CARE HOMES FOR OLDER PEOPLE
Lynton Hall Care Centre 2 Lynton Road New Malden Surrey KT3 5EE Lead Inspector
Alison Ford Key Unannounced Inspection 26th October 2007 12:00 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 Lynton Hall Care Centre DS0000069165.V353367.R03.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. Lynton Hall Care Centre DS0000069165.V353367.R03.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Lynton Hall Care Centre Address 2 Lynton Road New Malden Surrey KT3 5EE 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) 0208 949 1765 0208 336 1288 www.bupa.co.uk BUPA Care Homes (ANS) Ltd Mrs Barbara Carter Care Home 57 Category(ies) of Dementia - over 65 years of age (2), Learning registration, with number disability (1), Learning disability over 65 years of places of age (1), Old age, not falling within any other category (57), Terminally ill (57), Terminally ill over 65 years of age (57) Lynton Hall Care Centre DS0000069165.V353367.R03.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. As agreed on 12/6/06 a variation has been granted to allow 2 specified service users in the Dementia, over 65 (DE(E)) service user category to be accommodated. A variation has been granted to allow one specified service user in the Learning Disability, over 65 (LD(E)) category and one specified service user in the Learning disability (LD) category to be accommodated. as agreed on 12/6/06 a variation has been granted to allow one specified service user (female) aged 54 years, requiring general nursing care, to be accommodated. 31st May 2006 Date of last inspection Brief Description of the Service: Lynton Hall is a nursing home owned by BUPA. It is situated in residential area, close to the town, in New Malden, Surrey and is close to public transport routes and the local shopping centre. A garden and off-street parking are to the rear of the home. It is currently managed by Mrs Barbara Carter. The home is registered to provide nursing care for older people and for those under the age of sixty-five who may have physical disabilities or may be terminally ill. Accommodation is arranged over two floors, each of which has its own lounge, and bathroom and toilet facilities are on each floor. There are five double and forty-seven single bedrooms. All have washbasins and eleven have en-suite facilities. Adaptations within the home ensure that it is accessible to those who have physical disabilities and nurse call bells are in all areas. The home is staffed twenty-four hours a day by both trained nurses and care staff. In addition, a chef, activities coordinator, handyman and domestic staff are employed. At the time of this latest inspection the fees were £820 per week. Extra charges may be payable for services such as chiropody or hairdressing and these would be discussed prior to admission. Copies of the Statement of Purpose for the home and Service User Guide may be obtained from the home while the latest inspection report may be downloaded from the Commission for Social Care Inspection website. Lynton Hall Care Centre DS0000069165.V353367.R03.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This report follows a key inspection visit on 26th October, and a visit on 13th November made to check compliance with an immediate requirement that was issued. Both visits were unannounced and contribute to the inspection process of the home for the year 2007/2008. In compiling this report consideration has also been given to information received about the home throughout the year such as comment cards, complaints, and the notification of any incidents. In addition, the Registered Manager had completed an Annual Quality Assurance Assessment which is a document that they are now obliged to return to let us know about their service and how well they consider that they are meeting the needs of those people that they are caring for. During these visits all of those standards considered, by The Commission for Social Care Inspection, to be key to the inspection process have been assessed. A tour of the premises was undertaken and several residents, members of staff and three relatives, who were visiting, were spoken with. A sample of care plans was assessed and various records and documentation, required to be kept by the home as evidence of their commitment to the health and safety of their residents, was seen. Staff files of those who have been employed since the last inspection were also checked, to ensure that appropriate pre - employment checks had been completed and that people who use this service are protected from those who should not be working with vulnerable adults. Since the last inspection three issues of concern have been investigated, using local authority safeguarding procedures. In all of these investigations any allegations against the home were not proved. What the service does well:
The people that were spoken with during the course of the inspection visit generally consider that their healthcare needs are met in a way, which suits them. Several of them commented on a perceived lack of staff, saying that they sometimes had to wait along time when they rang the bell, although they all agreed that the staff working in the home are kind and caring. Many of the residents said how much they enjoyed the activities that are arranged for them, and the entertainers that visit and generally they are happy with the meals that are served to them.
Lynton Hall Care Centre DS0000069165.V353367.R03.S.doc Version 5.2 Page 6 They say that they are able to make choices in their daily lives particularly with regard to getting up and going to bed, with the food that they eat and with the clothes that they wear. Comprehensive pre-admission assessments ensure that the home considers that it is able to meet the healthcare needs of people who are admitted and these are reviewed regularly to identify any changes. A brochure is available to them so that they can see what the home is like if they are not able to visit prior to admission. Although much of the home requires redecoration it is clean and generally free from malodour and all of those people who were living there appeared happy and well cared for. Subsequent conversations, with members of the senior management team, have provided the information that there is a considerable amount of money due to be spent on the home during the forthcoming year. What has improved since the last inspection?
The home was acquired by BUPA last year and since that time the management team have been working to establish the BUPA range of policies and procedures. Staff are now being enrolled onto the “Personal Best Programme” which encourages them to become more customer focussed in their approach and provide more individualised care for those who live in the home. In addition BUPA Care Homes has achieved Investors In People accreditation. New standardised care plans have been introduced into all BUPA care homes, which help staff identify all residents’ healthcare needs and provide a more structured package of care. They also include evidence to show that work is being undertaken to discover more about residents past achievements and interests in order for staff to gain a greater understanding of the people that they are caring for. In addition,this will allow activities programmes to be tailored to meet their interests. Staff training is ongoing and a coordinator is being appointed to ensure that any training are identified. However, turnover of care staff has lead to only 4 members of staff being qualified to NVQ level 2. There are plans for eight more to commence this training. Since the last inspection the homes nurse in charge of clinical care, now works mainly in a supernumerary capacity to enable her to provide closer supervision of staff and help with their training. Lynton Hall Care Centre DS0000069165.V353367.R03.S.doc Version 5.2 Page 7 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. Lynton Hall Care Centre DS0000069165.V353367.R03.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 Lynton Hall Care Centre DS0000069165.V353367.R03.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): Standards 3,6, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who use this service have a comprehensive pre admission assessment, which ensures that they can be confident that the home will be able meet their healthcare needs. They would be encouraged to visit prior to moving in and they are given written information to help them decide if it will suit them. This home does not offer intermediate care: this standard does not apply. EVIDENCE: A Statement of Purpose and Service User Guide has been compiled according to BUPA guidelines and these are available to all residents and are in their rooms. Lynton Hall Care Centre DS0000069165.V353367.R03.S.doc Version 5.2 Page 10 Prior to them moving into the home, potential residents have an assessment undertaken by the senior nurse, either in hospital or their own homes, to ensure that their healthcare needs can be met. They would be encouraged to visit the home, if they could, to see if they liked it and one resident explained how she had been taken round and shown the room that she would occupy. A brochure for the home has been produced which includes pictures of current residents. A comment was received that the brochure was not entirely reflective of the home although several of those people who feature in the pictures were seen during the visit. It was recommended that photographs of various aspects of the home could also be taken which could be shown to potential residents at the time of their assessment if they were not able to visit. It is also recommended that consideration could be given to supplying documentation, intended for residents, in an alternative format such as audio, and large print for those with sensory impairment. Lynton Hall Care Centre DS0000069165.V353367.R03.S.doc Version 5.2 Page 11 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 7,8,9,10 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People who use this service have an individual care plan, which identifies the support that they require so that all staff know how to meet their healthcare needs in the way that they prefer. Medication procedures in the home generally ensure the protection of residents and they are confident that they will always be treated in a way, which respects their dignity and privacy. EVIDENCE: All the residents in the home have an individual care plan and six of these were looked at during the inspection. It is acknowledged that they are continuing to improve since the introduction of new BUPA documentation. Standardised care
Lynton Hall Care Centre DS0000069165.V353367.R03.S.doc Version 5.2 Page 12 plans are used for identifying problems and outlining the interventions required and there is evidence that these have been reviewed regularly. Where practicable, residents or their families have been involved in the planning process and risk assessments are also in place where they are required. Nutritional screening is undertaken and there is regular review of factors, which could lead to the incidence of pressure sores. Other healthcare professionals contribute to the care of residents as necessary. Some care plans showed that consideration has been given to the wishes of residents at the end of their lives although this will need to be in place for all of them. Information was in there regarding funeral arrangements however, it should also contain details about whether residents would wish to be transferred to hospital if they became very unwell or would prefer to remain in the home. In this way all staff would be aware of their wishes and unwanted hospital admissions would be avoided. All the residents have a key worker however conversations with them showed that although there are photographs, showing who they are they are in their bedrooms, residents remain uncertain about the role that they have. More work will need to be undertaken to help them understand the purpose of this system. Medication records and storage were assessed: a Monitored Dosage System is used. These were generally in order however, it was noted that there were occasions when medication had been refused however, the reason for this was not documented. Care must be taken to ensure that records are always completed accurately in order to maintain the safety of residents and monitor their compliance. Residents spoken with at the time of the inspection agreed that they are always treated with respect by staff who were observed to have a kind and caring attitude towards everyone. Lynton Hall Care Centre DS0000069165.V353367.R03.S.doc Version 5.2 Page 13 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 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who use this service say that they enjoy the activities that are arranged for them and that generally they enjoy the food that is served to them. They would be encouraged to exercise as much choice over their own lives, as they are able, in order to maintain their independence. EVIDENCE: Residents are encouraged to make choices within their capabilities and the management team are trying to encourage staff to make routines as flexible as is possible in a large home. Visitors that were in the home agreed that they always felt welcome when they came in and there were no restrictions put on them. Tea and coffee is made available to them in the entrance hall. Lynton Hall Care Centre DS0000069165.V353367.R03.S.doc Version 5.2 Page 14 A dedicated activities organiser arranges a range of activities for residents to participate in if they wish to and several people said how good that she was and how much they enjoyed these sessions which now include chair based exercise and aromatherapy. Some residents are able to be taken out or to go shopping and there are strong links with the local church. Photographs on display illustrate various events that have taken place. Most of the residents spoken with consider that the meals served in the home are quite good although some adverse comments were made about watery vegetables. Care staff help residents make choices, from a printed menu, the day before and alternative dishes would always be available. The home has recently reviewed their dining facilities so that there are additional quieter areas available which they feel that some residents might find less intimidating especially when they are new to the home. It was observed that a resident who was served a meal in their room was not given any cutlery or condiments. They were also served desert at the same time as their main meal, which would mean that it would not be hot when they ate it. It is recommended that some consideration could be given to supplying plate warmers for residents who have their meals in their rooms. Lynton Hall Care Centre DS0000069165.V353367.R03.S.doc Version 5.2 Page 15 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 16,18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use this service are given information about the complaints procedures and believe that any concerns that they have will be dealt with appropriately. Measures are in place to protect them from those who have been deemed as unsuitable to work with vulnerable adults and staff are aware their responsibilities to report any suspected abuse. EVIDENCE: There have been three concerns raised since the last inspection, which were all investigated using the local authority safeguarding procedures. None of these resulted in any allegations being made against the home. Each resident has a copy of the company complaints procedure, which has a clearly defined framework for reporting and dealing with complaints. Some of them understood the procedure and others, although they did not, considered that the homes manager would deal with any concerns that they might have. Lynton Hall Care Centre DS0000069165.V353367.R03.S.doc Version 5.2 Page 16 As with the Service User Guide, it is recommended that some consideration should be given to developing the procedure in alternative formats so that more residents would be able to understand it. Staff displayed an understanding of the issues around elder abuse and regular training is undertaken within the home. All staff have received the necessary pre-employment clearance, from The Criminal Records Bureau which means that they are suitable to be employed working with vulnerable adults, Lynton Hall Care Centre DS0000069165.V353367.R03.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19,26 Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. People who use this service do not live in a home, which meets the standards that they expect. EVIDENCE: A tour of the premises was undertaken and it was considered that the environment falls short of the standards that residents and their relatives might expect. The home was clean and tidy on the day of the inspection however much of it, particularly the first floor requires redecoration and repair. Wallpaper is torn and scruffy, paintwork and doors are scuffed and chipped and plaster is cracked and broken. Bathroom and toilet doors and floors need to be repaired or replaced.
Lynton Hall Care Centre DS0000069165.V353367.R03.S.doc Version 5.2 Page 18 Particular concerns were also raised about the kitchen, which, on the day of the visit, was dirty with broken wall tiles. Kitchen equipment was also worn and baking tins still had food debris on them. Mindful that this situation could lead to contamination and illness amongst people who are already quite frail and this is not the first time that concerns have been raised about standards of cleanliness in the kitchen, an immediate requirement was issued under standard 38 to rectify this situation within forty-eight hours. Lynton Hall Care Centre DS0000069165.V353367.R03.S.doc Version 5.2 Page 19 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 27,28,29,30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Although staffing levels in the home generally comply with regulatory standards residents do not perceive that they are always sufficient to meet their needs. Statutory training has been undertaken however; numbers of staff with an NVQ level 2 qualification is below the standard expected. Recruitment processes are in place, which ensure that residents are protected from those who are judged as being unsuitable to work with vulnerable adults. EVIDENCE: The home is staffed by both trained nurses and care staff and the rotas showed that numbers generally correspond to those which would be expected in a home this size. However, some resident’s felt that more staff were needed saying that “they had to wait a long time for help” and that “staff are always rushing”. Certainly on the day of inspection it was noted that not all of the beds had been made by midday. Staff that were spoken with also felt that their workload was often very heavy. It is recommended that some consideration should be given to the dependency of people living in the home, not just the numbers, when compiling rotas and
Lynton Hall Care Centre DS0000069165.V353367.R03.S.doc Version 5.2 Page 20 to completing a dependency analysis to ensure that there are enough staff at peak times of the day. Statutory training has been undertaken and staff were able to confirm that they had attended sessions concerned with food safety, moving and handling, adult abuse, and fire training. Unfortunately some of those staff who had gained an NVQ level 2 qualification have now left the home. Eight more are due to start the course and the management team are aware that this number needs to be increased. BUPA run a training scheme, “Personal Best, for staff aimed at providing individualised care for residents and 20 staff members are about to start this. A new post of training of training co-ordinator is being developed and their role will be to maintain records and identify individual staff training needs. The intention is now to provide at least one teaching session a month. Recruitment procedures and staff management issues are supported by BUPA’s human resources policies and appropriate pre-employment checks are undertaken to ensure the safety of residents. Lynton Hall Care Centre DS0000069165.V353367.R03.S.doc Version 5.2 Page 21 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 3133,35,38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. People who use this service consider that the home is managed by a person fit to be in charge and that they are able to have the opportunity to express their views and influence the running of the home. Health and safety procedures are not always sufficient to protect residents and staff. EVIDENCE: Lynton Hall Care Centre DS0000069165.V353367.R03.S.doc Version 5.2 Page 22 The Registered Manager has been in post for some time and, as she is not a trained nurse, is supported by a senior nurse responsible for clinical issues in the home. There are regular staff meetings held in the home on a monthly basis and also meetings for trained nurses. The senior nurse now works more of her hours on a supernumerary basis to allow her more time to supervise and guide other staff members. An annual quality assurance monitoring form had recently been sent to out residents; some discussion was held with one person about these. Residents are invited to comment on all aspects of their care and the services provided by the home. There are also residents /relatives meetings held in the home every six months to allow them the opportunity to express their opinions. The Annual Quality Assurance Assessment, provided dates when equipment and services were checked in the home and all of these were appropriate to maintain the health and safety of residents and staff. Staff undertake yearly updates in mandatory training, including fire safety, provided by an in-house trainer and appropriate records are kept of accidents and other incidents occurring in the home. The outcomes for this standard are affected by the fact that a tour of the home revealed that the kitchen was very dirty which could lead to contamination of food being served to people in the home. Baking tins had food debris on them, wall tiles were missing and a rubbish bin was without a lid. Given that this was not the first time concerns had been raised about the cleanliness of this area an immediate requirement was left to ensure that the issue was rectified within 48 hours. It is considered that this reflects a lack of intervention from the management team to monitor the situation and ensure it was resolved. The return visit that was made showed that this requirement had not been complied with and that records did not provide evidence that cleaning was being undertaken in accordance with cleaning schedules. Lynton Hall Care Centre DS0000069165.V353367.R03.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 1 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 1 Lynton Hall Care Centre DS0000069165.V353367.R03.S.doc Version 5.2 Page 24 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 OP7 Regulation 15 Requirement Timescale for action 30/12/07 2 OP7 13(2) 3 OP19 23(2)(d) 4 OP38 16(1)(g) Residents care plans must contain information relating to their wishes in the event of them becoming unwell so that staff are all aware of their preferences and unwanted hospital admissions can be avoided. If residents do not take any of 26/10/07 their prescribed medication the reason for this must be documented on their MAR sheets in order to provide an accurate record. There must be an improved plan 30/12/07 of redecoration and refurbishment of the home in order to provide a pleasant environment for people to live in which meets their expectations. The kitchen and all of the 28/10/07 equipment in there must be kept clean and in a good state of repair, wall tiles must be replaced and rubbish bins must have lids on in order to comply with health and safety regulations and protect the health of the people who use this service.
DS0000069165.V353367.R03.S.doc Version 5.2 Lynton Hall Care Centre Page 25 Immediate Requirement notice issued.28/10/07 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 OP3 Good Practice Recommendations It is recommended that consideration should be given to producing any information, intended for the people who use this service, in alternative formats to make it easier for them to understand. It is recommended that some work should be undertaken to make sure that residents are aware of the roles and responsibilities of their key workers and named nurses. It is recommended that plate warmers should be purchased for the use of residents who prefer to have their meals in their own rooms. It is recommended that a dependency analysis is undertaken in order to ensure that there are always sufficient staff to meet the needs of residents. 2 3 4 OP7 OP15 OP27 Lynton Hall Care Centre DS0000069165.V353367.R03.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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
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