Inspection on 27/02/09 for Lyndhurst Lodge

This inspection was carried out on 27th February 2009.

CSCI found this care home to be providing an Adequate service.

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

Lyndhurst Lodge 28/01/08

Lyndhurst Lodge 18/08/06

Lyndhurst Lodge 05/10/05

Lyndhurst Lodge 23/06/05

Lyndhurst Lodge 02/11/04

Lyndhurst Lodge 07/04/04

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London Road Neurological and Specialist Care Unit

Carlton Care Home

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St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

CARE HOMES FOR OLDER PEOPLE Lyndhurst Lodge 87 Burton Road Ashby De La Zouch Leicestershire LE65 2LG Lead Inspector Lesley Allison-White Unannounced Inspection 27th February 2009 09:00 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 Lyndhurst Lodge DS0000001811.V374561.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. Lyndhurst Lodge DS0000001811.V374561.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lyndhurst Lodge Address 87 Burton Road Ashby De La Zouch Leicestershire LE65 2LG 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) 01530 563007 01530 831779 Mr Keith Halliwell Mrs Irene Anita Keevins Mr Keith Halliwell Care Home 19 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (6), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (6), Old age, not falling within any other category (19) Lyndhurst Lodge DS0000001811.V374561.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service user numbers. No person falling within category MD(E) or DE(E) may be admitted to the home when 6 persons in total of these categories/combined categories are already accommodated within the home. 28th January 2008 Date of last inspection Brief Description of the Service: Lyndhurst Lodge is a 19-bedded residential home for older people, some of whom have a mental disorder or dementia. It is situated close to the centre of Ashby de la Zouch. The home was originally a large private house. The home has bedrooms on the ground and first floor. Access to the first floor is via the stairs or a shaft lift. The home has two large lounges, one of which is also used as a dining area, and an enclosed garden, which provides a safe place for residents to sit and walk in. The home is on a main bus route and has car parking available. Parking is available to the back of the building off Churchill Street. Fee £357.00 per week. The Statement of Purpose and Service User Guide (information about the service provided) is readily available in the reception area. A copy of the Commission of Social Care Inspection (CSCI) certificate and the Employers certificate is displayed in the hallway. A copy of the CSCI report is available on request from the office. Lyndhurst Lodge DS0000001811.V374561.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is on outcomes for individuals who live at the home and their views of the service provided. The home provides care for up to nineteen people. On the two days of inspection there were seventeen people living at the home, one person was in hospital. Preparation included examining inspection records and looking at the service history and annual quality assurance record (AQQA). This is information sent into CSCI when requested about the service that is provided at Lyndhurst Lodge. This Key inspection started by looking at the last requirements that were made in 28/01/2008 and to check compliance with them. None of them were met. Code B notices was served to progress compliance by the responsible individual (owner). Further requirements were also made. This inspection was completed over two days. A discussion was held with four people who lived there. The primary method of inspection used was “case tracking”. This involved speaking with or observing the people who use the service provided, looking at two peoples care plans and making observations. Care plans are records about the care or support provided for an individual. The Registered Manager had retired. The senior carer and the owner facilitated the inspection. What the service does well: Lyndhurst Lodge DS0000001811.V374561.R01.S.doc Version 5.2 Page 6 Individuals who spoke with the inspector felt they were well treated by the staff who provided care to them and felt that they lived in a comfortable environment. A questionnaire from the relatives also indicated that they felt the home met the needs of their relative who lived at the home. The felt the staff gave good care, were very approachable and helpful at all times What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Lyndhurst Lodge DS0000001811.V374561.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 Lyndhurst Lodge DS0000001811.V374561.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): Standards 3 and 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. An appropriate admissions process ensures that they can meet the prospective person’s needs before they make the decision to accept the application for admission and offer a placement. EVIDENCE: The Statement Of Purpose and Service Users Guide explains that a trial period is offered to anyone who expresses an interest in staying at the home permanently. Information about the home is found in this document and it is readily available on request and is displayed in the entrance hallway. Two people living at the home were often unable to remember the admission process and had had help from relatives to make their decision to stay at the care home. However two other individuals who spoke with the inspector said that they were given the opportunity to try the home before deciding to stay permanently. Lyndhurst Lodge DS0000001811.V374561.R01.S.doc Version 5.2 Page 9 Assessments are provided for potential individuals who wish to stay at the care home. Social service assessments are also included however the staff at the home should ask them to revise a persons care with them when changes have occurred. One private client who was case tracked had a contract although it was not signed or dated by anyone. Intermediate care, Standard 6 is not offered at the care home. Lyndhurst Lodge DS0000001811.V374561.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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Medication practice must be reviewed accompanied by further staff training in this area. EVIDENCE: People who spoke with the inspector felt their care needs were being met. However for one person their day was spent in bed day and night. The curtains were opened during the day and a radio was put on as companionship. The inspector was told that the family were unable to visit often and no staff were allocated to sit and talk or read to this person. This person was thin and was no longer able to be weighed. This person took and good diet and took drinks well. They had no pressure sores on their skin and the involvement with the District Nurses was for continence care when the staff asked them to visit. A pressure relieving mattress and repositioning at two hourly intervals for this persons small frame supported them. When moved they became uncomfortable and were on analgesia for pain. Lyndhurst Lodge DS0000001811.V374561.R01.S.doc Version 5.2 Page 11 Their care plan was up to date. They were kept clean and wore an incontinence pad. They were moved up the bed for meals so that they were not lying flat staff advised the inspector. Their eyes were bathed by the staff and medication prescribed applied to them. An arrangement for end of life care was written in the care notes. Stronger analgesia was prescribed although the greater amounts were not given. The care notes indicated that this had been discussed with the Doctor. However, as they cried out with possible pain after being moved this could be reviewed again. Analgesia for a sore mouth was prescribed by the Doctor and given by the care staff. In the bedroom chairs were used back to back as a safety measure to prevent this person from rolling out of bed. This should be reviewed and the opinion of the District Nurses sought. The bed that this person is nursed on is low and cannot adjust in height. This must be further discussed with the District Nurses, as there is a Health and Safety implication for staff at the home and for the person being moved in bed. Although the family have taken the entire day clothes home with them this person has plenty of night wear and bed socks for their feet. This person received care on a regular basis but their psychological and emotional needs were not being met as they spent much of their day in bed alone with little change. Another person case tracked was able to speak with the inspector. They were more independent and were able to make some choices for themselves. They were provided with assistance for baths and other forms of personal care and remained independent. At night they needed further supervision, as they tended to rise without asking for help and often fell in their room. The staff kept accident records of these falls. Family were also made aware of the falls and were aware that this person would not wait for help when they needed it. This person said that they were satisfied by the care provided and had made friends with the staff at the home and referred to some of the staff by name. Two peoples’ medications were checked. The person giving the medicines had received medication training to carry out the task. However, when asked what the majority of medicines were given for the staff member was not able to say. A copy of the medications book was not on the trolley for her to look up the medicines. This is not good or safe practice and a review of staff that give medicines at the home must be carried out, as further training in this area is required. A requirement will be made for this to happen. Lyndhurst Lodge DS0000001811.V374561.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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff at the home tries to be as flexible as possible to meet the needs of the individuals. People living at the home feel that their needs are met. EVIDENCE: Four people spoke with the inspector. They said that they were happy living at the care home and felt that their needs were being met. All four people said that their families and friends were made welcome by the staff when they visited and they liked living at the home. One person said that the home was boring and did not feel that they were occupied most of the time. However, the senior person in charge on inspection was able to show that bingo, a craft afternoon, an accordion player and a church service had taken place during January 2009 to February 2009. It is recommended that more individual activities be considered. This is particularly so for people with dementia or a mental disorder. In this way the home will be able to demonstrate that they comply with the registration category that they have been permitted to have. On the day of inspection there was no sign of any visible activity for anyone living at the home. The television was on in both lounge areas although no one was seen taking an interest in it. Lyndhurst Lodge DS0000001811.V374561.R01.S.doc Version 5.2 Page 13 On the day of inspection there were nine people dining in the dining room and two people in the lounge. One individual was taken out by a member of their family for lunch. Others were in their bedrooms. Two people were seen who needed assistance with their food. One person who was seen receiving a pureed diet on the first day of inspection was left unattended by the care staff member as she went to assist somewhere else. This staff member was reminded by the inspector to take the food with her to keep warm as it was already becoming cold. The staff member did this and returned afterwards. Food and meal times are treated as an occasion to look forward to and people who spoke with the inspector said that they enjoyed their meals at the home. A set menu is proved for each day with a choice of jacket potatoes as an alternative. A senior member of care staff with a food hygiene certificate does the cooking in the kitchen. A cook was recruited but as there were problems was unable to continue. Lyndhurst Lodge DS0000001811.V374561.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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living and working at the home are able to express a concern when they have them. EVIDENCE: A concern has been raised and the Commission for Social Care Inspection has been made aware of it and this is being dealt with. The home sought appropriate advice. The complaints procedure is displayed within the home however the current details for the Commission must be updated with contact details whenever they change. All four people who spoke with the inspector said that they would seek help either from the staff or their family members if they had concerns about the care that they receive at the home. Staff are encouraged to receive training to the minimum standard of a National Vocational Qualification level 2 in care and certificates are displayed in the home of the staff achieving this level or above. Since the last inspection report staff have received training in the protection of vulnerable adults and have completed a questionnaire about the subject. However, on speaking with staff the instruction that has been received was insufficient and further training Lyndhurst Lodge DS0000001811.V374561.R01.S.doc Version 5.2 Page 15 must be provided to all staff. In this way they will continue to meet the needs of the individuals in their care. Lyndhurst Lodge DS0000001811.V374561.R01.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): Standard 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is kept clean and pleasant. Attention to the safety of all individuals must be regularly considered and appropriate action taken. EVIDENCE: The home is kept clean and tidy. On the days of inspection one person was seen cleaning the home. One person is employed to clean the home for five mornings a week and a part time domestic is employed for three evenings a week. A requirement served at last inspection with regard to the unprotected radiator was not satisfactorily met. A notice had been displayed to warn individuals that the towel radiator could become very hot and radiator valves to adjust the temperatures was fitted. However, as any individual could still alter them this could pose a risk from scaling or burning to an individual and a code B notice was served. (A code B notice is used, as evidence gathered during an inspection should the Commission wish to take the action further). Lyndhurst Lodge DS0000001811.V374561.R01.S.doc Version 5.2 Page 17 However, before the inspector left the owner contacted a plumber who made the radiator safe and explained that he would return to put radiator covers over this radiator and to protect all radiators in the home in public places and anywhere identified as posing a risk to individuals as required. In another upstairs public area the inspector noticed that when both taps were on, the hot tap did not allow hot water to run. The owner explained that new mixer valves to make the water temperatures safer had been fitted. The care staff and people living or visiting the home were to report any problems with any taps and they would be replaced. Lyndhurst Lodge DS0000001811.V374561.R01.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): Standards 27, 28, 29 and 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Improvements in the area of recruitment is required in this way the safety of all the people who live at the home will be protected. EVIDENCE: A copy of the duty rota was seen. Four care staff are provided in the morning although they are not full shifts as one person leaves at 10am and another at 2pm within this shift the senior carer is in the kitchen cooking. Two main staff covers the evening shift with another member of staff staying until 5pm. Two waking care assistants cover night duty. It is important to review the numbers of staff on duty at any one time as it must be able to meet the needs of the people living at the care home including people who receive care in bedrooms. The new cook had been placed on the duty but as full references had not been received by the care home and she did not have any cooking qualifications she was deemed inappropriate for the cooking of individuals meals at this moment in time until training and verification of her skill had been obtained. As a result the seniors with a food hygiene certificate were asked to cover the kitchen again. It is important that the correct recruitment procedures are followed in this way people living at the home will be better protected. A code B notice was served and a further requirement about staffing levels made. Previous Lyndhurst Lodge DS0000001811.V374561.R01.S.doc Version 5.2 Page 19 copies of the staffing rotas were not available at the inspection this must always be available for inspection purposes. The rota was written in pencil this is not acceptable as staff can change it too easily. The rota is kept in the kitchen and all staff has access to it. Staff need further training in the area of medications an a copy of all staff training for medications and what is covered in the training is requested for the Commission to see as part of the improvement plan. Lyndhurst Lodge DS0000001811.V374561.R01.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): Standards 31, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The health, safety and wellbeing of staff and individuals living at the home must be improved. EVIDENCE: The Registered Manager had retired in January 2009. The owner produced a letter to notify the Commission officially at inspection. A senior carer had been appointed to provide the management of the care home with some support from the owner. She has not been approved for registration by the Commission. The inspector was able to check her Criminal Records Bureau (CRB) details. However the owner needs to decide if she will be put forward as the potential new Registered Manager for the care home. Lyndhurst Lodge DS0000001811.V374561.R01.S.doc Version 5.2 Page 21 A cook was recruited but as there were problems with the recruitment process as at inspection it was found that her two written references had not yet returned and she had been started to work in the kitchen of the care home. Other checks were satisfactory on this person. The owner discontinued her employment once this was found. Individuals may keep their own money however; security of their money is unclear. The owner will advise that individuals who need help ask their families to help them with their financial arrangements. Small amounts of money are held by the owner on their behalf this is correctly managed and secured. Fire safety records were seen and they were satisfactory. However the inspector requested the acting manager check with the fire officer that the front door exit and access by key pad was satisfactory with the fire officer. At this inspection it was noticed that accommodation in the form of a flat is found on the second floor within the premises. This is let to people who may not relate to the care of people living in the home. This arrangement should be reviewed as it has the potential of placing people living at the home at risk. The owner of this arrangement should also notify the contracting team at Social Services. The requirements from the last inspection report had not been met and those that were attempted were unsatisfactory. Returned questionnaire surveys seen by the inspector dated 26 November 2008 included comments from relatives who wrote that ‘the staff were caring in all aspects and would do anything for you.’ Lyndhurst Lodge DS0000001811.V374561.R01.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 2 9 2 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 2 1 X X X X X X 3 STAFFING Standard No Score 27 1 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 2 X X 2 Lyndhurst Lodge DS0000001811.V374561.R01.S.doc Version 5.2 Page 23 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP27 Regulation 18 Requirement The Registered Person must ensure that the staff members receive appropriate training to the work they are to perform. This is particularly true for the preparation, handling and cooking of the food provided for the people living at Lyndhurst Lodge. 28/04/08 Timescale for action 28/04/09 2. OP18 13 (6) Staff in care should be aware of 28/04/09 adult protection issues and training in this area must be updated and provided to all staff. In this way improvements to the safety and well-being will be maintained for all the people living at the home. 28/04/08 28/04/09 The radiator in the toilet & shower room with the hand towel rail needs a further risk assessment. In this way the risk of people burning themselves on it will be reduced. Regular checks must be made around the area of heating. 28/04/08 DS0000001811.V374561.R01.S.doc Version 5.2 Page 24 3. OP22 13 Lyndhurst Lodge 4. OP27 18 5. OP29 19 6. OP9 13 (2) 7. OP27 18 8. OP31 9 It is important for the people receiving care at this home to be able to benefit from the experience of all the care staff. A cook should be provided and identified separately on the staff rota especially as the needs of the people who live at the home changes. 28/04/08 The Registered Manager must check all the references on the staff files and ensure that references have been obtained from the previous employers or reasons and dates given where this has not been possible. Only then will the people living at the home be fully supported and protected by the staff. 28/04/08 Medication training for all staff giving medications must be revised and staff must receive an assessment for their knowledge and competency. Staff will then be able to recognise when side effects may be occurring and seek advice sooner. The skill mix of staff must be sufficient to meet the assessed needs of the people who live at the home. This will involve reviewing the numbers of staff that are able to provide care during the course of the day and night. The registered person must appoint a member of staff who will be willing to undertake the registered manager responsibility at the care home and register with the Commission for Social Care Inspection. 28/04/09 28/04/09 28/04/09 28/04/09 28/05/09 Lyndhurst Lodge DS0000001811.V374561.R01.S.doc Version 5.2 Page 25 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 OP19 Good Practice Recommendations Meaningful daily activities should be provided which are suitable to the type of residents accommodated Random water temperature monitoring and recording is recommended. Lyndhurst Lodge DS0000001811.V374561.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Lyndhurst Lodge DS0000001811.V374561.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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