Inspection on 25/10/06 for Montague Street Care Home

This inspection was carried out on 25th October 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Montague Street Care Home 14/08/07

Montague Street Care Home 02/11/05

Montague Street Care Home 19/07/05

Montague Street Care Home 15/02/05

Montague Street Care Home 10/01/05

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Montague Street Care Home 28-30 Montague Street Mansfield Nottinghamshire NG18 2PN Lead Inspector Joanna Carrington Key Unannounced Inspection 25th October 2006 10:00 Montague Street Care Home DS0000008720.V314861.R01.S.doc Version 5.2 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 Montague Street Care Home DS0000008720.V314861.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 Adults 18-65. 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. Montague Street Care Home DS0000008720.V314861.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Montague Street Care Home Address 28-30 Montague Street Mansfield Nottinghamshire NG18 2PN 01623 653 253 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) www.mencap.org.uk Royal Mencap Society Mrs Joanna Christine Turner Care Home 12 Category(ies) of Learning disability (12), Learning disability over registration, with number 65 years of age (12) of places Montague Street Care Home DS0000008720.V314861.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users shall be within categories LD or LD(E) Date of last inspection 2nd November 2005 Brief Description of the Service: 28/30 Montague Street is a care home providing personal care and accommodation for 12 adults with learning disabilities in two linked houses. Ages of current residents range from 48 to 86 years. The home is located in a residential area, close to shops, pubs, the post office and other amenities. The entrances provide level access. All bedrooms are single and located on two floors. A stair lift is provided in each house. There is a small patio providing an outdoor seating area, which is accessible by wheelchair users and there is a small car parking area. The fees for living at the home range from £343 - £543 per week. Montague Street Care Home DS0000008720.V314861.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over eight and a half hours on 25th October 2006. This was the home’s key inspection for this inspection / financial year. The main method of inspection was called ‘case tracking’ which meant selecting four service users and tracking the care and support they receive through checking their records, observation of care practice and discussion with them and with staff. All four service users case tracked were spoken with along with three staff. Staff records were examined and a partial tour of the premises also took place in order to assess environmental standards. A pre-inspection questionnaire was also supplied to the Commission and was used to make judgements about the service. The registered manager and deputy manager are currently absent from the service. A manager has been brought in from another Mencap service, to provide management cover and some stability in the home. The temporary manager came in on her day off to provide information, receive feedback and support the staff team during the inspection. What the service does well: What has improved since the last inspection? There have been some redecorating work done in communal areas and in some of the bedrooms, which makes the environment more homely and comfortable for service users. Bedrooms are personalised to suit individuals’ taste. Montague Street Care Home DS0000008720.V314861.R01.S.doc Version 5.2 Page 6 There have been some improvements to the development and detail of care plans, which helps ensure that all personal, health and social needs of service users are met. 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. Montague Street Care Home DS0000008720.V314861.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Montague Street Care Home DS0000008720.V314861.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 4 Quality for this outcome area is adequate. The admissions procedure is adequate in ensuring the home is suitable in meeting prospective service users needs. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A service user from another Mencap home has recently moved to Montague Street. There was evidence on the service user’s file that there was an introductory period when the service user visited the home to see if they liked it and would get on with other service users. They came for tea and had overnight stays. The social worker was involved in the process and a staff member from the other home has been working at Montague Street, which also eased the transition. In terms of assessing the individual’s needs, the community care assessment on their file is not up date and there have been minimal entries on daily records. As this service user is new, more detailed monitoring would have been invaluable in reviewing the placement and how they are settling into their new home. Montague Street Care Home DS0000008720.V314861.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality for this outcome area is good. Some improvements have been made to the care planning process, to ensure that needs and choices are met and that risk assessments are used effectively for promoting safety and quality of life. This judgement has been made using available evidence including a visit to the service. EVIDENCE: It is evident that since the last inspection some work has been carried out in developing detailed care plans that cover all aspects of health, personal and social care needs. Care plans seen are comprehensive and up to August of this year care plans have been reviewed on a monthly basis. Given that the majority of service users living in the home are over sixty-five it is recommended, in line with the National Minimum Standards for Older People that monthly reviews continue. This ensures any changes in needs are identified then met. Staff spoken with demonstrated an awareness of the individual needs of service users, which was reflected in the relevant care plans. Montague Street Care Home DS0000008720.V314861.R01.S.doc Version 5.2 Page 10 Service users spoken with said they are able to exercise choices and make decisions on a day-to-day basis. Service users can choose when they wish to spend time alone or with others and what activities they would like to participate in. Some service users choose to go to day centre while others have made the decision to retire from such activities and spend time at home. There are care plans in place identifying communication needs, for example it is noted that a service user wears a hearing aid. On the files of the service users case tracked there are various risk assessments in place, which are cross-referenced to the relevant care plans. These are used to identify dangers and how these can be minimised for service users chosen activities such as going swimming and out in the community. There are also necessary risk assessments for moving and handling and assistance with bathing. Montague Street Care Home DS0000008720.V314861.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality for this outcome area is good. Staff are committed to providing meaningful activities, enabling service users to access the community and maintain relationships. The rights and responsibilities of service users are mainly upheld but this must be embedded in all staff members practice. Service users enjoy their meal times but menu planning needs to improve to ensure meals are varied, balanced and nutritious. This judgement has been made using available evidence including a visit to the service. EVIDENCE: At the time of the inspection some service users were out at their chosen day centres while others stay at home. Activity records show that service users get to go out with their key workers to go shopping or out for lunch etc. One service user spoken with is going Christmas shopping. Service users are supported to attend church every week if that is their wish, and needs around religion and culture is identified in relevant care plans. Care plans also indicate that service users regularly meet with their relatives and service users spoken with confirmed that they speak with friends and family on the phone in private. Montague Street Care Home DS0000008720.V314861.R01.S.doc Version 5.2 Page 12 While a service user was being spoken with in the privacy of her own bedroom a staff member from an agency walked straight in without knocking. Staff members spoken with did however demonstrate the importance of respecting individuals dignity and privacy and gave good examples of how they would ensure this when providing support. Good practice was also observed: staff interacting with service users in a respectful manner. Service users spoken with reported that they like the meals and service users were observed enjoying their mealtime together. Service users are involved in menu planning at their house meetings. Menu records show that alternatives are always provided but in the last week there have been three occasions when service users have eaten chips. Montague Street Care Home DS0000008720.V314861.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality for this outcome area is adequate. Healthcare needs are met and service users receive personal support in the way they prefer and require. Medicine management fails to protect the safety of service users. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Care plans on how to support service users with personal care tasks such as washing and dressing are detailed and include individuals’ preferences. For example, one states “I like lots of towels with me”. Daily records also show that there is some flexibility: “[The service user] did not want a bath today but just a wash”. There was evidence on all four care files seen that relevant healthcare professionals such as community nurses, clinical psychologists and psychiatrists are involved in the support of service users, when appropriate. Service users spoken with confirmed that when they are feeling ill staff arrange an appointment and assist them to see a doctor. There are records, which indicate that service users have regular health care checks and attend dentist and opticians etc. Four medicines were audited and there were errors found with the stock control of all of them. For example for one medicine on the medication Montague Street Care Home DS0000008720.V314861.R01.S.doc Version 5.2 Page 14 administration record (MAR) it states that fifty-six tablets have been received. According to what has been signed on the MAR as administered only sixteen tablets should remain. There were seven other boxes of the same medicine in the store cupboard, all opened with tablets still in them. Altogether there were a total of seventy-one tablets left over, unaccounted for. For the same service user there is a ‘when required’ medicine stored but this is not recorded on the MAR so again these tablets are not accounted for. Night staff are carrying out stock checks on all service users prescribed paracetamol. The quantity on the stock check record does not tally with the MAR, so this system is not working. It is not clear as to whether one service user is actually self-medicating. Their medicines are being stored by the home and MAR records are being filled in, which in effect means the service user is not self-medicating. Some staff sign when the tablets are given while other staff are adding a code and stating on the back of the MAR that the service user is self-medicating. The quantity on the MAR states twenty-eight was received but a total of sixty-three were found. This medication is a Schedule 4 controlled drug. There is no requirement for this medicine to be stored in a controlled drug cupboard nevertheless it is still of grave concern that there are a significant number of these tablets unaccounted for. How this medicine is being taken does not reflect what is written on the MAR. This must be clarified with the GP. The procedure at the home is that two staff members administer medication together. One staff member was observed leaving the room to give medicines to a service user while the other staff member stayed in the lounge, and signed the record. This is not safe practice because the staff member that signed the record did not actually see the drugs being given to the right service user. Montague Street Care Home DS0000008720.V314861.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality for this outcome area is poor. The complaints procedure has not been followed, which does not ensure service users concerns are taken seriously and acted on. Service users are not protected from abuse. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The pre-inspection questionnaire states three complaints had been made in the preceding twelve months but no records of complaints and action taken could be located. Since the temporary manager has been in post at the home there have been three notified incidents to the Commission concerning the protection of service users. All of these incidents have involved service users assaulting other service users. The notifications indicated that the necessary action is being taken. Referrals to Social Services have been made in accordance with the local Safeguarding Adults procedures so that strategies for protecting service users can be agreed. Incident records were looked at during the inspection and showed that there have been other assaults between service users, which should have also been notified to the Commission. This is made a requirement in this report. The incident records for the last three months were analysed and found to contain a total of twenty-one separate occasions when service users have physically attacked staff. From talking with staff it seems that this has been the norm and accepted for some time now, with no consequences for service users actions. Staff spoken with reported not having had any form of training in how to manage challenging behaviour such as breakaway and de-escalation Montague Street Care Home DS0000008720.V314861.R01.S.doc Version 5.2 Page 16 techniques. This must be addressed as a matter of urgency so that staff can gain confidence in how to deal with these situations appropriately. This is made a requirement in this report. Montague Street Care Home DS0000008720.V314861.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality for this outcome area is good. Service users live in a clean and homely environment but bathing facilities are currently not adequate and do not meet service users preferences. This judgement has been made using available evidence including a visit to the service. EVIDENCE: On a partial tour of the premises it is evident that the home is kept clean and tidy. Laundry facilities are appropriate to the needs of service users. There have been some changes made to décor since the last inspection. The lounge / dining room in House 28 has been redecorated, and service users spoken with confirmed they were involved in choosing colours etc. Bedrooms seen are also nicely personalised to suit individuals’ tastes. Currently the home is without working adapted facilities for the baths, which mean only two service users’ can use the bath while others have to take showers. A service user spoken with admitted preferring baths but not able to have them at present. A staff member reported that the temporary manager is arranging for the adaptations to be upgraded. Until this work is complete this is included as a recommendation in this report. Montague Street Care Home DS0000008720.V314861.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36 Quality for this outcome area is good. Recruitment practices are good in protecting service users and staff are well trained and supported which helps ensure the needs of service users are met. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The files of three randomly selected staff members were looked at. Although there is not a central training record a file containing certificates show that these staff have attended training relevant to the individual and collective needs of service users and also that mandatory refresher training such as food hygiene, first aid and moving and handling is mainly up to date. The preinspection questionnaire states that all of the staff team are working towards at least National Vocational Qualification level 2. A recommendation to reach the minimum target of fifty percent of the staff team is included in this report. Two of the three staff files looked at contained evidence of all the necessary recruitment checks: a satisfactory Criminal Records Bureau (CRB) check and two written references. The other staff member had transferred from another Mencap service but not all the required information had transferred with her. A requirement is made in respect of this. The Commission have been kept informed prior to the inspection of staffing difficulties at the home. A lot of staff have left and there has been long term sickness. As a result agency staff are being used on a frequent basis. Staff Montague Street Care Home DS0000008720.V314861.R01.S.doc Version 5.2 Page 19 spoken with confirmed that the same agency workers are used when possible so that there is stability for service users. The roster shows that shifts are always being run with required numbers, so that service users are not placed at risk. The organisation was quick to arrange temporary management cover and staff spoken with confirmed that they have been getting the necessary support during a very difficult and unsettling time for them. All staff commented on how supportive the temporary manager has been and how they are feeling “empowered” by being more involved in the day-to-day running of the home and encouraged to speak out about past problems, currently being investigated. Montague Street Care Home DS0000008720.V314861.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality for this outcome area is adequate. The health, safety and welfare of service users are not fully protected. Good systems for monitoring the quality of care are in place, to ensure the home is run in the best interest of service users. This judgement has been made using available evidence including a visit to the service. EVIDENCE: As mentioned in the previous outcome area, staff spoken with only had positive comments to make about the temporary manager and her management style. It was evident from discussion with staff and from observation that changes being made are welcomed and put into practice. Mencap carry out full service reviews of their services every three years. The home is due its service review. A manager from another Mencap home visits the service annually to chat with service users and audit care practice issues. A ‘lay person’, with a learning disability, also regularly visits the service to speak with service users to obtain their feedback. The manager completes a Montague Street Care Home DS0000008720.V314861.R01.S.doc Version 5.2 Page 21 monthly ‘Service Improvement Plan’, which was seen. The provider also carries out monthly visits in accordance with Regulation 26 of the Care Home Regulations 2001. The pre-inspection questionnaire confirmed that gas and electrical systems are regularly serviced and that there are measures in place for the prevention of Legionella. The daily temperature records for fridge and freezers were looked at during the inspection. Big gaps in these records were seen and the last record was 11th September 2006. The requirement from two previous inspections, to install radiator covers has still not been complied with. Montague Street Care Home DS0000008720.V314861.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 2 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 1 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 2 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 X 3 X 3 X X 1 X Montague Street Care Home DS0000008720.V314861.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP20 Regulation 13(2) Requirement Ensure there are adequate arrangements in place for the recording, handling, safekeeping and safe administration of medicines received into the home. This refers to: 1. Ensure all tablets in the home are accounted for. This can be easily achieved by carrying over remaining tablets onto the next cycle’s medication administration record (MAR). 2. Ensure the MAR be signed by a person that can confirm the right medicine and dose has been given and to the right service user. 3. Ensure all medicines prescribed and in the home are included on the relevant MAR. 4. Ensure there is consistency with support given for named service user that ‘self medicates’. Review and amend the risk assessment to reflect support given. Improving medicine management is an outstanding DS0000008720.V314861.R01.S.doc Timescale for action 30/11/06 Montague Street Care Home Version 5.2 Page 24 2. 3. YA22 YA23 17, 22 37 4. 5. YA23 OP34 13 17 6. OP38 13(4) requirement, initial timescale, 02/11/05 not met. Ensure a record of all complaints is kept along with action taken. Ensure all incidents which adversely affect the well-being or safety of any service user are notified to the Commission in writing. This refers to service users assaulting service users and any other Safeguarding Adults issues. Identify and arrange appropriate training for staff in managing challenging behaviour. Ensure all information as specified in Schedule 2 is contained in the care home for all staff. Provide radiator covers (or replace radiators). This is an outstanding requirement from two previous inspections, initial timescale 01/08/05 not met. 30/11/06 26/10/06 31/12/06 31/12/06 31/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard YA2 YA6 YA17 YA27 YA42 Good Practice Recommendations Ensure new service users’ needs are fully assessed before they move to the home. In line with the National Minimum Standards for Older People, review care plans and risk assessments on a monthly basis. Ensure meals provided are varied. Ensure appropriate bathing facilities and adaptations are provided to meet the needs and preferences of service users. Ensure the recording and monitoring of fridge / freezer temperatures is kept up to date, in line with Health and Safety requirements. DS0000008720.V314861.R01.S.doc Version 5.2 Page 25 Montague Street Care Home Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 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 Montague Street Care Home DS0000008720.V314861.R01.S.doc Version 5.2 Page 26 - 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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