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Inspection on 21/11/06 for Nightingale House (Strafford Road)

Also see our care home review for Nightingale House (Strafford Road) for more information

This inspection was carried out on 21st November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Residents feel that staff know their individual needs and provide good care. The staff and management team is stable and knows residents well. Friends and families feel welcome when they visit and say that staff provide good care for their relatives. Professionals say that the home provides good care and communicates well with them when needed.

What has improved since the last inspection?

A part-time activities co-ordinator post has been advertised. Several staff have achieved qualifications relevant to their roles. The recoding of training has improved. Moving and handling assessments have been carried out, although these need improvement. Risk assessments have been carried out, although these need improvement. A Quality Assurance system has been introduced. A new call bell system has been installed.

What the care home could do better:

Improve the activities and outings available to residents. Improve the recording of medication. Produce a written development plan for the home. Ensure that moving and handling assessments contain all information necessary to support residents safely, with dignity and according to their preferences.Ensure that risk assessments identify risk factors where they occur and control measures where necessary. The owner must complete the Registered Managers Award. Arrange infection control training for staff. Replace the carpet in one second floor bedroom. Address the issue of urine odour within the home.

CARE HOMES FOR OLDER PEOPLE Nightingale House (Strafford Road) 10 Strafford Road Twickenham Middlesex TW1 3AE Lead Inspector Simon Smith Unannounced Inspection 21st November 2006 12:30 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 Nightingale House (Strafford Road) DS0000017384.V326407.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. Nightingale House (Strafford Road) DS0000017384.V326407.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Nightingale House (Strafford Road) Address 10 Strafford Road Twickenham Middlesex TW1 3AE 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) 020 8892 1854 02088915541 v.nayar@btinternet.com Mr Vipin Nayar Ms Sushma Nayar Mrs Sushma Nayar Care Home 21 Category(ies) of Dementia - over 65 years of age (9), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (1), Old age, not falling within any other category (21) Nightingale House (Strafford Road) DS0000017384.V326407.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Condition of registration of categories of care The Commission has a list of the service users who have dementia or mental health needs. A condition of registration of the categories of care, is that the number of places for dementia and mental health needs are for the existing service users only and the home is not to admit any new service users with these conditions unless another variation is submitted for consideration. Date of last inspection Brief Description of the Service: Nightingale House has been registered as a care home since 1976 and was purchased by the present owners in 1998. The home provides accommodation for a maximum of 21 older people in single and shared rooms. Current weekly fees range from £450 to £510. There were two resident vacancies at the time of inspection. The registration category of the home currently includes provision for nine residents who have dementia. It should be noted that this provision relates to specific residents and is not a permanent amendment to the home’s registration category. The property is situated in a quiet residential area and is within walking distance of Twickenham town centre, which provides a range of shops, pubs, restaurants and community resources. The River Thames and open spaces are within easy reach and access to public transport is good. Nightingale House (Strafford Road) DS0000017384.V326407.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector used evidence from a number of sources when making judgements about the home. These included visiting the home and talking to residents, relatives, the owner, the manager and staff. A sample of records was checked at the home, including staff and residents’ files. The inspector was made welcome and would like to thank all the people who gave their views about the home. The home met 17 of 25 National Minimum Standards assessed at this visit. Seven Standards were almost met, one Standard was not met and one Standard was not applicable. There were enough staff on duty to meet residents’ needs during the inspection. Some staff have worked at the home for a long time and know residents very well. Residents, relatives and professionals said that the home provides good care. Residents said that they can have privacy when they want it and that staff treat them with respect. The home has recently improved the way in which it asks residents for their views about the home. Residents’ families’ said that the home gives them important information about their relatives when they need it and that staff make them welcome when they visit. Residents said that they usually like the food at the home and that they can eat their meals at times to suit them. Residents also said that they are able to have something else if they do not want the dish on the menu. The lack of good activities for residents has been a problem for some time. Although the activities have yet to get better, the owner said that a new job has been created for someone to arrange the activities. Staff files showed that the home makes checks on new staff before they start work. Several staff have completed relevant qualifications since the last inspection. The home needs to improve some written information to make sure that residents’ safety is maintained. For example moving and handling assessments must provide better information to make sure that residents are supported to move around safely. Nightingale House (Strafford Road) DS0000017384.V326407.R01.S.doc Version 5.2 Page 6 Risk assessments also need to improve. The home must make sure that any risks to residents are recorded so that measures to manage these risks can be put in place. What the service does well: What has improved since the last inspection? What they could do better: Improve the activities and outings available to residents. Improve the recording of medication. Produce a written development plan for the home. Ensure that moving and handling assessments contain all information necessary to support residents safely, with dignity and according to their preferences. Nightingale House (Strafford Road) DS0000017384.V326407.R01.S.doc Version 5.2 Page 7 Ensure that risk assessments identify risk factors where they occur and control measures where necessary. The owner must complete the Registered Managers Award. Arrange infection control training for staff. Replace the carpet in one second floor bedroom. Address the issue of urine odour within the home. 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. Nightingale House (Strafford Road) DS0000017384.V326407.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 Nightingale House (Strafford Road) DS0000017384.V326407.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): Standards 2, 3 and 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents have a written contract with the home that sets out the terms and conditions of their stay. Residents’ individual needs are effectively assessed at the time of admission. EVIDENCE: The last inspection report made a Requirement that all residents must be issued with “a written agreement that accurately sets out the terms and conditions of their placement”. The Requirement also stated that “Contracts must be signed by residents or their appointed representatives”. All the residents’ files examined at this inspection contained appropriate, signed contracts. Nightingale House (Strafford Road) DS0000017384.V326407.R01.S.doc Version 5.2 Page 10 Residents’ files also contained needs assessments, including local authority assessments where these had been carried out by a care manager. The home does not admit residents for intermediate care. Nightingale House (Strafford Road) DS0000017384.V326407.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. Guidance for staff about the delivery of care has improved. Residents, relatives and professionals feel that staff provide good care. Staff liaise effectively with other healthcare professionals when necessary. Residents have access to privacy when they want it and feel that staff treat them with respect. The information recorded in moving and handling assessments must improve. The recording of medication must improve. EVIDENCE: Nightingale House (Strafford Road) DS0000017384.V326407.R01.S.doc Version 5.2 Page 12 The last two inspections have found that guidance for staff about how to deliver personalised care to residents and the quality of care planning has improved. Residents’ care plans are now more person-centred and identify individual needs, strengths, likes and dislikes. A number of people said that the home meets residents’ healthcare needs well, including relatives and a visiting general practitioner. The general practitioner also said that staff from the home communicate well with health care professionals when necessary. The last inspection report made a Requirement that the home “Develop a policy and demonstrate a proactive approach to the prevention of falls” and “Provide evidence of an up to date moving and handling assessment for each resident”. The manager and the owner were able to demonstrate that the home has worked on addressing these issues. Where falls occur, details are now more accurately recorded. Details of falls are collated monthly in order to identify and address any trends emerging. The residents’ files examined also contained moving and handling assessments. The home’s policy states that these assessments should be reviewed every three months. Two of those seen contained evidence of three-monthly review, one did not. Whilst it is encouraging that moving and handling assessments were in place, further improvement is needed regarding the information recorded in the assessments. For example, assessments contained references such as, “bath – use hoist”. Assessments should specify how many staff are needed to support the resident for each task, what techniques they should use when supporting and which hoist (or other equipment) should be used for the task. See Requirement 1. There is an appropriate system for the storage and administration of medication. All medication coming into or leaving the home is recorded. The home has a written medication policy. Inspection of medication administration records for five residents indicated one error in recording in November 2006. In addition, the medication record was unclear as to whether creams had been administered in many cases. One member of staff currently signs “R” when administering medication. The letter ‘R’ indicates ‘refused’ on a medication administration record. The member of staff must use an alternative, identifiable signature. See Requirement 2. Discussion with staff demonstrated that carers have a good knowledge of residents’ individual needs. Residents’ care plans illustrate that staff liaise well with other professionals when necessary. Nightingale House (Strafford Road) DS0000017384.V326407.R01.S.doc Version 5.2 Page 13 Discussion with residents confirmed that they have access to privacy when they want it and that staff treat them with respect. Staff were observed to maintain the privacy and dignity of residents throughout the inspection. Personal care needs were met promptly and with discretion. Staff knocked before entering private accommodation and addressed residents with respect. Nightingale House (Strafford Road) DS0000017384.V326407.R01.S.doc Version 5.2 Page 14 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. Family members are made welcome when they visit. Family members feel the home keeps them well informed about their relatives. Most residents enjoy the food provided by the home. The home does not provide enough activities and outings for residents. Some risk assessments do not fulfil their purpose and must be improved. EVIDENCE: The lack of good activities for residents has caused concern for some time, and this has been reflected in previous inspection reports. Although the activities provided have yet to improve, the owner reported that a part-time activities co-ordinator post has been advertised. Nightingale House (Strafford Road) DS0000017384.V326407.R01.S.doc Version 5.2 Page 15 The owner said that the successful applicant would attend relevant training, which is essential to equip the post holder with the skills to develop a programme of activities and events that meets residents’ needs. It is hoped that the allocation of dedicated staff hours to the development of an activities programme will realise benefits to residents once the post has been filled. However as the activities currently available are poor the Requirement made at the last inspection is reinstated. See Requirement 3. It is also hoped that the programme of activities will include more opportunities for residents to go out as there is little evidence to suggest that residents are taken out regularly by staff. Residents’ families’ comments indicated that they are kept well informed by the home of important events affecting their relative and that they are made welcome by staff when they visit. Relatives also said that staff are willing to spend time with them to discuss their relative’s needs. The home has recently introduced a new risk assessment format designed to identify and minimise risks in activities undertaken by residents. The owner said that risk assessments will be reviewed every three months. Whilst this is a positive step, some of the risk assessments seen on the day of inspection did not fulfil their purpose and must be improved. For example the inspector saw a risk assessment for a resident who regularly travels independently. The risk assessment indicated that the home supports the resident’s choice to make this decision but does not feel that the activity is safe. This is of little value as it fails to identify any risk factors involved in the activity or to make the activity more safely achievable by the resident. In order to be of benefit to residents, risk assessments must identify risk factors where they occur and implement control measures where necessary. In this way, the home will support the rights of residents to make informed choices whilst ensuring that inherent risks are minimised wherever possible. See Requirement 4. Residents said that they like the food provided by the home and that they are able to eat their meals at times to suit them. Residents also said that they are able to have an alternative if they do not like the options on the published menu. Nightingale House (Strafford Road) DS0000017384.V326407.R01.S.doc Version 5.2 Page 16 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 good. This judgement has been made using available evidence including a visit to this service. Appropriate procedures are in place for the management of complaints. Residents feel any complaints raised would be properly addressed. The volume of complaints about the home is not a cause for concern. Training is provided for staff in the recognition and prevention of abuse. EVIDENCE: The home has a Complaints procedure, which gives details of arrangements for dealing with complaints and concerns. Residents spoken to during the inspection were confident that any complaint they made would be dealt with properly. No complaints have been made about the home to the CSCI since the last inspection. The last inspection report made a Requirement that all staff attend training in the Protection of Vulnerable Adults (POVA). The owner said that all staff have now attended this training and that POVA training would be included in the induction for all new staff. Nightingale House (Strafford Road) DS0000017384.V326407.R01.S.doc Version 5.2 Page 17 Nightingale House (Strafford Road) DS0000017384.V326407.R01.S.doc Version 5.2 Page 18 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, 20, 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. Communal rooms are welcoming and homely. Residents’ bedrooms are personalised and reflect individual tastes and preferences. Unpleasant odours are a problem in some areas of the home. EVIDENCE: The communal rooms of the home include a residents’ lounge and separate dining room. The owner said that if planning permission can be obtained it is hoped to build a conservatory to increase the communal space available to residents. Nightingale House (Strafford Road) DS0000017384.V326407.R01.S.doc Version 5.2 Page 19 The home has a well maintained garden. Residents’ accommodation is arranged over three floors, which can be reached by lift. Basic aids to mobility, such as grab rails in bathrooms and double handrails on the stairs, are in place throughout the home. The owner said that a new call bell system had been installed since the last inspection. The manager reported that residents were finding the new system easy to use. Residents’ bedrooms were personalised and reflected the tastes and preferences of their occupants. A number of bedrooms contained evidence of hobbies and interests. Residents are able to bring personal items, including furniture, with them on admission. The last inspection report made Requirements that the home: • • • Fit covers to all radiators to prevent the risk of scalding. Replace the carpet in one second floor bedroom. Keep the home free of unpleasant odours. The owner advised that the home has decided not to cover all radiators but to risk assess each radiator individually and to fit covers to those presenting a risk. The carpet on the second floor of the home has yet to be replaced. See Requirement 5. Whilst improvements have been made to the management of odours, this issue has yet to be resolved and the Requirement is reinstated here. See Requirement 6. Nightingale House (Strafford Road) DS0000017384.V326407.R01.S.doc Version 5.2 Page 20 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 good. This judgement has been made using available evidence including a visit to this service. The staff team is stable and staff know residents well. The home makes appropriate checks on new staff before they start work. New staff receive an induction to the home. Staff receive training appropriate to their roles. EVIDENCE: There were enough staff on duty to meet the needs of residents during the inspection. The staff team is stable, which is much appreciated by residents. The owner said that there was one part-time staff vacancy at the time of inspection. The owner said that staff had attended moving and handling training since the last inspection and that two senior staff attended mental health training. A course on infection control had been booked but cancelled. It is recommended that this training be re-arranged. Nightingale House (Strafford Road) DS0000017384.V326407.R01.S.doc Version 5.2 Page 21 The owner said that three staff had recently completed NVQ level 2 and that all staff now have a minimum qualification of NVQ level 2. The owner reported that three staff are working towards NVQ level 3. Three staff files were examined. All contained evidence of application form, references, contract of employment, Criminal Records Bureau (CRB) disclosure, induction, supervision and training. Nightingale House (Strafford Road) DS0000017384.V326407.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The owner needs to complete a relevant professional qualification. Quality Assurance systems have been introduced since the last inspection. The home must provide evidence of a development plan for the service. Standards of health and safety at the time of inspection were good. EVIDENCE: Nightingale House (Strafford Road) DS0000017384.V326407.R01.S.doc Version 5.2 Page 23 The manager has been in post since May 2005, although the owner continues as the manager registered with the CSCI. The last inspection report made Requirements that: • • • The owner complete the registered managers’ award (RMA). The Registered Person develop an effective Quality Assurance system, which takes into account the views of residents and other stakeholders. The Registered Person produce a written development plan for the home, which is subject to regular review and is based on positive outcomes for residents. The owner reported that the registered managers’ award is almost complete and that she planned to meet her assessor in the week after the inspection. See Requirement 7. The owner was able to demonstrate that systems of Quality Assurance have been introduced since the last inspection. Surveys have been distributed to residents, relatives and visiting professionals to seek their views about the home. The owner reported that this exercise will be repeated at regular intervals to ensure that the home is proactive in seeking stakeholders’ views and identifying areas for potential improvement. In addition, the owner said that the home seeks residents’ views through monthly meetings, which relatives are also encouraged to attend, and that it is planned to produce a monthly newsletter about the home. The owner said that a development plan for the service has been drawn up, although was not able to locate the plan at the time of inspection. The Requirement is therefore reinstated here. See Requirement 8. Residents manage their own money where they wish and are able to do so. The home provides facilities for residents to deposit valuable items for safekeeping. The home does not act as appointee for residents. A fire risk assessment was carried out in October 2006. The last fire drill took place in October 2006. The fire alarm system was serviced in September 2006. The home’s fire fighting equipment was checked in June 2006. Portable appliance testing (PAT) was carried out in July 2006. Nightingale House (Strafford Road) DS0000017384.V326407.R01.S.doc Version 5.2 Page 24 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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X 2 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 3 Nightingale House (Strafford Road) DS0000017384.V326407.R01.S.doc Version 5.2 Page 25 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 OP8 Regulation 12 13(4) Requirement Ensure that moving and handling assessments contain all information necessary to support residents safely, with dignity and according to their preferences. 1. All residents’ medication must be administered and recorded accurately. 2. Medication records must clearly record the administration of creams. 3. All staff administering medication must use an appropriate, identifiable signature. Improve the range of activities and outings available to residents. This Requirement is reinstated from the last inspection. Risk assessments must identify risk factors where they occur and implement control measures where necessary. Replace the carpet in one second floor bedroom. This Requirement is reinstated Nightingale House (Strafford Road) DS0000017384.V326407.R01.S.doc Version 5.2 Page 26 Timescale for action 30/01/07 2 OP9 13(2) 30/01/07 3 OP12 16(m)(n) 30/01/07 4 OP14 12(1) 13(4) 16(2) 23(2) 30/01/07 5 OP24 30/01/07 6 OP26 16(2)(k) from the last inspection. Address the issue of urine odour within the home. This Requirement is reinstated from the last inspection. The owner must complete the Registered Managers Award. This Requirement is reinstated from the last inspection. Produce a written development plan for the home, which is subject to regular review and is based on positive outcomes for residents. This Requirement is reinstated from the last inspection. 30/01/07 7 OP31 9(2) 30/01/07 8 OP33 24 25(1) 30/01/07 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 OP30 Good Practice Recommendations Re-arrange infection control training for staff. Nightingale House (Strafford Road) DS0000017384.V326407.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 Nightingale House (Strafford Road) DS0000017384.V326407.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. 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