Inspection on 24/02/06 for Oaklands Care Centre

This inspection was carried out on 24th February 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 but made no statutory requirements on the home.

Other inspections for this house

Oaklands Care Centre 13/05/09

Oaklands Care Centre 16/06/08

Oaklands Care Centre 26/07/07

Oaklands Care Centre 20/09/06

Oaklands Care Centre 11/11/05

Oaklands Care Centre 10/02/05

Oaklands Care Centre 08/09/04

Oaklands Care Centre 29/10/03

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

CARE HOMES FOR OLDER PEOPLE Oaklands Care Centre 4 Oakland Road Moseley Birmingham West Midlands B13 9DN Lead Inspector Alison Ridge Unannounced Inspection 24th February 2006 11:20 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 Oaklands Care Centre DS0000024872.V284131.R01.S.doc Version 5.1 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. Oaklands Care Centre DS0000024872.V284131.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Oaklands Care Centre Address 4 Oakland Road Moseley Birmingham West Midlands B13 9DN 0121 449 6662 0121 449 3097 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) Exceler Healthcare Services Limited Mrs Rachel Christine Daley Care Home 46 Category(ies) of Old age, not falling within any other category registration, with number (46) of places Oaklands Care Centre DS0000024872.V284131.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the Manager successfully undertakes the Registered Managers Award or equivalent by April 2005. 11th November 2005. Date of last inspection Brief Description of the Service: Oakland’s Care Centre provides 24 hour nursing care for older adults. The home has been adapted and extended from an existing property and is situated on a quiet road not far from Moseley village. There is a range of community facilities to be found nearby, and a number of bus routes are within a fairly short walk of the home. There is off road car parking to the front of the property. Bedrooms are a mixture of shared and single rooms; spread over three floors of the premises. There are no en suite facilities provided by the home. There are lounges situated on two of the three floors of the home and there is a pleasant enclosed garden area for residents to access. The home has a passenger lift to all floors, a nurse call system and some aids and adaptations to assist residents with limited mobility. Oaklands Care Centre DS0000024872.V284131.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the inspector’s second visit to the home. The inspection was undertaken over the lunch-time, afternoon and early evening of one day. The information used in this report was collected by talking with people who live in the home, and observing the care and support they received. The inspector spoke with staff as they were undertaking their duties. Records about care, health and safety and the staff rota were inspected. The manager and deputy manager were present for the visit. It is suggested that this report be read along side the report of the visit undertaken in November 2005 to get a fuller picture of life in this home. The inspector extends her thanks to everyone who assisted with the inspection. What the service does well: What has improved since the last inspection? The manager has recruited a new activity worker to support service users in planning and undertaking activities. Oaklands Care Centre DS0000024872.V284131.R01.S.doc Version 5.1 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. Oaklands Care Centre DS0000024872.V284131.R01.S.doc Version 5.1 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 Oaklands Care Centre DS0000024872.V284131.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 5 All potential service users are assessed prior to being offered a place in the home. The potential service user or their relative can visit the home before deciding if it is the right place for them. EVIDENCE: The inspector tracked two service users who had quite recently moved into the home. It was evident from both files, and from talking with these two service users that they had been assessed prior to being offered a place, and that they had been able to visit the home before moving in. One of the service users the inspector spoke with reported that she had visited the home, and stayed for a day before deciding to move in. She was also given opportunity to choose a room from the vacant rooms available. Oaklands Care Centre DS0000024872.V284131.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 10 Service users needs and wishes are generally well planned for and delivered. Some specific shortfalls had previously been identified, and these continue to require addressing. Staff work in a way that ensures privacy and dignity is maintained. EVIDENCE: The staff responsible for developing the service users plan of care had consulted and included service users in this as far as was possible. The plans were very individual and personalised for each service user. The inspector has previously raised the need to make explicit in care plans the action that is required to be taken. Previously tracked plans regarding this were assessed and this work was found to remain outstanding. For one person tracked a physiotherapist had prescribed specific exercises to help maintain or regain strength. It was not apparent in the daily notes that these were being undertaken, or that staff were tracking if the service user had undertaken these. One person tracked was eating a soft diet and thickened fluids. No clear guidance on how food and drinks were to be prepared was available, and no risk assessment regarding choking or dysphasia had been developed. Oaklands Care Centre DS0000024872.V284131.R01.S.doc Version 5.1 Page 10 One service user with diabetes was tracked. The plan of care did not evidence how often blood sugars should be tested, or what a normal blood glucose range for that person would be. Service users had manual handling assessments, which had been kept under review. It was required these be further developed to provide specific guidance to staff on the type of hoist, and size of sling to be utilised. Examples of entries in some of the care plans and risk assessments that need to be made more specific were shared with the care manager. Phrases such as “ assist to” or “support to” without clear guidance on “how” should be avoided. The tissue viability nurse visited the home in August 2005 and undertook a full audit of service users skin and tissue integrity. The report identified that a quantity of equipment required condemning and replacing. This work remains outstanding. The report also requested people receive continence assessments. The deputy manager reported work towards undertaking this had been made with the Primary Care Trust (PCT) but to date is outstanding. The manager and deputy manager reported that the current prevalence of pressure injury is very low. It is required that the actions required in the tissue viability report be urgently actioned. The inspector spent time in the lounges on the ground and first floor. It was not evident that people had been supported to undertake personal care to a good standard. Examples of men who had not been supported to shave, people whose hair had not been brushed, people wearing very dirty glasses, and people with food and sleep residue on their face was apparent. The management team reported this was largely due to the staff on duty still learning the morning routine, as most of the people on duty usually work nights. In each plan of care a record of the appointments offered and attended was recorded. It was apparent in all the cases assessed that people had been enabled to access GP, optician, dentist, and specialist healthcare appointment’s as they needed. The way staff moved and hoisted service users was very positive in all but one instance, when one staff undertook a drag lift with a service user to sit her up in a chair. The inspector met with one of the GP’s who covers this home. Her comments about the way health care needs are planned for and met by staff at this home were very positive. The inspector observed how staff maintained service users privacy, and asked service users about their experience of this. Oaklands Care Centre DS0000024872.V284131.R01.S.doc Version 5.1 Page 11 The observation and comments made were all positive regards this area of care. Oaklands Care Centre DS0000024872.V284131.R01.S.doc Version 5.1 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 The staff provide a range of in house and community based activities. Friends and family were observed to visit service users. People important to each service user and if visits had been undertaken was recorded in the care file. Most service users were happy with the food served. Some problems with food were observed and reported on the day of inspection. EVIDENCE: The home has employed a new member of staff to plan and provide activities. The service users spoken to reported favourably regards this. There were photos, and reports of parties and events undertaken to mark Christmas and Valentines Day, and it is planned to celebrate Pancake Day. Some service users reported they had been supported out of the home, to a local pub or to shops. This was an obvious hi-light, and something thoroughly enjoyed. Staff were observed to undertake ad-hoc games and activities with service users during the visit, including a ball game, chats and sing-along. The need to provide opportunities for stimulation and engagement for service users with a higher level of dependency remains outstanding, but the manager reported plans are in hand to address this. It was positive to see how cultural needs including hair and skin care for afroCaribbean service users was being undertaken. Staff and service users Oaklands Care Centre DS0000024872.V284131.R01.S.doc Version 5.1 Page 13 reported that meals of different cultural origins were offered and generally enjoyed. Two service users the inspector spoke with were of West Indian origin. They both reported that there are opportunities to eat food of their culture, and one lady reported favourably about the sweet potato and yams included in the meals. The home has a very open visiting policy. Friends and family were observed to visit the home throughout the time of the inspection, and to be supported to visit people in private or in the communal lounges. People important to the service user were recorded in the plan of care. The inspector sat with service users during the lunch and teatime meal. On both occasions the food served looked tasty, and smelt nice. The home had a temporary cook on duty, and the quantity of food prepared wasn’t adequate, and some people received their lunch very late. The amount of tea served was less than usual, and caused some service users distress. Staff on duty rectified this. The dining tables were clean and set for each meal. No condiments or menus were provided. The service users inspectors spoke with confirmed they would like to have sauce and vinegar for example on their fish and chips. The staff support provided at lunch-time was not adequate. Service users were offered food they couldn’t eat, as staff were not familiar with their needs, and one service user ate both his main meal and desert from the end of a knife before staff noticed and supported him to use the correct cutlery. Several service users are visually impaired, and it is recommended that adapted cutlery and crockery be explored to enable them to eat more successfully. The inspector observed one service user in his bedroom, who staff serving lunch forgot to call. The inspector brought this to the deputy manager’s attention. Without this intervention she was not certain the service user would have received lunch. Two service users who required a liquidised meal were tracked. The meal had been liquidised by the kitchen staff and was in three distinct sections of the plate, as is good practice. Staff feeding the service users went on to mash the three areas together, and service users would not have been able to differentiate any difference in taste or texture. The management team reported these observations were largely due to the staff team on duty still learning the day job, as they mainly work nights. It has been required that the impact on service users of such staff rotations be reviewed and minimised. Oaklands Care Centre DS0000024872.V284131.R01.S.doc Version 5.1 Page 14 Oaklands Care Centre DS0000024872.V284131.R01.S.doc Version 5.1 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Staff had followed up concerns about service users safety and welfare with the GP and Social Care and Health. The home had not taken action to ensure such incidents are consistently recorded, or action taken to prevent further incidents. EVIDENCE: Accident records and care notes identified one service user had on occasions physically or verbally harmed other service users and staff in the home. The deputy manager evidenced how this had been followed up with the GP and placing social work team, which was positive. It was not apparent how the home was ensuring such incidents would not reoccur, or that a detailed record of the incidents was being maintained to ensure a baseline was established. It was required that further work to ensure the needs of the service user were being met, and that other service users and staff were being protected be undertaken. Oaklands Care Centre DS0000024872.V284131.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 The Oakland’s Care Centre is a large building over three floors. It has adequate communal space, bedrooms and bathrooms to meet service users needs, and to provide a comfortable and homely environment. EVIDENCE: The inspector did not undertake a tour of the premises on this occasion. The communal lounges were comfortable and warm. The general standard of cleanliness was good, with some areas requiring further specific attention. The manager reported work to manage the temperature of the first floor lounge, replace grab rails in toilets and bathrooms, and to re-fit the kitchen cupboards has been scheduled for attention. In the first floor lounge and some bedrooms curtains were observed that required re-fixing to the rails. Oaklands Care Centre DS0000024872.V284131.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 30 Adequate numbers of staff are employed, but the management must ensure staff on duty have the required levels of competence and experience to meet service users needs. EVIDENCE: The manager had undertaken a rotation of day and night staff to enable staff who usually work nights to receive training and supervision. While this is positive it was not evident that the knock on effects to service users had been fully explored. During the inspection examples of staff not working to the required standard, or being unaware of service users needs were observed and reported. The manager must review this to ensure a balance is achieved. The way staff approached and interacted with service users was positive. One service user said, “Staff are very pleasant and helpful” Oaklands Care Centre DS0000024872.V284131.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 38 The management of this home is strong and stable. The management team have a clear service user focus. Service users finances are well managed. EVIDENCE: The management of this home is very stable, and it was apparent both the manager and deputy manager have a strong service user focus. A condition of the manager’s registration was that she completes NVQ level 4 by April 2005. This has been breached, and neither the manager nor provider has pursued this with the CSCI. The manager reported she anticipates finishing this by April 2006. The home is generally well organised and run. One member of staff the inspector spoke with reported that the manager, and wider management team were very approachable, and that she felt confident to raise any concerns or worries. Oaklands Care Centre DS0000024872.V284131.R01.S.doc Version 5.1 Page 19 The management must ensure that previously made requirements are addressed, as fourteen of the previously made thirty requirements have been carried forward. The financial records of four service users were assessed. The home has a robust system in place for accounting for cash, and money held in the bank on the service users behalf. The new provider had undertaken a fire risk assessment of the home. It was not evident that the work identified as being required to address observed shortfalls had been undertaken. This must be addressed. Oaklands Care Centre DS0000024872.V284131.R01.S.doc Version 5.1 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 X X 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 2 X X X X X X 2 STAFFING Standard No Score 27 1 28 2 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 3 X 3 X X 2 Oaklands Care Centre DS0000024872.V284131.R01.S.doc Version 5.1 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 OP7 Regulation 12(1)(a) Requirement Unmet from the previous inspection. (Completion due by 16/12/05) Personal care must be undertaken to an acceptable standard Requirements made by the tissue viability nurse, (to include purchase of equipment, assessments and developed plans of care) must be addressed. Unmet from the previous inspection. (Completion due by 16/12/05) Evidence that required therapies are being provided must be available. Unmet from the previous inspection. (Completion due by 16/12/05) Service users with dysphasia must have an eating and drinking plan and choking risk assessment. Unmet from the previous inspection. (Completion due by 16/12/05) A full plan of care must be DS0000024872.V284131.R01.S.doc Timescale for action 06/03/06 2. OP8 12(1)(a) 13(1)(b) 01/04/06 3. OP8 12(1)(a) 13(1)(b) 01/04/06 4. OP8 12(1)(a) 13(4)(c) 01/04/06 5. OP8 12(1)(a) 13(4)(c) 01/04/06 Oaklands Care Centre Version 5.1 Page 22 6. OP8 12(1)(a) 13(4)(c) 7. 8. OP8 OP12 13(5) 16(2m-n) 9. OP15 16(2)(i) 18(1)(b) 18(1)(a) 10. OP15OP28 11. 12. OP18 OP19 13(6) 23(2)(b) 13. 14. OP19 OP21 23(2)(b) 23(2)(b) (j) 15. OP25 23(2)(p) provided for all service users with diabetes. Unmet from the previous inspection. (Completion due by 01/02/06) Care plans must detail the specific actions to be undertaken, and equipment required. All staff must undertake correct procedures for manually handling service users. Unmet from the previous inspection. (Completion due by 01/02/06) Staff must improve the stimulation and engagement for service users with higher dependence levels. The manager must ensure that the use of temporary kitchen staff does not have a negative effect to service users. The support provided to service users at meal times must be adequate to ensure their welfare and meet their needs. The manager must ensure that service users are safe within the home at all times. Unmet from the previous two inspections. (Completion due by 01/02/06) The Registered Person shall ensure that the storage units and cupboards in the in the kitchen are repaired/replaced. All curtains/window coverings must be securely hung. Unmet from the previous inspection. (Still within timescale. Due for completion 01/03/06) Toilets and bathrooms in the home must be improved. Air conditioner on order, but not yet supplied. The Registered Person shall DS0000024872.V284131.R01.S.doc 01/04/06 06/03/06 01/04/06 06/02/06 06/03/06 06/03/06 01/05/06 01/04/06 01/05/06 01/05/06 Oaklands Care Centre Version 5.1 Page 23 16. OP26 16(2)(k) 17. OP27 18(1)(a) 18. OP28 18(1)(c) 19. OP29 13(4c) 13(6) 19(1a) 13(4c) 13(6) 19(1a) 9(2)(b)(i) 20. OP29 21. OP31 22. OP33 24(1)(b) 23. OP36 18(2) ensure that the air temperatures in the first floor lounge are maintained at around 21 degrees centigrade at all times. Unmet from the previous inspection. (Completion due by 16/12/05) Effective odour management must be achieved. Specific cleaning must be undertaken as required. The manager must ensure the skill mix of staff on duty is always adequate to meet service users needs. Unmet from the previous two inspections. The Registered Person shall ensure that a minimum ratio of 50 trained members of care staff (NVQ Level 2 or equivalent) is achieved by 2005. Not assessed at this inspection. Evidence how concerns raised in the recruitment process are addressed and resolved must be available. Not assessed at this inspection. Written evidence that risks have been considered for employing people with one reference must be available in the staff file. Unmet from the previous two inspections. (Still within timescale. Due for completion 01/06/06) The Registered Manager is required to obtain a recognised management qualification by 2005. Not assessed at this inspection. Evidence of how information gathered in the Quality questionnaire is used must be provided. Not assessed at this inspection. All staff must receive adequate levels of supervision. (Six times DS0000024872.V284131.R01.S.doc 01/04/06 06/03/06 01/08/06 01/06/06 01/06/06 01/06/06 06/03/06 06/03/06 Oaklands Care Centre Version 5.1 Page 24 24. 25. OP38 OP38 23(4) 13(4) 26. OP38 13(4)(c) 23(2)(c) 27. OP38 13(4)(c) 23(4)(c) 28. OP38 13(4)(c) 23(4)(c) per year) Not assessed at this inspection. All fire alarm call points must be tested in turn. Outstanding from the previous inspection. All requirements made by West Midlands Fire Service must be addressed. Not assessed at this inspection. Evidence that a Landlords Gas safety test has been undertaken on appliances in the laundry and kitchen must be provided to the CSCI. Not assessed at this inspection. Evidence that remedial work identified at the lift service in May 2005 has been undertaken must be forwarded to the CSCI. Not assessed at this inspection. The Electrical hard wiring must be tested every five years (Due October 2005) 06/01/06 01/04/06 01/04/06 01/04/06 01/04/06 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 OP12 OP12 OP12 OP15 OP15 Good Practice Recommendations It is recommended that the programme of activities continue to be developed and increased. It is recommended that stimulation other than TV is explored, and that the quality of the TV picture is improved where poor. It is recommended aids and adaptations to support service users who have visual impairments or physical impairments to undertake activities be explored It is recommended that condiments and menus be provided on the table at meal times. It is recommended that equipment to facilitate eating for people with impaired vision be obtained. DS0000024872.V284131.R01.S.doc Version 5.1 Page 25 Oaklands Care Centre 6. OP36 Not assessed at this inspection. It is recommended that deficits in performance or knowledge identified in appraisal be subject to goal setting/monitoring. Oaklands Care Centre DS0000024872.V284131.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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. 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