Inspection on 03/07/07 for Magna Nursing Home

This inspection was carried out on 3rd July 2007.

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

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

Other inspections for this house

Magna Nursing Home 12/06/08

Magna Nursing Home 02/01/08

Magna Nursing Home 22/01/07

Magna Nursing Home 05/09/05

Magna Nursing Home 01/06/05

Magna Nursing Home 26/10/04

Magna Nursing Home 22/04/04

Magna Nursing Home 24/07/03

Magna Nursing Home 16/10/02

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

CARE HOMES FOR OLDER PEOPLE Magna Nursing Home Long Street Wigston Leicestershire LE18 2BP Lead Inspector Debbie Williams Key Unannounced Inspection 10:00 3 and 11th of July 2007 rd 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 Magna Nursing Home DS0000001918.V341709.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. Magna Nursing Home DS0000001918.V341709.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Magna Nursing Home Address Long Street Wigston Leicestershire LE18 2BP 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) 0116 2883320 0116 2812780 magna@schealthcare.co.uk Southern Cross Care Centres Limited vacant Care Home 36 Category(ies) of Dementia - over 65 years of age (36), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (36), Physical disability (1) Magna Nursing Home DS0000001918.V341709.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No additional conditional of registration apply. Date of last inspection 22nd January 2007 Brief Description of the Service: Magna is a care home providing personal and nursing care and accommodation for thirty-six older people. The Southern Cross Group, operators of a number of care facilities in the Midlands region, privately owns the home. It is a purpose built two-storey building with level entry access and both floors are accessible by passenger lift or stairs. Located near to the town centre of Wigston, close to shops, pubs, the post office and other amenities, the home is easily reached by private or public transport. The home has twenty-five single bedrooms sixteen with en-suite facilities. There are five double bedrooms without en-suite facilities. A choice of lounge and dining areas are sited throughout the premises for service users care and comfort. There is a well-maintained garden to the side of the building, which is accessible to all service users. At the time of this inspection the weekly fee ranged from £493 to £877. There was a copy of the last inspection report available at the home. Magna Nursing Home DS0000001918.V341709.R01.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 and took place over two days. The inspection was facilitated by the nurse in charge on the first day of the inspection and by the company operations manager on the second day. At the time of this inspection there was an ongoing complaint investigation that had also been referred to social services. The concerns raised were regarding staffing numbers, staff training, moving and handling equipment, vulnerable adults procedures and care practices. The registered providers were cooperative and professional regarding the investigation of this complaint. The focus of inspections is upon outcomes for residents living at the home and obtaining their views of the service provided. The main method of inspection used was ‘case tracking’ which meant selecting four residents and tracking the quality of their care by checking records, discussion with them, discussion with visitors to the home and with staff. The inspector spoke with three staff members and one visitor. This inspection was unannounced, staff and on duty were helpful and professional at all times. Eight requirements and one recommendation were made. What the service does well: Care plans and assessments were in place for each resident, these were comprehensive and addressed all assessed needs. Care records included detailed risk assessments and individual preferences, likes and dislikes. Religious and cultural needs were addressed in detail within the care plans inspected. Care practice and procedures for the prevention of pressure sores was of a high standard. Residents living at the home had high dependency needs and at the time of this inspection none of the people living at the home had pressure sores. Staff spoken with were knowledgeable about the care they provided to reduce the risk of pressure sore. Magna Nursing Home DS0000001918.V341709.R01.S.doc Version 5.2 Page 6 Medication policies and procedures were robust and provided good protection for people living at the home. A full and comprehensive quality assurance system was in place. What has improved since the last inspection? What they could do better: Staff training was not up to date; care staff had not received annual updates of mandatory health and safety training. Not all care staff had received training in caring for people with dementia and challenging behaviour. Therefore staff were not equipped with the specialist skills and competencies required to care for this client group. Care provided regarding dementia and challenging behaviour was not evidence based or with identified positive outcomes at its focus. Because of this there was a tendency for some staff to patronise people living at the home and this did not promote wellbeing or reduce anxiety. Staffing numbers were not always sufficient to meet the needs of people living at the home. People living at the home had high dependency needs and therefore any shortfall in staffing numbers was detrimental to the wellbeing of people living in the home. There were two hoists and two stand aids at the home. There appeared to be some confusion amongst staff as to which hoists and stand aids could be used. This resulted in only one hoist and one stand aid being used and this was not sufficient to meet the high dependency needs of people living at the home. At the time of this inspection the registered manager post was vacant and the acting manager had resigned their position. Management and leadership was Magna Nursing Home DS0000001918.V341709.R01.S.doc Version 5.2 Page 7 unclear and the providers could not demonstrate that some key management responsibilities were being carried out such as staff supervision and reporting of incidents, the records for these could not be located. There were strong unpleasant odours in the reception area and downstairs corridor. Requirements were made regarding this odour at the last two inspections. Some carpets have been replaced but this has not remedied the situation. Some attention was needed to the décor in both corridors due to some ripped wallpaper and scratched paintwork. Recreational activities available to people living in the home were limited and staff had not received training on providing meaningful activities for people with dementia. 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. Magna Nursing Home DS0000001918.V341709.R01.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 Magna Nursing Home DS0000001918.V341709.R01.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): Standard 3 (Standard 6 was not applicable to this service) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessment procedures in place ensure that residents’ needs are assessed and can therefore be understood and met by staff. EVIDENCE: The care records for four case tracked residents were inspected. Assessment records were comprehensive. A record of the pre inspection assessment was seen within care records, as were social services assessments where applicable. Assessment records included social profiles and individual likes, dislikes and preferences, cultural and religious needs. Detailed information was in place Magna Nursing Home DS0000001918.V341709.R01.S.doc Version 5.2 Page 10 regarding one resident’s religion, this ensured that staff could understand and meet their needs. Risk assessments were also comprehensive. All residents have their needs assessed prior to moving into the home. Magna Nursing Home DS0000001918.V341709.R01.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 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Good care planning and risk assessments were in place but these were not always followed or understood by staff, therefore residents may not always receive evidence based care with identified positive outcomes. EVIDENCE: Care plans for four case tracked residents were inspected; care plans were comprehensive and were in place for all assessed needs. Care plans included detailed risk assessments with corresponding care plans and provided detailed instruction for staff to follow in order to meet resident’s needs. Care plans Magna Nursing Home DS0000001918.V341709.R01.S.doc Version 5.2 Page 12 were regularly updated and reviewed, where possible residents and their relatives are encouraged to participate in the care plan review. Interactions observed between staff and residents were not considered appropriate to meet resident’s needs. During this inspection two residents were displaying challenging behaviour that included verbal and physical aggression, while staff remained calm and kind throughout, they did not appear equipped with the skills required to calm the situation and relieve or reduce the residents anxiety. Each resident had a care plan in place regarding challenging behaviour but staff did not seem to be following these care plans. Records are kept of all incidents of challenging behaviour, again these records demonstrated that some staff had little understanding of how to react to this challenging behaviour or that they lacked the skills and competencies to meet the specific care and management needs of people with dementia and instead appeared to patronise residents by telling them to sit down or that their behaviour was unacceptable. The home provides nursing care so therefore there is always at least one qualified nurse on duty. Care records seen confirmed that residents had good access to healthcare services, GP visits and hospital appointments were recorded. There were seven GP surgeries providing a service to the home; one qualified nurse spoken with said that that GP visits were arranged as required. The qualified nurses were responsible for administering and ordering medication. Medication administration and disposal records were seen and these appeared to be in good order. The controlled medication register was seen and appeared accurate. A monitored dosage system of medication administration was used. Medication administration is included within the providers quality assurance system and this is how the competency or otherwise of staff administering medication is monitored. Magna Nursing Home DS0000001918.V341709.R01.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 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Daily life and social activities may not fully meet the needs of people who live in the home EVIDENCE: Staff spoken with said that residents start getting up with the night staff from six in the morning (sometimes earlier) but only residents who were awake and wanted to get up at this time did so, the majority of residents getting up between eight and ten o clock in the morning. Staff were extremely busy on the first day of this inspection due to one staff member being off sick, staff were heard commenting that it had taken them until nearly ten o clock to get everybody washed and dressed. Residents living at the home had high dependency needs and it would be difficult to attend to residents personal hygiene needs in this short time period with the amount of staff on duty, a recommendation was made that the providers review working practices and Magna Nursing Home DS0000001918.V341709.R01.S.doc Version 5.2 Page 14 speak with staff to ensure that care was provided in a more person centred and less task orientated way. Care records included social profiles and individual likes, dislikes and preferences, cultural and religious needs. Detailed information was in place regarding one resident’s religion and this was commended as good practice. Religious/cultural diets were being provided for two residents. An activities organiser was employed Monday to Friday, however the range of activities on offer was very limited and the activities organiser had not received any training on how to provide meaningful activities to people with dementia or mental health needs. A small number of residents were provided with the opportunity to take part in recreational activities outside of the home. One relative spoken with said they visited the home on a daily basis and was always made welcome. Information on how to contact external advocates was available in the reception area. The lunchtime meal was served during this inspection and the meal appeared appetizing and nutritious. There are two dining rooms and the lunchtime meal is staggered beginning first at twelve o clock on the ground floor and then being served at twelve thirty on the first floor, this is in order to accommodate the large proportion of residents who require assistance with their meals and this is commended as good practice. The cook was spoken with and confirmed that enough resources were available to provide a wholesome and nutritious menu. Menu records and individual likes and dislikes were maintained. The kitchen is locked out of office hours but the nurse in charge has a key. Staff said there were always extra sandwiches and snacks available for residents. Staff and one relative spoken with felt the quality and quantity of meals provided was good. Pureed, diabetic and cultural diets were being provided at the time of this inspection. Magna Nursing Home DS0000001918.V341709.R01.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 and 18. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Management and care practices did not promote best protection for residents. EVIDENCE: All complaints are investigated according to the company complaints procedure. Some concerns had recently been raised by the social services department regarding the providers response time and investigation style with regards to a complaint referred to the provider to investigate. Staff spoken with had received adult protection training and more of this training was being arranged. However, according to the providers training matrix which sets out the dates and details of staff training provided, the majority of care staff did not have up to date adult protection training. Staff spoken with had not received challenging behaviour training despite the fact that many of the people living at the home did display both verbal and physical aggression. Staff were aware that this training was in the process of being arranged. Staff spoken with said that physical intervention or restraint is not used in response to challenging behaviour. Magna Nursing Home DS0000001918.V341709.R01.S.doc Version 5.2 Page 16 The company operations manager said that regular staff supervision had been taking place but up to date supervision records could not be located during this inspection. Policies and procedures regarding residents personal money were robust and provided protection against financial abuse. Magna Nursing Home DS0000001918.V341709.R01.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, 22, 24 and 26. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Due to unpleasant odours, residents were not provided with a pleasant and comfortable environment. Staff did not have access to all the specialist equipment required to meet resident’s needs. EVIDENCE: There were unpleasant odours in the reception area, in one resident’s room and in part of the downstairs corridor. Requirements have been made at the last two inspections regarding this unpleasant odour. The providers said that some carpets had been replaced but this has not remedied the problem. All Magna Nursing Home DS0000001918.V341709.R01.S.doc Version 5.2 Page 18 other areas of the home seen appeared clean and hygienic. Staff spoken with had received infection control training but again according to the providers training matrix only one member of care staff had up to date training in infection control. The private rooms of case tracked residents were personalised to suit individual needs. Communal areas such as lounges and dining areas were congenial, furniture; fixtures and fitting were of a good standard, domestic in character and appeared homely and comfortable. Some attention was needed to the décor in both corridors due to some ripped wallpaper and scratched paintwork. Staff spoken with felt there were insufficient numbers of hoists available to meet the needs of residents, as there was only one hoist and one stand aid. However, the operations manager said there were in fact two hoists and two stand aids in the home. There was some confusion as to whether staff were asked not to use one of the hoists and whether or not one stand aid was broken. The doors to resident’s private accommodation were routinely locked during the day meaning that residents did not have access to their private accommodation. The company operations manager said that on a previous inspection this had been made a requirement. It was agreed that resident’s private rooms would only be kept locked if the resident requested this. Magna Nursing Home DS0000001918.V341709.R01.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 and 30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Staff do not have the training required to meet the needs of people living in the home. Recruitment procedures are robust and promote protection for people living in the home. EVIDENCE: Staffing numbers provided did meet the staffing guidelines provided by the Department of Health when the home was fully staffed. However, on the first day of this inspection one staff member was off sick and staff on duty were finding it very difficult to meet resident’s needs due to the high dependency needs, both physical and psychological of residents living in the home. Staff spoken with felt that staffing numbers were not always sufficient to meet residents needs. One visitor spoken also expressed this opinion. Five care staff employed at the home had achieved a National Vocational Qualification in care (one at level two and four at level three). There were eight care staff working towards this qualification. Magna Nursing Home DS0000001918.V341709.R01.S.doc Version 5.2 Page 20 Two staff members spoken with said they had not received any dementia or challenging behaviour training. The activities organiser had not received any training in providing meaningful activities for people with dementia. According to the providers training matrix, mandatory training for staff was not up to date. The company operations manager was aware that the staff training programme had fallen short and was not up to date. Steps had been taken to remedy this and a programme of staff training was underway. Staff records for two staff members were inspected and these were found to contain all relevant checks and references. Magna Nursing Home DS0000001918.V341709.R01.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 31,33,35,36 and 38. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. There was no clear leadership or management in place and therefore the home was not well run. EVIDENCE: At the time of this inspection there was not a registered manager in post and the acting manager had just resigned their position. The company operations manager was providing management cover with the help of the qualified nursing staff and the registered manager of the sister home next door to the home. Magna Nursing Home DS0000001918.V341709.R01.S.doc Version 5.2 Page 22 The providers could not demonstrate that some key management roles and responsibilities such as staff supervision and the reporting of incidents (regulation 37) were being carried out as records for this could not be located. A full and comprehensive quality assurance and audit programme was in place. All staff had previously received mandatory health and safety training but this training was not up to date. Staff spoken with said that regular staff meeting were held. Staff spoken with said they had not received supervision or appraisal in the last six months. The company operations manager said that all routine maintenance work required to maintain a safe environment was up to date and that quality assurance audits monitored this. Risk assessments were in place for individual residents and for environmental hazards. Policies and procedures regarding residents personal money were robust and provided protection against financial abuse. Magna Nursing Home DS0000001918.V341709.R01.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 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 1 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 x 18 1 1 x x 2 3 x x 1 STAFFING Standard No Score 27 2 28 3 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 x 3 x 3 1 x 2 Magna Nursing Home DS0000001918.V341709.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Magna Nursing Home DS0000001918.V341709.R01.S.doc Version 5.2 Page 25 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(a) Requirement At all times staff should be deployed in sufficient numbers to meet the needs of residents accommodated. The registered person must ensure that staff employed at the care home receive training appropriate to the work they perform. This requirement is with particular reference to all mandatory health and safety training, dementia care training, dealing with challenging behaviour and providing meaningful activities for residents with dementia. Staff must be equipped with the knowledge and skills to promote and support the specific needs of people with dementia and or challenging behaviour. The offensive odour in the reception area and downstairs corridor must be eradicated in order to ensure that residents live in a comfortable environment The ripped wallpaper and chipped paintwork seen on both corridors must be repaired in DS0000001918.V341709.R01.S.doc Timescale for action 31/08/07 2. OP30 18(c)(i) 30/09/07 3 OP26 23(2)(d) 31/08/07 4. OP19 23(2)(d) 30/09/07 Magna Nursing Home Version 5.2 Page 26 order to bring the décor up to a reasonable standard. 5. OP22 13(5) Safe and appropriate systems for the moving and handling of residents must be in place. This is with particular reference to the provision of hoisting equipment. The type and number of hoists available must meet the needs of residents accommodated. The registered provider must inform the Commission for Social Care Inspection of any death, illness or any other event which adversely affects the well-being or otherwise of any resident. Meaningful activities for people with dementia must be provided in order to meet the recreational interests and needs of residents. Staff must receive supervision and support appropriate to their roles. 31/08/07 6. OP38 37 04/07/07 7. OP12 12 31/08/07 8. OP36 18 (2) 31/08/07 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 OP12 Good Practice Recommendations Staff working practices should be reviewed and staff spoken with to ensure that care was provided in a more person centred and less task orientated way. Magna Nursing Home DS0000001918.V341709.R01.S.doc Version 5.2 Page 27 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 Magna Nursing Home DS0000001918.V341709.R01.S.doc Version 5.2 Page 28 - 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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