,21,2 4 Privacy locks which would allow access in an emergency must be fitted to all bathroom and toilet doors. 16 (2) Appropriate activities and stimulation must be provided based on individual needs and choices. (Previous timescales of 30.9.04 and 31.12.04 have not been met). 16 (2)(c ), The planned refurbishment 23(2) programme which includes (c,d) replacement of carpets, curtains, furniture and bathroom fittings D C51 C08 S50670 Linden Manor Care Home V222699 280405 Stage 4.doc 12 (1) (a & b),17 (1) (a) schedule 3.3 (m) 12 (4) (a) A thorough assessment must be carried out prior to the admission of all service users and any discrepancies in information clarified. Up to date care plans must must 15.07.05 be in place which cover all areas of care needs including health care needs and have specific information regarding the individual needs and the required actions of the carer. Food and fluid must be provided 15.06.05 to all Service Users at regular intervals and accurate records kept where a risk is identified. 15.06.05 15.07.05 30.07.05 Linden Manor Care Home Version 1.30 Page 23 7. 8. 9. 20 20 24 10. 11. 26 27 12. 28 with suitable adaptations must be completed. 23 (2) (g) Sufficient dining furniture must be provided for Service Users. 12 (1) (a Smoke free lounge and dining & b), 13 space must be provided for (4) (c ) Service Users. 12 (4) (a) Service Users rooms must be 13 (4) (c ) fitted with locks which are suited to their capabilities and are accessible to staff in an emergency. 12 (4) Bins for the disposal of used (a), 16 continence pads must have lids. (2) (k) 12 (1) (a Staffing levels must be increased & b) 18 to meet the needs of Service (1) (a) Users throughout the twenty four hour period. 12 (1) (a A review of Staff training must & b) 18 be carried out and training (1) (a),18 provided to meet identified )1) (c ) (i) shortfalls. This must include National Vocational Qualification training and dementia care training. 30.07.05 15.06.05 30.07.05 15.06.05 15.06.05 30.07.05 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 8 8 Good Practice Recommendations A review of opportunities for physical activity and movement should be carried out and individual arrangements incorporated within the care plan. Records should be put in place of the times and findings of checks made on a Service User following an accident. Linden Manor Care Home D C51 C08 S50670 Linden Manor Care Home V222699 280405 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Northamptonshire Office Newland House, First Floor Campbell Square Northants, NN1 3EB 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 Linden Manor Care Home D C51 C08 S50670 Linden Manor Care Home V222699 280405 Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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