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Inspection on 03/11/06 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 3rd November 2006.

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

Service users receive a high standard of care, look well kempt and are treated with dignity and respect. The home benefits from an experienced manager who has worked at the home for several years and knows the residents well. Prospective service users are visited prior to coming to live at the home so that the staff are confident that they can meet their needs and know what help they will need as soon as they arrive. The home promotes independence and allows people to make choices and exercise as much control over their lives as is practically possible.

What has improved since the last inspection?

Staff members feel that the home has become a `nicer and happier` place of late and the improvement in morale is evident in the delivery of care to service users. Previous conflicts between senior people within the company have been resolved and the residents now enjoy a calmer, more pleasant atmosphere. Refurbishments and repairs that have been carried out since the last inspection mean that service users live in a home, which is now much safer and cleaner. The opinions of service users and family members are being sought in order to get feedback about the service, which the manager and provider can then address in order to continue to improve the quality of life for service users.

What the care home could do better:

All equipment must have regular maintenance checks to ensure it is safe to use. Medication records must be accurate so that it is clear who received what medication, at what time, and who gave it. All new employees must be properly checked for their suitability to care for vulnerable people before starting work at the home. The very low temperature of the kitchen needs to be regulated in order to be a healthier environment in which for staff to work. This would help prevent sickness and low staffing levels which could have an impact on service users. The smell of cigarette smoke should be addressed as could be offensive to some service users.

CARE HOMES FOR OLDER PEOPLE Lodge The Residential Care Home Heslington York YO10 5DX Lead Inspector Donna Burnett Key Unannounced Inspection 3rd November 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Lodge The Residential Care Home DS0000038016.V314900.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.V314900.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lodge The 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.V314900.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th May 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 twenty-two rooms are for single accommodation, two are for shared accommodation. 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. The 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. Lodge The Residential Care Home DS0000038016.V314900.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out by one inspector. Four hours were spent preparing for the visit and seven hours were spent at the home talking to service users, staff and visitors, observing the day to day running of the home and looking at a selection of records and paperwork. Prior to the visit to the home, a pre-inspection questionnaire was completed by the manager and returned to the Commission for Social Care Inspection. The information provided was used to help plan the inspection. The inspection was carried out due to problems within the management team earlier this year, which had resulted in unrest and some concern for the people living at the home. Since the last inspection, new directors of the company have been appointed and the Commission for Social Care Inspection has not had any further concerns brought to its attention. Four GP’s were sent comment cards and ten members of staff were sent surveys. Comments and feedback are included in the main body of the report. Several requirements were made at the last inspection due to shortfalls, which compromised the health, safety and wellbeing of service users. These were checked to make sure the improvements had been made. What the service does well: What has improved since the last inspection? Staff members feel that the home has become a ‘nicer and happier’ place of late and the improvement in morale is evident in the delivery of care to service users. Lodge The Residential Care Home DS0000038016.V314900.R01.S.doc Version 5.2 Page 6 Previous conflicts between senior people within the company have been resolved and the residents now enjoy a calmer, more pleasant atmosphere. Refurbishments and repairs that have been carried out since the last inspection mean that service users live in a home, which is now much safer and cleaner. The opinions of service users and family members are being sought in order to get feedback about the service, which the manager and provider can then address in order to continue to improve the quality of life for service users. 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.V314900.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.V314900.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): 1 & 3. Quality in this outcome area is good. Detailed pre-admission assessments ensure that no one is admitted whose needs cannot be met. This judgement has been made using available evidence including a visit to this service EVIDENCE: The home has updated its statement of purpose, which sets out its aims and objectives, philosophy of care, terms and conditions and the range of facilities and services on offer to people living at the home. This allows prospective service users to make an informed choice about where they want to live and know what to expect. The registered manager, along with another member of staff, visits all prospective service users prior to being offered a placement at the home. After the assessment, the manager talks to the staff team before deciding whether or not the home is able to meet that persons specific care needs. Where appropriate, some service users also have a copy of their Social Services assessment on file so that the care staff are well informed about the needs of the people they care for. Written assessments were evident in each service Lodge The Residential Care Home DS0000038016.V314900.R01.S.doc Version 5.2 Page 9 user’s file looked at and were in enough detail for care staff to know what help to give and what that person could or could not do for their self. Care records looked at confirmed that the staff team were giving the necessary care and support. The home does not offer an intermediate care service. Lodge The Residential Care Home DS0000038016.V314900.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is adequate. Service users receive a good standard of care but are at risk of harm from unsafe practices related to the administration of medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service user plans looked at were clear in describing what each person’s health, personal and social care needs were and how they were to be met. The plans were regularly reviewed to take into account the changing needs of the service users and there was evidence that other professionals were being consulted with in order to meet the needs of person as a ‘whole.’ GP’s who returned comment cards described the quality of care as ‘excellent’ and gave positive feedback about the service. They felt that staff demonstrated a clear understanding of service users care needs and were responsive when specialist advice was given. The home has good contacts with a variety of health care professionals including the continence nurse, district nurses, chiropodist and optometrist. This ensures that service users health Lodge The Residential Care Home DS0000038016.V314900.R01.S.doc Version 5.2 Page 11 care needs are properly assessed and they receive any help they might be entitled to. Some care staff had received training in preserving peoples dignity after death. Good records of medicines received and leaving the home were inspected, which minimised the risk of mishandling. Not all controlled drugs were recorded in the same way, however, which was poor practice and could lead to confusion and errors among the staff. Medicines were safely stored although the controlled drugs cupboard was also being used to store money. Whilst this does not have any obvious negative impact on the service users it is not seen as good practice. The person in charge of a shift does not always have access to all the cupboards in which medication is stored. This means that there is a risk that service users may not get their prescribed medication, especially if it prescribed on an ‘as required’ basis. Some medication records looked at were inaccurate as often the member of staff who actually gave the medication to service users was not the same person who removed the tablet from its container. This puts service users at risk from medication errors as the person giving the medication cannot always be certain what it is they are actually giving. Staff were observed providing support in a kind and helpful manner. Service users looked clean and well cared for as did their clothing and footwear. Several ladies were also wearing items of jewellery, which further enhanced their dignity and individuality. Lodge The Residential Care Home DS0000038016.V314900.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): 12, 13, 14 & 15. Quality in this outcome area is good. The home allows service users to maximise their independence and maintain as much control over their lives as is reasonably possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A list of activities and equipment available to service users was observed during the visit to the home. Whilst the majority of service users were not being engaged in specific activity, one female service user was having her nails painted and a few other people were reading. Two service users spoken to were in receipt of newspapers and magazines of their choice. The manager stated that recreational activities are available such as outings into York or to the local pub. The hairdresser was visiting the home during the inspection and several service users seemed to be enjoying having their hair done. Two relatives were spoken to and two GP’s returned comment cards as part of the inspection. They all felt able to visit in private and felt that they were kept informed and consulted with as and when appropriate Lodge The Residential Care Home DS0000038016.V314900.R01.S.doc Version 5.2 Page 13 There was good evidence of service users exercising their right to choose what they wanted to eat, when they wanted to get up, how often they bathed and where and how they wanted to spend their time. Service users were clearly being encouraged and supported to maintain their independence. One service user spoken to said there was ‘usually a fair choice’ of food on offer. Choices and preferences were also recorded in care records to give care staff a better understanding of that person. Following the previous inspection the home now offers a non-meat alternative should service users choose not to eat meat. The dining area provided a pleasant environment in which to enjoy lunch. Service users were being offered a choice of meals and were being assisted sensitively and discreetly in order to maintain their dignity and independence. Comments about the food ranged from ‘not bad’ to ‘very nice’. Lodge The Residential Care Home DS0000038016.V314900.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): 16 & 18. Quality in this outcome area is good. There is a system for dealing with complaints so that service users and their families can make a complaint and know how it will be dealt with. Relevant training provides staff with the necessary skills to protect service users from risk of harm through abuse or neglect. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure has been updated since the last inspection and is clearly written, accessible and on display on the ‘residents notice board’. The system of recording complaints was looked at although there have not been any complaints made to the home since the last inspection. Service users and relatives who were spoken to felt able to talk to the manager about any concerns they might have and seemed confident that they would be listened to and taken seriously. 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.V314900.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): 19, 22 & 26. Quality in this outcome area is good. Service users live in a clean and comfortable home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Several requirements were made following the last inspection due to issues about the general environment, which made it unpleasant and potentially unsafe for service users. All of these issues have since been addressed and the home is continuing to undergo a period of refurbishment in order to continue to provide a more pleasant environment for people to live in. The home has regular visits from both fire and environmental health officers to ensure compliance with fire and health and safety regulations. The manager was able to show that improvements had been made in order to safeguard service users following the last environmental health inspection. The kitchen was very cold and a member of the kitchen staff attributed her recent period of sickness to the low temperatures in which she was working. Lodge The Residential Care Home DS0000038016.V314900.R01.S.doc Version 5.2 Page 16 Whilst service users do not use the kitchen, and it is arguable what effect this has on them, the low temperatures have the potential to cause sickness and low staffing levels could impact on how responsive the staff become to service users needs. During this inspection it was noted that a smell of cigarette smoke was prevalent to some ground floor areas of the home. The home does permit service users to exercise their right to smoke but a system should be put into place so that the smell of smoke does not become unpleasant for other service users. Communal areas are comfortably furnished and decorated to a reasonable standard. There are additional sitting areas around the home where service users can get away from others without having to go to their bedrooms. One service user said the home had ‘nice rooms’ and were ‘quite comfortable.’ One GP who returned a comment card described ‘a nice friendly environment’. The home has a variety of equipment available to assist with maintaining service users independence. The equipment looked at was discreet, clean and did not detract from homely environment. However, some of the equipment had not had regular maintenance checks and service users are at risk of being harmed by equipment that has not been checked for its safe use. 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 service users. The laundry facilities are adequate and service users clothing looked to be clean and in a good condition. Lodge The Residential Care Home DS0000038016.V314900.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): 27, 28, 29 & 30. Quality in this outcome area is adequate. Despite some poor recruitment practices, service users are cared for by competent, suitable staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Throughout the inspection there appeared to be sufficient staff on duty to meet the needs of the service users and keep the home clean and tidy. A relative said that the home seemed to be ‘quite well staffed’ and the GP’s who returned comment cards were always able to talk to someone senior when they visited. The number of care staff who hold a formal qualification in care is low but several staff have many years of experience. Agency staff are not used so that service users are cared for by the same, regular team of carers who know them well. Two care staff that returned surveys described staff at the home as ‘fully trained’ and ‘the quality of care’ as ‘excellent’. One service user described the staff as ‘approachable and friendly.’ A relative said the staff were ‘very caring’. Four staff files were looked at. Application forms and references were available for all newly recruited staff. The staff members whose files were looked at had not had Criminal Records Bureau checks completed before they started work at Lodge The Residential Care Home DS0000038016.V314900.R01.S.doc Version 5.2 Page 18 the home. This is poor, unsafe practice, which places service users at risk of being cared for by potentially unsuitable people. New staff receive induction training that ensures they are given the right information to be able to do their jobs well. One member of staff spoken to who had no previous experience of working with this type of client group was provided with additional training to be able to understand the needs of the service users better. Records were available for inspection that showed that staff had recently undergone training relevant to the needs of the service users. The manager was able to talk about training that some care staff had received in preserving peoples dignity after death. Lodge The Residential Care Home DS0000038016.V314900.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. Quality in this outcome area is adequate. Quality of care is very good but shortfalls in equipment checks, the recruitment of staff and the administration of medication have the potential to put service users at risk of harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager of the home is suitably skilled and trained to run the home in the best interests of the service users having managed the home for several years and had appropriate training. Previous conflict between senior people in the company has been resolved which has lead to better staff morale, which in turn has had a positive impact for service users. One staff member commented that the senior staff and the provider were ‘approachable.’ Lodge The Residential Care Home DS0000038016.V314900.R01.S.doc Version 5.2 Page 20 At the last inspection it was felt that little was being done to get the views of service users and their families about the service. During this inspection, it was evident through questionnaires that had been both sent out and left around the home for completion, that active feedback on people’s thoughts about the home was being sought. The manager was also considering other ways of gathering comments and ideas such as a suggestions box and comments book in order to continue to improve the service for people living at the home. Personal monies were being held on behalf of the majority of service users. Monies deposited and withdrawn from individually named wallets were accounted for and a random check of money tallied with the records. Information supplied by the manager on a pre-inspection questionnaire gave information of dates when various maintenance checks had last been carried out in order to maintain the health and safety of service users. During the inspection, several records were checked at random and most were found to be in order and up to date. However, as mentioned under ‘environment’, some essential equipment had not had maintenance checks carried out for some time and was a potential hazard for service users. Some service users whose files were looked at required the use of manual handling equipment to assist them with various activities of daily living. Clearly written assessments explained to care staff what equipment to use and the risks associated with its use so that they could help people in the safest way possible. The selection of training records looked at showed that those staff had undergone training to ensure safe working practices when caring for service users. Fire notices were evident throughout the home advising people what to do in the event of a fire and the staff notice board provided further information for staff to refer to in order to ensure the safety of service users. The kitchen was inspected and the catering staff that were spoken to showed good knowledge of food safety and hygiene to prevent the risk of service users coming to harm from incorrectly stored or cooked food. Substances hazardous to health were stored correctly and could not be accessed or accidentally ingested by service users. Random checks of some records, and information supplied by the manager prior to the inspection, evidenced compliance with legislation intended to safeguard service users. Lodge The Residential Care Home DS0000038016.V314900.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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 2 X X X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Lodge The Residential Care Home DS0000038016.V314900.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 OP9 Regulation 12(1)(a) 13(1)(b) 13(2) 13(4)(c) 17(1)(a) Schedule 3(3)(i) Requirement The person in charge at any given time must be able to give service users the medication they are prescribed as it is required. That person must know what medication it is they are giving and they alone must sign the medication chart so that the chart is a clear record of what medication has been given and by whom. Equipment provided for use by service users must be maintained in good working order, checked every six months by a competent person and records kept to verify as such. All prospective employees must be checked with the Criminal Records Bureau for their suitability to work at a care home before being deployed to deliver care. Safe systems of administrating medication and legally required equipment checks must be DS0000038016.V314900.R01.S.doc Timescale for action 10/11/06 2. OP22 23(2)(c) 03/02/07 3. OP29 19 Schedule 2 (7)(a) 03/02/07 4. OP38 12(1)(a) 13(1)(b) 13(2) 03/02/07 Lodge The Residential Care Home Version 5.2 Page 23 13(4)(c) 17(1)(a) Schedule 3(3)(i) 23(2)(c) carried out to ensure the health, safety and welfare of service users. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations In accordance with pharmaceutical guidelines, the controlled drugs cupboard should only be used to store controlled drugs and nothing else. The smell of cigarette smoke should be dealt with as could be offensive to some service users. 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. 2. 3. OP19 OP28 Lodge The Residential Care Home DS0000038016.V314900.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.V314900.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!