Inspection on 18/04/07 for Lowmoor Care Home

This inspection was carried out on 18th April 2007.

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

Lowmoor Care Home 30/09/09

Lowmoor Care Home 25/08/09

Lowmoor Care Home 22/07/08

Lowmoor Care Home 25/04/06

Lowmoor Care Home 20/12/05

Lowmoor Care Home 09/08/05

Lowmoor Care Home 03/02/05

Lowmoor Care Home 17/08/04

Lowmoor Care Home 09/02/04

Lowmoor Care Home 02/10/03

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

CARE HOMES FOR OLDER PEOPLE Lowmoor Care Home Lowmoor Road Kirkby In Ashfield Nottinghamshire NG17 7JE Lead Inspector Rehana Rashid Unannounced Inspection 18th April 2007 09:20 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 Lowmoor Care Home DS0000024647.V334204.R02.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. Lowmoor Care Home DS0000024647.V334204.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lowmoor Care Home Address Lowmoor Road Kirkby In Ashfield Nottinghamshire NG17 7JE 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) 01623 752288 01623 752288 Lowmoorcarehome@msn.com Lowmoor Nursing Home (Kirkby) Limited Mr Thiyagraja Govindaraju Care Home 50 Category(ies) of Dementia (50), Mental Disorder, excluding registration, with number learning disability or dementia - over 65 years of of places age (50) Lowmoor Care Home DS0000024647.V334204.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th April 2006 Brief Description of the Service: Lowmoor is a privately run, purpose built two storey 50 bedded care home for people with dementia and mental heath needs. Qualified nursing care is provided throughout the 24-hour period. The home is situated in a semi residential area within half a mile of local amenities and the town centre of Kirkby-in-Ashfield. It can accommodate up to 50 people, in 40 single bedrooms, 10 of which are en-suite and there are 5 double bedrooms. The home has an enclosed garden and a car park for visitors and staff. There is a passenger lift to the first floor. There are lounges on the ground and first floor. Bathrooms are fitted with adapted facilities. Information about the service is provided in the statement of purpose and service user guide. The current range of fees are between £326 to £351 per week, as specified in the pre-inspection questionnaire by the registered manager. There are additional costs for hairdressing and chiropody. Lowmoor Care Home DS0000024647.V334204.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which was conducted on 18 April 2007. The inspection took approximately six and half hours. The main method of inspection was case tracking, which involved selecting four residents and examining their care records. Case tracking is used to establish if the needs of the residents are being appropriately assessed by the home and their needs are being catered for. Indirect and direct observation of practice and interaction between staff and residents was also carried out as part of the inspection methodology. The communal areas, shower room, bathrooms, kitchen, four bedrooms and gardens were viewed during this site visit. Documentation including health and safety records were also examined. Three members of staff were spoken with and three staff files were examined. Three residents and one relative were spoken with. Prior to the inspection a pre-inspection questionnaire was sent out toLowmoor Care Home, which asked questions around the service including staffing levels and number of service users. The pre-inspection questionnaire, which was returned to the Commission for Social by the registered manager, was used within this inspection report Surveys were sent out to service users and their relative’s representatives and advocates to gain their views about the service received. Fourteen surveys from service users and four completed surveys from residents, relatives and their representatives were received by the Commission for Social Care Inspection. On the day of the inspection there were thirty eight residents in residence. The registered manager supplied much of the information provided for the inspection. What the service does well: Resident’s benefit from an environment, which provides specialist equipment such as hoists. Bedrooms viewed by the inspector were clean and personalised. Staff were observed to be respectful towards the residents. Lowmoor Care Home DS0000024647.V334204.R02.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Following this inspection nine requirements have been set. One requirement remains outstanding from the last key inspection. The registered manager must ensure that the needs of all prospective residents are assessed prior to them moving to the home. This will ensure that identified needs can be met by the home. The registered person must ensure care plans are reviewed at least once a month and updated to reflect changing needs. The registered person must ensure all staff receive training in safeguarding adults. Also for all staff to receive annual updates to ensure that they are aware of updates and best practice. This will ensure service users are safeguarded from abuse. The registered person must ensure that personal creams and any prescribed medications/shampoo of service users are not left in bathrooms or used for anyone other than for the person it is prescribed for. The registered person shall make suitable arrangements to ensure the care home is conducted in a manner, which respects the privacy and dignity of residents. The registered person must ensure that there are accessible toilets for service users. The registered person must look at alternative methods of entry to these facilities and find alternative means of preventing flooding. The registered manager must ensure that new staff do not commence work in the home until all the necessary recruitment checks have been carried out which include Protection Of Vulnerable Adults (POVA) first check and a satisfactory Criminal Records Bureau (CRB) disclosure. This is to ensure the protection of service users from harm. The registered person should ensure that a training matrix or plan for all staff must be produced, which will identify when individual staff members will receive training, including mandatory training – for example moving & handling, fire, safeguarding adults, and records kept to show that staff have received the necessary basic training, and where appropriate annual updates. Lowmoor Care Home DS0000024647.V334204.R02.S.doc Version 5.2 Page 7 The registered person must ensure that resident’s personal finances are maintained individually and are not used to supplement other residents. This remains outstanding from the last inspection 25 April 2006. 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. Lowmoor Care Home DS0000024647.V334204.R02.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lowmoor Care Home DS0000024647.V334204.R02.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents needs are not always assessed prior to them moving to the home. Lowmoor Care home does not offer intermediate care. EVIDENCE: Four residents care files were examined. The files viewed contained assessments completed by Social Services identifying the specific needs of prospective residents. Two of the files contained basic in-house preadmissions assessments. This supported that prospective residents, were assessed prior to them moving into the home. The other two files did not contain preadmissions assessments. Lowmoor Care Home DS0000024647.V334204.R02.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans identifying individual needs are in place, but these are not reviewed regularly. Arrangements for handling medication are satisfactory. Service users right to privacy is not maintained. EVIDENCE: Four care plans were viewed. These generally detailed the needs of the residents, with a basic action plan for care staff. Care plans and risk assessments have been completed for the four residents case tracked. One residents care plan has not reviewed frequently. The resident’s files viewed at the inspection did include some healthcare information. There was some evidence of health promotion relating to check ups with health care professionals such as the GP and Chiropodist. Resident care files also contained details of resident’s nutritional needs including weight charts. Following the last key inspection April 2006 there has been some improvements in medication management. Medication that cannot be placed in the medication trolley during the medication round is no longer left on top of Lowmoor Care Home DS0000024647.V334204.R02.S.doc Version 5.2 Page 11 the medication trolley. This is now stored in a box and kept locked, this practice was observed at the inspection. Policies and procedures were in place with regards to the administration of medication. During the inspection staff interactions was observed between staff and residents this was positive. Three residents spoken with stated that staff knocked on doors before entering. One relative who was visiting Lowmoor Care Home on the day of the inspection, stated that staff ensured his relatives privacy and dignity is maintained. During a partial tour of the building it was observed that the toilets, bath and shower rooms were fitted with bolts from the outside. The registered manager stated this was necessary to prevent residents entering these facilities without supervision. As in the past some residents have caused flooding. This practice does not promote resident’s privacy and dignity. The registered person must make suitable arrangements to ensure the care home is conducted in a manner, which respects the privacy and dignity of all residents regarding all aspects of daily living. Where resident’s bedroom doors have been fitted with stair gates, this practice should ensure that the resident’s privacy and dignity is maintained. Consultation with residents, relatives and representatives must take place when the registered person feels it is appropriate to fit stair gates. The registered manager must ensure where possible they obtain written consent from the resident who has a stair gate fitted to their bedroom door. It is recognised that in some cases residents may not be able to give consent, so it is necessary this is obtained from the residents relative or representative. Lowmoor Care Home DS0000024647.V334204.R02.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 adequate. This judgement has been made Residents are using available evidence including a visit to this service. supported to access some daily activities, parts of the local community and maintain contact with family and friends. Lowmoor Care Home provides its residents with a wholesome diet. EVIDENCE: Service users were observed sitting around in the communal areas for a long period of time. During the morning some service users were observed in the main lounge taking part in a soft ball game. One relative and two residents spoken with confirmed that social activities organised by the staff included bingo. The relative commented staff have organised day trips where residents are able to go into the community. Another resident said that there was not enough to do, but did not want to see anything change. Three service users were spoken with about family visits, all said that they had regular visits from their family members. One relatives spoken with confirmed that they are able to maintain contact with their relative and there are no restrictions regarding visiting. When asked in the survey for relatives what the home does well a relative wrote, “Made to feel welcome when people visit.” Lowmoor Care Home DS0000024647.V334204.R02.S.doc Version 5.2 Page 13 Residents spoken with commented positively on the quality of food and stated that they get plenty to eat. Records are kept by the cook regarding food preparation and storage. Comments in another relatives survey stated, “they have the best cooks.” Lowmoor Care Home DS0000024647.V334204.R02.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 adequate. This judgement has been made using available evidence including a visit to this service. The home has policies and procedures for dealing with complaints and adult protection issues. Residents at Lowmoor Care home are not fully protected from abuse, and are potentially at risk from harm. EVIDENCE: Records of complaints received were recorded in a book. Since the last inspection Lowmoor Care Home have received one complaint directly, the records showed that this had been resolved satisfactorily. The Commission for Social Care Inspection received two anonymous complaints, which were investigated by the home and upheld. Discussions with the residents indicated that they were clear who to talk to if they wished to complain. A copy of the complaints procedure was on the notice board and a copy enclosed in the statement of purpose. Three members of staff spoken with demonstrated an understanding of the whistle blowing procedures and what action to take should they suspect an allegation of abuse. Two members of staff stated that they had attended training in adult protection. One staff member stated that the care assistants are still waiting to attending this training. Training records viewed showed that qualified nurses and senior carers have received training in protecting vulnerable adults from abuse. All staff employed by the home must receive training in Lowmoor Care Home DS0000024647.V334204.R02.S.doc Version 5.2 Page 15 safeguarding adults this will ensure residents are safeguarded from all forms of abuse. Lowmoor Care Home DS0000024647.V334204.R02.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Lowmoor care was generally clean at the time of this inspection. The home is not fully maintained to the benefit of the residents. EVIDENCE: A partial tour of the premises was undertaken. Bedrooms viewed were clean and comfortably furnished. The refurbishment program for 2007 was viewed; maintenance work is planned including redecorating some bedrooms. The communal lounge area was clean and spacious. During the partial tour of the building it was observed that toilet, shower, bath room facilities on the first floor were fitted with bolts to the outside of the doors. The registered manager stated these were in place as some residents in the past have caused flooding by leaving taps running. The registered person must ensure that there are accessible toilets for service users. They should also consider looking at different methods of entry to these facilities and find alternative means of preventing flooding; the current arrangements in place are not adequate. Lowmoor Care Home DS0000024647.V334204.R02.S.doc Version 5.2 Page 17 There was Emollient Cream in a bathroom with a prescription label on it. Staff should ensure that once they have used the prescription creams to store them appropriately and safely. Lowmoor Care Home was generally clean and free from mal-odours. Three residents and one relative spoken with stated that the home was clean. A comment written in the survey for relatives, carers and advocates stated that “the home is always clean.” Lowmoor Care Home DS0000024647.V334204.R02.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The procedures for the recruitment of staff are not adequate and do not fully protect residents living at the home. Staff at Lowmoor are not adequately trained. EVIDENCE: The staff rota provided evidence that there are sufficient staff on duty to meet the current needs of the thirty-eight residents at Lowmoor Care home. Staff spoken with that the current staffing levels are adequate. They also expressed that if the needs of the residents change or if there are more admissions the staffing level will need to be re-assessed. One relative spoken with stated that there are usually sufficient numbers of staff on duty. Comments written in the survey for relatives, carers and advocates when asked if care staff have the right skills and experience to look after residents included “this depends how long the carers stay in the job, there appears to be a fast turn over of the carers.” Three staff files were viewed which evidenced that recruitment practices at the home must be more robust offering protection to the residents. Two files viewed showed that a Criminal Records Bureau (CRB) check was in place after the staff members had commenced employment. No evidence was seen to confirm that a Protection Of Vulnerable Adults (POVA) check had been carried out prior to the three members of staff commencing employment. The registered manager must ensure that new staff do not commence work in the Lowmoor Care Home DS0000024647.V334204.R02.S.doc Version 5.2 Page 19 home until all the necessary recruitment checks have been carried out which include POVA first check and a satisfactory CRB disclosure. A review of staff training records showed that not all of member’s staff had received training in all mandatory areas. There was no evidence of annual updates to ensure that staff were aware of the latest best practice. The registered person should ensure that a training matrix or plan for all staff is produced, which will identify when individual staff members will receive training, including mandatory training including safeguarding adults, and records kept to show that staff have received the necessary basic training, and where appropriate annual updates. Lowmoor Care Home DS0000024647.V334204.R02.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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. This judgement has been made using available evidence including a visit to this service. Some improvements are required to ensure the home is fully run in the best interest of residents. Resident’s financial interests are not safeguarded. Some aspects around the health, safety and welfare of residents and staff are not fully promoted and protected. EVIDENCE: The registered manager at Lowmoor Care Home is a registered nurse, with experience of working with people with Dementia. Three staff members spoken with commented that the registered manager is supportive. A comment from the Survey for relatives, carers and advocates included “ I feel that the manager and the staff always help you, if you have a problem.” Lowmoor Care home have a quality assurance system in place. No completed questionnaires from residents were seen; three questionnaires completed by relatives were seen. The feedback was generally positive. Lowmoor Care Home DS0000024647.V334204.R02.S.doc Version 5.2 Page 21 Resident’s finances are maintained in a joint account at a local bank. Resident’s monies received from relatives or representatives by cheque or cash are pooled all together into this account. The home maintains individual records. Receipts for amounts spent are kept for a period of time and then handed over to the resident’s relative or representative. These records showed that some residents were not in credit within the joint account this is in essence loaning money from one resident to another. Despite a requirement being set at the last key inspection April 2006 regarding residents finances this remains outstanding, the registered person must take appropriate action to address this issue. Three staff members spoken with stated that they are supported by the manager and receive supervision. No record of supervision was seen on staff files. A range of records relating to health and safety were examined. Records for equipment servicing for the hoist and lift and other health and safety records including portable appliances testing were observed and were found to be carried out at the required intervals. Lowmoor Care Home DS0000024647.V334204.R02.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 1 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 2 2 X 2 X X X X 2 STAFFING Standard No Score 27 2 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 1 2 X 2 Lowmoor Care Home DS0000024647.V334204.R02.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14 Requirement The registered manager must ensure that the needs of all prospective residents are assessed prior to them moving to the home. This will ensure that identified needs can be met by the home. The registered person must ensure all care plans are reviewed and updated to reflect changing needs in respect of service users health and welfare. The registered person shall make suitable arrangements to ensure the care home is conducted in a manner, which respects the privacy and dignity of residents. The registered manager should as far as possible obtain and take into account service users wishes and views when making provision of care. Written consent to be obtained where stair gates are fitted. The registered person must ensure all staff receive training in safeguarding adults. Also for all staff to receive annual updates to ensure that they are DS0000024647.V334204.R02.S.doc Timescale for action 18/05/07 2. OP7 15 18/05/07 3. OP10 12 (4) 17/05/07 4. OP10 12 30/05/07 5. OP18 13(6) 31/07/07 Lowmoor Care Home Version 5.2 Page 24 6. OP21 23 (2) (n) 7. OP26 12, 13, 14, 16 8. OP29 19 9. OP30 18 10. OP35 20 aware of updates and best practice. This will ensure service users are safeguarded from all abuse. The registered person must ensure that there are accessible toilets for service users. The registered person must look at alternative methods of entry to these facilities and find alternative means of preventing flooding. The registered person must ensure the personal creams and any prescribed medications/shampoo of service users is not left in bathrooms or used for anyone other than for the person it is prescribed for. The registered manager must ensure that new staff do not commence work in the home until all the necessary recruitment checks have been carried out which include POVA first check and a satisfactory CRB disclosure. This is to ensure the protection of service users from harm. The registered person should ensure that a training matrix or plan for all staff must be produced, which will identify when individual staff members will receive training, including mandatory training – for example moving & handling, fire, safeguarding adults, and records kept to show that staff have received the necessary basic training, and where appropriate annual updates. The registered person must ensure that resident’s personal finances are maintained individually and are not used to supplement other residents. This remains outstanding DS0000024647.V334204.R02.S.doc 17/05/07 17/05/07 30/04/07 30/08/07 17/05/07 Lowmoor Care Home Version 5.2 Page 25 from the last inspection 25 April 2006. 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 OP12 OP18 Good Practice Recommendations Training in specialist activities, dementia mapping be considered. The registered person should review the whistle blowing policy to reflect the procedures outlined in the Nottinghamshire Committee For The Protection Of Vulnerable Adults (NCPVA) policy. The registered person should ensure that service users have specialist equipment they require to maximise their independence by using signage. The registered person should consider using signage, to assist the needs of the service users taking account of their cognitive impairment. The registered manager should ensure results of service user surveys are published and made available to current and prospective service users and the Commission for Social Care Inspection. 3. OP22 4. OP33 Lowmoor Care Home DS0000024647.V334204.R02.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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