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Inspection on 15/06/07 for Meadow Bank Nursing Home

Also see our care home review for Meadow Bank Nursing Home for more information

This inspection was carried out on 15th June 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Meadow Bank is a small care home with a family atmosphere. It caters mostly for local people and enjoys a number of local visitors. People living in the home say they feel well looked after and that the "staff are lovely" and "could not be kinder". Visitors told us their relatives in the home were being well looked after. Peoples` bedrooms had been made individual and personal to them. The meals were popular and people said they enjoyed the menu choices. There was some evidence of joint working with health professionals outside of the home, which is good.

What has improved since the last inspection?

Since the last full inspection in October 2006 many improvements have taken place at Meadow Bank but not all of them had been consistently maintained up to this visit. Improvements have been made to the environment with redecoration of most of the areas damaged by damp. New carpet had been laid in the entrance hall, stairway and the upstairs corridor. The ground floor bathroom was in the process of being refurbished. Some of the homes` policies and procedures had been reviewed and updated. Staff training and supervision had commenced but has not been sustained. Some improvements had been noted in the management of medicines, but again these improvements had not been maintained. A lot of work has been done to improve care planning and whilst this is not complete, the inclusion of peoples` social histories and personal interests had helped staff introduce more activities.

What the care home could do better:

There are still many areas in which the home needs to improve. The information provided to prospective clients and their relatives, is quite poor, and pre-admission assessments of peoples` personal, health and social care needs are very basic. Care planning is confused and does not always support peoples more complex needs in a consistent way. The management of medicines is not good enough and could place people at risk of their medical conditions not being properly managed. Training and supervision for staff needs to be improved. Activities could be further improved. There needs to be a proper quality assurance system in place and the manager needs to undertake some formal management training to help with this. There is still some work to do to improve the quality of the environment, namely the completion of the ground floor bathroom, and a new carpet for the ground floor corridor, along with some decorating.

CARE HOMES FOR OLDER PEOPLE Meadow Bank Nursing Home Curthwaite Wigton Cumbria CA7 8BG Lead Inspector Jenny Donnelly Unannounced Inspection 15th June 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Meadow Bank Nursing Home DS0000010101.V338829.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. Meadow Bank Nursing Home DS0000010101.V338829.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadow Bank Nursing Home Address Curthwaite Wigton Cumbria CA7 8BG 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) 01228 710279 Mr B & Mrs L Whalley Mrs Linda Whalley Care Home 19 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (19), of places Physical disability (2) Meadow Bank Nursing Home DS0000010101.V338829.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 19 service users to include: up to 19 service users in the category of OP (Old age, not falling within any other category) Two named service users in the category of PD (Physical Disabilities) may be accommodated within the overall number of registered places. Three named service users in the category of DE(E) (Dementia over 65 years of age) may be accommodated within the overall number of registered places. No further service users shall be admitted to the Home until the requirements listed on the inspection report dated 4 October 2006 and the Statutory Requirement Notices dated 14 August 2006 have been complied with to the satisfaction of the Commission for Social Care Inspection. 4th October 2006 2. 3. 4. Date of last inspection Brief Description of the Service: Meadow Bank Care Home is an adapted Victorian House set in extensive grounds in a rural area approximately eight miles from Carlisle. Mr and Mrs Whalley are the Registered Providers of the home, and Mrs Whalley is the registered manager. Nursing Care is provided for a maximum of 19 people, but because double bedrooms tend to be let singly there are not usually that number living in the home. There are bedrooms on both floors with the first floor being accessible by either the stairs or the passenger lift. There are two bathrooms; one on each floor, there is also a shower on the ground floor. The lounge has big windows providing lovely rural views. There is a separate dining room. The weekly fees at the time of this inspection were £396.00 plus any free registered care contribution entitlement. The care home has produced a statement of purpose and a service user guide, but these did not supply sufficient information and were not freely available in the home. Neither were previous inspection reports available in the home. Meadow Bank Nursing Home DS0000010101.V338829.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. I carried out this full inspection on 15th June between 09.30 and 15.00 hours, and was accompanied by a second inspector, Margaret Drury. The pharmacist inspector Angela Branch visited on 7th June, and her findings are included in this report. This unannounced visit comprised of a tour of the building, talking with people who live in the home, with staff and the manager, and looking at care, medication and staffing records. We also observed the daily activity within the home and saw lunch being served. Prior to this unannounced visit to the care home I collected some written information from the manager, and I sent out surveys forms. I received 3 completed surveys from people who live in the home and 2 from relatives. Their comments are included in this report. The last full inspection of this service took place in October 2006. Since then short unannounced inspections took place on 12/12/06, 28/02/07 and 17/04/07. Reports of these “random” visits are not published on the CSCI website, but can be obtained from CSCI by request. What the service does well: What has improved since the last inspection? Since the last full inspection in October 2006 many improvements have taken place at Meadow Bank but not all of them had been consistently maintained up to this visit. Improvements have been made to the environment with redecoration of most of the areas damaged by damp. New carpet had been laid in the entrance hall, stairway and the upstairs corridor. The ground floor bathroom was in the process of being refurbished. Some of the homes’ policies and procedures had been reviewed and updated. Staff training and supervision had commenced but has not been sustained. Some improvements had been noted in the management of medicines, but again these improvements had not been maintained. A lot of work has been done to improve care planning and whilst this is not complete, the inclusion of peoples’ social histories and personal interests had helped staff introduce more activities. Meadow Bank Nursing Home DS0000010101.V338829.R01.S.doc Version 5.2 Page 6 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. Meadow Bank Nursing Home DS0000010101.V338829.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 Meadow Bank Nursing Home DS0000010101.V338829.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Information about the care home was not readily available and did not give enough detail about the services offered. Admission assessments were very basic and meant people admitted may have specialist needs that have not been identified and cannot be adequately meet. EVIDENCE: The statement of purpose was not readily available in the care home and had to be fetched from the providers own home later that day. There was a “User Guide” seen in peoples’ bedrooms. Neither the statement of purpose or the user guide included all the information required by the care home regulations. The pre-admission assessment for the newest person in the home was seen, and while this covered the essential areas, the information gathered was very basic. Copies of the contracts for each person living in the care home were kept on file, and these detailed the fees and who was responsible for payment. Meadow Bank Nursing Home DS0000010101.V338829.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People looked and felt well cared for at Meadow Bank and there were good links with outside healthcare professionals. However, the management of peoples’ medicines was not good enough and could place people at risk. EVIDENCE: We looked at four care plans in detail and a number of others more randomly. These showed that in general the quality of information had improved and now included social histories or pen pictures, telling peoples interests and what was important to them. There was still some confusion with the care plan documents being kept in a separate file to the daily notes, and in some cases giving different information. Staff appeared to work to the daily notes, which was where current information was held. There was evidence in the records we saw that people had regular access to outside health professionals including the doctor, chiropodist and mental health Meadow Bank Nursing Home DS0000010101.V338829.R01.S.doc Version 5.2 Page 10 services as appropriate. There were records of multi-disciplinary reviews, which included people’s social workers and families. People living in the home looked well cared for. They were dressed appropriately in clean tidy clothes, with their nails and hair tidy, and they were wearing stockings and footwear. People being nursed in bed appeared clean and comfortable, and had quiet background music playing. The people we spoke to felt very well cared for in Meadow Bank, saying they were happy with the care they received and remarked on how caring the staff were. One person said, “we’re all very well looked after here”. The survey cards from relatives stated: • “My husband is well looked after, always clean and well cared for by all the staff” • “… makes my mother feel at home and comfortable” Medicines that were prescribed for, and given to, people were not always recorded accurately or handled properly and this puts peoples health at risk of not getting the treatment as the doctor intended. Medicines were not always disposed of or recorded properly and could not be accounted for. Ordering systems should be reviewed to prevent stockpiling of medicines that is wasteful and increases the risk of expired medicines being used. People were able to look after and take their own medicines if they wished and this allowed them to manage their own health and remain independent. However, people should be monitored and medication reviews requested if necessary so that they get the best treatment. People were able to have days out but arrangements should be in place to make sure they are able to take their medicines with them so that treatment is not missed. Meadow Bank Nursing Home DS0000010101.V338829.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People felt they were able to exercise some choice, and said they enjoyed the type of food served. The provision of activities and entertainment was quite limited both in its’ variety and frequency. EVIDENCE: During the morning we saw one of the care staff spending time with individuals, both in their bedrooms and in the lounge, doing manicures and chatting. A visiting entertainer was said to visit every two months, but had not been since February. There was an activity list on the notice board, showing that on three days each week staff would facilitate some activity. People we spoke to were unsure about activities, but when asked were able to confirm that the vicar visited and held services regularly, the hairdresser came weekly, a visiting singer did come and staff organised small in-house events. The activity records showed most things were geared towards individuals or small groups and consisted of walks outside, dominoes, nail care, word games and ball darts. Meadow Bank Nursing Home DS0000010101.V338829.R01.S.doc Version 5.2 Page 12 Three people said they preferred to remain in their bedroom with the daily papers or television, and one survey form stated, “activities are available when needed, I am content with the situation”. We saw the mid-morning tea and coffee being served, along with biscuits and fresh fruit, which staff peeled and chopped as needed. We spoke with the cook and looked at the food stores and menus, which showed a choice was offered at each mealtime. People spoke highly of the food saying, “The food is very good here”. People who needed a soft or pureed meal were provided with the items served separately on the plate, not all mixed up. Meadow Bank Nursing Home DS0000010101.V338829.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People felt that any concerns they had would be listened to and acted on by the home manager. EVIDENCE: People who responded to our survey said they knew how to complain about the service, but had not needed to do so. The manager said she had not received any formal complaints, and none had been reported to CSCI. People we spoke to said there were never any problems, and if there were, they felt confident the manager would sort it out. One survey form stated, “Since coming here I haven’t felt unhappy”. The policy and procedure on safeguarding people had been updated to include the need to make any safeguarding referral to the appropriate public authority. Staff had attended a training session on abuse and protection last year, and one carer said she felt confident about this subject as she was covering it in detail in her National Vocational Qualification. Meadow Bank Nursing Home DS0000010101.V338829.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 24, 25 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Work to improve the standard of accommodation was ongoing and people felt the home was warm, clean and comfortable. EVIDENCE: A tour of the building showed a number of improvements had taken place or were in progress. A new good quality carpet had been laid in the entrance hall and stairway. People living in the home had been able to see the carpet samples and “vote” for the one they liked. New floorboards and carpet had been provided for the upstairs corridor, and this was a great improvement, although the lighting here was poor. The ground floor corridor was also going to have a new carpet once the bathroom work was completed. The ground floor bathroom had been stripped ready for re-decoration and refurbishment with a new hi-low bath with built in hoist seat. The manager said this should be completed by the end of June, and then the dining room was to be Meadow Bank Nursing Home DS0000010101.V338829.R01.S.doc Version 5.2 Page 15 decorated and re-carpeted. There was no plan to refurbish the first floor bathroom. The home was clean and fresh throughout, and staff said the new “Ozone” laundry system was working very well and had improved the cleanliness of the laundry. With the exception of one bedroom, where the radiator was not working, the home was warm. The manager was aware of the faulty radiator and had requested maintenance for it. A supplementary heater had been provided in the meantime. People were happy with their bedrooms, most of which had been nicely personalised. People had their names with a picture of their choice on the bedroom door. The only areas of damp remaining were those by the front door and in the nearby toilet. The damaged plaster had been scraped off in preparation for repair. Meadow Bank Nursing Home DS0000010101.V338829.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing arrangements were satisfactory to meet peoples’ basic care needs and staff had received training in essential areas. EVIDENCE: Staff rotas for June and July showed the home was staffed with 1 nurse and 2 carers during the day, and 1 nurse and 1 carer at night. This was sufficient to meet the basic needs of the 14 people in residence. The manager worked four or five nursing shifts each week. There were sufficient domestic and catering staff to provide a satisfactory service. During the last year staff had received training in fire safety, infection control, safeguarding people, dementia care and moving and handling. There were certificates on file showing an external trainer had provided these sessions. There was no annual training plan in place, and the manager said she was trying to set up a staff matrix for this purpose. There was no evidence of registered nurses taking on additional training in specialist areas such as the management of wounds, diabetes or continence. The home was supporting care staff to undertake National Vocational Qualifications in care, and 3 out of the 8 carers had an NVQ with another 2 working towards this. Consequently 37 of care staff had an NVQ and on Meadow Bank Nursing Home DS0000010101.V338829.R01.S.doc Version 5.2 Page 17 completion of current training this would be 62 , which will be good for the people receiving care. One staff member said, “Meadow Bank is a good place to work and I receive good support from the manager and the qualified nurses”. No new staff had been employed since the last inspection and a review of staff files showed relevant paperwork including references and criminal records bureau checks to be in place. People told us “the staff are lovely” and, “the staff could not be kinder”. We noted there was a pleasant atmosphere in the home. Meadow Bank Nursing Home DS0000010101.V338829.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 36, 37 and 39 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registered manager lacks formal management training, and does not demonstrate strong leadership skills. Forward planning and managerial oversight of quality are not given the priority and time needed to provide a really good service. EVIDENCE: Mrs Whalley is the registered provider and registered manager of Meadow Bank. She does not hold a registered managers award or and NVQ 4 in management, although she has been working towards this for some time, and suffered delays with her training provider. Mrs Whalley says she has applied for some management training through the local authority, but could not evidence this. Meadow Bank Nursing Home DS0000010101.V338829.R01.S.doc Version 5.2 Page 19 Some of the homes’ policies and procedures had been reviewed and updated recently, these included medicines, fire, safeguarding adults, and equal opportunities. Mrs Whalley says the other policies and procedures had been reviewed but there was no evidence to support this. Staff had received health and safety related training at the end of last year, and there was an updated fire risk assessment that had been approved by the fire officer. A system of formal staff supervision was set up last year, and although staff told us they received supervision, there was none recorded during the last five months. There is no complete quality assurance system in place, although the manager said she had made a start and showed us satisfaction surveys completed by three people. Time for carrying out management duties is limited because of the number of shifts the manager works as the nurse on duty. Meadow Bank Nursing Home DS0000010101.V338829.R01.S.doc Version 5.2 Page 20 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 2 2 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 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 3 2 X 1 X X 3 2 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X 2 2 3 Meadow Bank Nursing Home DS0000010101.V338829.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 4 and 5 Requirement There must a statement of purpose and service user guide, which includes all the information required under regulation. This is so that people can access information about the exact services on offer in this care home. Records for receipt, administration and disposal of medicines must be accurate to ensure that medicines are handled properly and that residents get the treatment they need. Previous timescale of 01/09/06, 04/10/06,14/12/06, 28/02/07 and 17/04/07 not met. The bathrooms on both floors must be repaired and ventilation improved, so that people can bathe in a pleasant environment. Previous timescales of 30/06/06, 30/09/06, 04/10/06, 14/12/06, 28/02/07 and 17/04/07 not met. Timescale for action 01/08/07 2. OP9 13 (2) 01/08/07 3. OP21 22(2p)23( 2b) 01/08/07 Meadow Bank Nursing Home DS0000010101.V338829.R01.S.doc Version 5.2 Page 22 4. OP30 18 (1) There must be an annual training 01/08/07 plan in place to ensure that all staff receive the specific training they need at appropriate intervals, in order to do their job well. There must be a quality 01/08/07 assurance system in place, which is based on the views of people who live in the home and other stakeholders. This is to ensure improvements can be made to the service in line with peoples’ expressed wishes and their expectations. Previous timescale of 31/10/06,14/12/06, 28/02/07 and 17/04/07 not met. The homes policies must be reviewed and updated on a regular basis, so they inform correctly how to carry out their duties. Previous timescale of 31/05/06, 30/09/06, 04/10/0, 14/12/06, 28/02/07 and 17/04/07 not met. 01/08/07 5. OP33 24 6. OP37 24(1) 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 Pre–admission assessments should be detailed and include all aspects of peoples’ personal, health and social care needs, to ensure the home can meet those needs before the person agrees to move in. Care plans should be organised so that up to date and important information about peoples care needs is easily DS0000010101.V338829.R01.S.doc Version 5.2 Page 23 2. OP7 Meadow Bank Nursing Home 3. 4. 5. 6. 7. 8. 9. 10. OP9 OP9 OP9 OP12 OP25 OP24 OP31 OP36 available to, and understood by, staff. Arrangements for monitoring people who take their own medicines should be reviewed and medication review requested if necessary. Arrangements should be in place to ensure that people who go out for the day are able to take the medicines that are prescribed for them. Ordering systems for medicines should be reviewed to prevent stockpiling and medicines becoming out-of-date. The provision of suitable activities and entertainment for people living in the home should be continued and expanded. The lighting in the upstairs corridor should be made brighter so people can see clearly when using the corridor. The damp patch by the front door and toilet should be repaired and re-decorated to improve the look of the home. The registered manager should undertake some management training to improve her skills and abilities in managing a care service. Staff should receive regular recorded supervision, which identifies any unmet training needs and enables staff to update their practice and to improve their performance. Meadow Bank Nursing Home DS0000010101.V338829.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Meadow Bank Nursing Home DS0000010101.V338829.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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