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Inspection on 02/11/07 for Lodge The Residential Care Home

Also see our care home review for Lodge The Residential Care Home for more information

This inspection was carried out on 2nd November 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

A varied menu with a good choice of food is available. Visitors are encouraged and made welcome. This supports people to maintain contact with their family and friends. One survey said " Always a smile and a nice word, makes visitors welcome". The manager from the home visits service users before they move in, she finds out about the kind of support the person might need. This helps the home decide whether they have the right knowledge and experience to be able to care for the person properly and safely.

What has improved since the last inspection?

There have been some major redecoration and refurbishment to some bedrooms and communal areas and a new garden feature installed. This helps make The Lodge a pleasant and homely place to live.

What the care home could do better:

The privacy and dignity of some people is compromised relating to the management of incontinence and how people are helped at mealtimes are compromised. Managers need to review these care practices to achieve a better standard of service for people. Improvements need to be made in getting staff to complete NVQ training so that a minimum of 50% of care staff have an NVQ level 2 or equivalent. Higher numbers of care staff achieving NVQ level 2 or above means more staff on each shift have received the training relevant to the work that they do. Further training about up to date dementia care is needed. This ensures that service users receive a service from a better-informed staff team whose practice is up to date. Staff need to provide more opportunities for people to be actively occupied in order for people to have a better more enriched quality of life. Staff could gather and write down more information about people, particularly about their past lives, the routines they have and things that are especially important to them. This will help staff settle people in, reassure them and have a better understanding of people`s behaviour and routines.

CARE HOMES FOR OLDER PEOPLE The Lodge Residential Care Home Heslington York YO10 5DX Lead Inspector Chris Taylor Key Unannounced Inspection 09:00 2 November 2007 nd 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 Lodge The Residential Care Home DS0000038016.V348941.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. Lodge The Residential Care Home DS0000038016.V348941.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Lodge Residential Care Home Address Heslington York YO10 5DX 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) 01904 430781 01904 870430 Colourscape Investments Limited T/A The Lodge Residential Home Mrs Geraldine Ann Timbs Care Home 24 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (24) of places Lodge The Residential Care Home DS0000038016.V348941.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd November 2006 Brief Description of the Service: The Lodge is a care home registered by Colourscape Investment Limited to provide accommodation and personal care to up to twenty-four older people who may have dementia. The company has recently been sold and new directors have been appointed. The home consists of a large, detached, pre-Victorian house with a newer purpose built extension. It is situated in the village of Heslington and is within walking distance of local facilities and amenities including shops, cafes and pubs. The amenities of York city centre are also accessible by transport. Twenty of the rooms for single accommodation, two for shared. None of these rooms has en suite facilities; there are however sufficient bathroom and WC facilities for the residents that are located close to bedrooms as well as ground floor shared rooms including the dining room, lounge and quiet room. Bedrooms are situated on the ground and first floors, the latter being accessed by one of two staircases. The home does not have a passenger lift but one of the staircases has a stair lift. There is ramped access to the home. The home has a large well-maintained garden and there is an area of hard standing for parking to one side of the building. At the last inspection current fees for the home range from £410-£425 per week. The fees do not include the use of services such as hairdressing and chiropody. The inspection report is made available upon enquiry. Lodge The Residential Care Home DS0000038016.V348941.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is what was used to write this report. • • • Information about the home kept by the Commission for Social Care Inspection. Information asked for before the inspection, this is called Annual Quality Assurance Assessment. A visit to the home that was unannounced. This lasted six hours and included talking to staff about their jobs and the training they have completed. Also spending time with people and checking some of the records polices and procedures the home has to keep. Two hours sitting in the lounge with the people who live at The Lodge watching how residents and staff interact. This is to get a picture of peoples well-being and the amount of activity that takes place. This is called a SOFI observation (Short Observation Framework for Inspection). Two surveys received from relatives. Looking at four peoples’ care files in detail. • • • What the service does well: What has improved since the last inspection? Lodge The Residential Care Home DS0000038016.V348941.R01.S.doc Version 5.2 Page 6 There have been some major redecoration and refurbishment to some bedrooms and communal areas and a new garden feature installed. This helps make The Lodge a pleasant and homely place to live. 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. Lodge The Residential Care Home DS0000038016.V348941.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 Lodge The Residential Care Home DS0000038016.V348941.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): Standard 3 People who use this service experience good quality outcomes in this area. Peoples’ needs are properly assessed prior to admission this helps make sure that staff know they will be able to meet peoples’ needs before the person moves in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Usually the manager and another member of staff will visit the prospective service user and complete an assessment to make sure staff at the home will be able to provide a service which will meet the person’s needs. If the person is referred to the home via the local authority then a local authority assessment is provided. As discussed with other members of staff takes place to establish whether the home will be able to meet the persons’ needs. Lodge The Residential Care Home DS0000038016.V348941.R01.S.doc Version 5.2 Page 9 Information gathered as part of the pre admission process is in sufficient detail for staff to know what support is needed and to help the person settle in. Four people’ files were looked which confirmed that pre admission assessments had been undertaken. Lodge The Residential Care Home DS0000038016.V348941.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): Standards 7, 8, 9 and 10 People who use this service receive adequate quality outcomes in this area. The standard of care is compromised by some care practices which affect peoples’ privacy and dignity. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four peoples’ case records were looked at in order to check that a plan had been formulated which helps staff provide support to people according to their needs and wishes. There were forms completed which contained information about the person such as date of birth, GP, next of kin. This was followed with specific documents to record information about the kind of support people needed and included aspects of the person’s life where they could retain some independence and individuality. For instance, it was noted on one person’s care plan the importance to the person that they wore jewellery and make up every day. Generally though there wasn’t sufficient information about people’s Lodge The Residential Care Home DS0000038016.V348941.R01.S.doc Version 5.2 Page 11 interests and social history. This kind of information is particularly useful when supporting people with dementia as it helps settle and reassure people and helps staff understand peoples’ behaviours and routines. Other documents recorded information about areas of risk, specifically with regard to moving and handling and falls. Care plans were reviewed every month using a tick checklist and if changes were needed the care plan was updated. There were some inconsistencies in dating and signing documents. This could mislead the reader about what was most up to date and who had been responsible for recording the information down. Daily records provided a fair picture of how people spend their day and would provide essential information to track any changes people may experience, with ill health. People are registered with the GP of their choice. People said that the GP visited regularly and staff arrange visits if the situation is more urgent. Staff said that District Nurses visited the home every day and that working relationships were good. There was evidence on the care plans looked at that specialist professionals are contacted appropriately, for instance the dietician and occupational therapist. The delivery of personal care is individual and flexible. Discussions with people confirmed this. They said that staff always treat them with respect and ensure their privacy and dignity. Comments heard include “staff are very kind and helpful and always cheerful” and “staff always knock on bedroom doors,” Staff were observed delivering care in a kind and helpful manner. People looked clean and well cared for. Protective pads were placed on chairs in public areas. The deputy explained that these are to protect the furniture from soiling by service users who are incontinent. Using these types of measures to manage incontinence demonstrates a lack of respect for the privacy and dignity of people and disregards the need to provide a discreet service. Medication is stored in a locked trolley. A monitored dosage system is now in use with proper procedures in place for the receipt, storage, administration, recording and return of medicines. It is usual that only senior members of staff administer medication and staff receive accredited medication training before they are permitted to do so. Lunchtime medication administration was observed and this was carried out safely and in a way that ensured people’ s dignity was maintained. A risk assessment is completed which identifies whether a person can take responsibility for looking after his or her own medication or whether the home takes on this responsibility. All four case records looked at had completed risk assessments. Lodge The Residential Care Home DS0000038016.V348941.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15. People who use this service experience adequate outcomes in this area. People have choice about how they spend their days. Better efforts to identify people’s preference and interests would ensure individual’s social, cultural and recreational interests are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The SOFI observation identified a number of issues. During the observation when staff were interacting with people, people were alert and interested. At all other times people were asleep. Because most people have restricted mobility they cannot get up and move about so any engagement in activity has to be within reach. Because of the lay out of the room there is nothing for people to look at or pick up and engage with. The room is long and narrow; chairs are placed next to each other around the walls. There were no tables located next to chairs where magazines, books, photo albums could be placed for people to look at. There was a radio/ CD player in the room but no television. Staff said the difficulties with the layout of the room had been discussed on many occasions and no resolution has been reached. They said that because the room is narrow placing small tables about would restrict the Lodge The Residential Care Home DS0000038016.V348941.R01.S.doc Version 5.2 Page 13 use of walking aids and wheelchairs. In fact small tables were placed close to people when they were given their mid morning coffee but removed again once people had finished. Very few people got up from their chairs independently to go to another room. Staff interaction was kind and courteous but again the layout of the room meant there were no spare chairs for staff to sit alongside people and be involved in a conversation or one to one activity. Most of the contact between staff and service users was task orientated; providing coffee, taking people to the toilet or checking people were ok. The availability of more individual information about people’s social history would also assist staff in engaging with people and provide individual stimulation. Currently staff are not facilitating or providing people with the opportunity for any self-determining stimulation or activity. Some organised group activities are arranged; there is a church service once a month, trips to the shops and local pub. Staff organise bingo and other board games and many of the women enjoy having their nails painted. The hairdresser visits once a week and was at the home on the day of the inspection and it was clearly an important event of the week. However, hairdressing is carried out in a double bedroom occupied by service users. Whilst the hairdresser is at the home these service users are prevented from having any private access to their bedrooms and other service users are using the person’s private bedroom space. Residents’ bedrooms must no be used as a hairdressing salon for everybody else who lives in the home. This is unacceptable and a different location for the hairdresser must be found. Meals are provided in an attractive dining room. Tables were set nicely but people were given coloured plastic beakers to drink their water from. Staff said they were given to prevent breakages. If there is a risk to health and safety then this must only apply to specific individuals not everyone in the home. In such a case then clear plastic beakers would provide a more discreet approach to maintaining the dignity of individuals. A choice of menu was offered for both courses and the meal looked appealing and people enjoyed it. Meals are plated and served by staff. Three people needed physical support to eat their meals. One person had her meal in the sitting room away from everyone. The member of staff giving her food didn’t talk to her to let her know what the food was, whether she was ready for another mouthful or make the occasion a social event. The other two people were being helped with their meals by staff standing up beside them, these staff had to help with serving and clearing away the meal at the same time. This meant people were not given the full attention of staff and by standing up beside the person draws attention to the fact that help is needed. For other people the meal was a relaxed and social occasion. Visitors are encouraged and made welcome. A number were seen in the home at the time of this visit. Lodge The Residential Care Home DS0000038016.V348941.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 People who use this service experience good quality outcomes in this area. A complaints procedure is made available to people and their relatives. There are sufficient effective systems in place to safe guard people from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a complaints procedure which is clearly written and is on display on the residents notice board. There is a system for recording complaints but there have been no complaints received by the home or the Commission for Social Care Inspection. All staff had recently attended abuse awareness training in order to increase their understanding of abuse issues and what to do if they suspected a service user of being abused. A copy of the local authority’s procedure for reporting abuse was available for inspection and its location in the office makes it easy for staff to refer to. Lodge The Residential Care Home DS0000038016.V348941.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26. People who use this service experience good outcomes in this area. People live in a clean, comfortable and safe home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is going through a refurbishment programme and those areas completed provide a bright, attractive and pleasant environment. There are still some improvements to be made, particularly bathroom and toilet areas. A sample of bedrooms were looked at and these were comfortable and personalised. Two of the bedrooms upstairs have French doors out onto a small balcony. It was not apparent whether the glazing in these doors is safety glass and for health and safety reasons this needs confirming. If not then they need fitting with safety glass or safety film. Lodge The Residential Care Home DS0000038016.V348941.R01.S.doc Version 5.2 Page 16 The home has a variety of equipment available to assist with maintaining people’s independence. This is now serviced at the required intervals to ensure the safety of people who use this equipment. Information from surveys confirmed that people always find the home ‘clean and tidy’, ‘fresh and clean’. The home is kept clean so that the risk of people becoming ill from poor hygiene is unlikely. The home was free from offensive smells for the duration of the visit and made the environment pleasant. Hand wash scrub, gloves and aprons are available throughout the home so as to minimise the risk of cross infection from one person to another. The premises are kept clean by domestic staff but also by care staff who have the added responsibility of maintaining toilet areas in a clean, hygienic condition for people. The laundry facilities are adequate and peoples’ clothing looked to be clean and in a good condition. Lodge The Residential Care Home DS0000038016.V348941.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30. People who use this service experience adequate outcomes in this area. Recruitment procedures help ensures that suitable people are employed. Further training would help improve staffs’ skills and knowledge in providing up to date care practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The deputy manager explained the recruitment process. She said that vacant posts were advertised and applicants were asked to complete an application form. Applicants were then given a formal interview. If candidates are successful references are sent for and a Criminal Records Bureau check (CRB) done. The records of the recruitment process were not available because they are only accessible to the manager who was on leave at the time of the visit. However, CRB checks and POVA first (Protection of Vulnerable Adults) checks were available and a discussion was held with the two most recently recruited staff to confirm the recruitment process. The same members of staff were able to discuss their induction programme that they felt was sufficient. Both had worked previously in care settings. They said induction was in the form of a workbook. Staff complete statutory health and safety training during their three month probationary period. Lodge The Residential Care Home DS0000038016.V348941.R01.S.doc Version 5.2 Page 18 The manager has stated in the AQAA document that they are hoping to improve the training staff receive. Particularly formal qualifications such as NVQ’s (National Vocational Qualification). Certainly staff would benefit from further dementia care training and in assisting people with mealtimes. During the inspection there appeared to be enough staff on duty to meet people’s needs. Some discussion with people confirmed this. One person said “ there’s always a member of staff around when I need them” and another said, “ the staff are wonderful, kind and attentive, always enough staff around”. Lodge The Residential Care Home DS0000038016.V348941.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): Standard 31, 33, 35, 36 and 38. People who use this service experience good outcomes in this area. The home is managed in the best interests of people. Further training to up date skills and knowledge would benefit staff and service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has many years experience of managing the home and she has qualified to NVQ level 4 and has obtained the Registered Managers Award. Staff spoke well of her and said that she is supportive and is accessible and available. Lodge The Residential Care Home DS0000038016.V348941.R01.S.doc Version 5.2 Page 20 Staff confirmed that they receive regular supervision and records were seen which confirmed this. Every effort is being made to gather the views of service users. Questionnaires, comment book, residents meetings and there are plans to implement a comment card system which is quick and easy for visitors to fill in. The manager has produced an annual development plan but this hasn’t been shared with service users. The manager needs to consider up dating her dementia care knowledge and cascade this to the staff team to bring up to date some of the practices in the home, in particular supporting people to be active and engaged in self determining activity. Records were seen which confirmed that equipment is maintained; electricity supplies in the home are safe and serviced appropriately. Fire detection and fire fighting equipment is tested and maintained regularly. Staff receive training with regard to all health and safety matters. Lodge The Residential Care Home DS0000038016.V348941.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 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 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 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 3 x 3 x x 3 Lodge The Residential Care Home DS0000038016.V348941.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 OP12 Regulation 12 Requirement More information should be gathered relating to peoples’ social and life histories and their daily and weekly routines. This would help staff understand peoples’ behaviours and routines. Help staff provide reassurance more effectively and consistently. And help staff provide opportunities for service users to be engaged in activity. Arrangements must be made to ensure that the management of incontinence respects service users privacy and dignity. Arrangements must be made that where people require support to feed themselves, this support is provided in a dignified manner. Records required as listed in Schedule 4 must be available for inspection at any time. Timescale for action 02/12/07 2 OP10 12 02/12/07 3. OP10 12 02/12/07 4. OP31 17(3) (b) 02/12/07 Lodge The Residential Care Home DS0000038016.V348941.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. 2. 3 4. 5 6 Refer to Standard OP10 OP10 OP27 OP28 OP30 OP38 Good Practice Recommendations The seat covers placed on service users chairs, as a way of managing incontinence should be removed. The use of a service user’s bedroom for the use of hairdressing should cease and an alternative room identified. Staff must be deployed at mealtimes to ensure that one staff member remains with service users who need help with feeding throughout the meal. The proportion of care staff that have achieved NVQ level 2 or above should be at least 50 so that service users are cared for by a suitably trained workforce. The manager and staff should up date their training in dementia care. Confirmation that the glass in both first floor bedrooms with French windows is safety glass should be sought. Lodge The Residential Care Home DS0000038016.V348941.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Lodge The Residential Care Home DS0000038016.V348941.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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