Inspection on 04/01/07 for Lake & Orchard Care Centre

This inspection was carried out on 4th January 2007.

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

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

Other inspections for this house

Lake & Orchard Care Centre 14/03/06

Lake & Orchard Care Centre 30/09/05

Lake & Orchard Care Centre 26/01/05

Lake & Orchard Care Centre 10/08/04

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Orchard House Nursing Home Orchard House Nursing Home Kelfield York North Yorkshire YO19 6RE Lead Inspector Ms Anne-Marie Foster Key Unannounced Inspection 4th January 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Orchard House Nursing Home DS0000045991.V326122.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. Orchard House Nursing Home DS0000045991.V326122.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orchard House Nursing Home Address Orchard House Nursing Home Kelfield York North Yorkshire YO19 6RE 01757 248868 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.europeancare.co.uk European Care (SW) Ltd Mrs Vikki Sara Hamblin Care Home 30 Category(ies) of Dementia - over 65 years of age (30), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (30) Orchard House Nursing Home DS0000045991.V326122.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Age range 55 years plus Service Users up to 30 (DE(E)) and 30 (MD(E)) up to a maximum of 30 service users 14th March 2006 Date of last inspection Brief Description of the Service: Orchard House is a care home providing nursing care for over the age of 55 years with dementia and mental health illness. The home is owned by European Care Limited and was registered with the Commission in July 2003. Orchard House is located in Kelfield a rural village close to York and Selby. It is situated in large private grounds. Orchard House is in the same grounds as Lake house, a care home owned by the same company. The main kitchen for both homes is situated in Lake house. Orchard house has a satellite kitchen and meals are brought over to the home via a heated food trolley. The accommodation provided is both in single and double bedrooms over two floors and there is a passenger lift for access to the first floor. There is both ramped and level access to the home, ample parking for visitors and staff and a large garden area. Weekly fees at January 2007 range from £359 to £595 this does not include chiropody, hairdressing and newspapers. Orchard House Nursing Home DS0000045991.V326122.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced site visit, which lasted six and a half hours excluding preparation time. Information about the home was gathered prior to the site visit from a variety of sources: • A pre inspection questionnaire was filled in by the manager about the home and sent to The Commission. This gave information, such as staff rotas, menus and fees. Ten surveys (comment cards) were sent to relatives of service users and three were filled in and returned. Two surveys (comment cards) were sent to GP practices that visit the home and both of these were filled in and returned. Notifications of deaths and illness sent to The Commission. Information about the service, held by The Commission about the home. • • • • On the day of the visit the inspector spoke with the registered manager, service users, relatives and staff. Because the home cares for people who may not be able to communicate their views to the inspector, time was spent observing staff interacting with service users throughout the day. What the service does well: The pre admission assessment of care needs is carried out in a detailed way. The prospective service user and/or their relatives can be assured that the home will only accept someone for admission if they can meet their needs. The care that is given is well planned and there are good numbers of knowledgeable staff to deliver that care. Good quality and appropriate activities are organised for service users, and they receive a varied lifestyle that meets their social, needs. The atmosphere in the home is relaxed and there are good interactions between staff and the service users. Orchard House Nursing Home DS0000045991.V326122.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Orchard House Nursing Home DS0000045991.V326122.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Orchard House Nursing Home DS0000045991.V326122.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. Quality in this outcome area is good. Service users have an assessment of their care needs carried out before moving into the home, so that staff can be sure they can meet those needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The deputy manager is responsible for carrying out an assessment of care needs with prospective service users. The assessment is then discussed with the manager and if they agree that their care needs can be met, then that person is offered a place at the home. The inspector looked at the assessment records of four service users. These contained good detail about the individuals needs and included; personal care and wellbeing, diet and weight, sight hearing and communication, mental state and cognition, social interests and hobbies, mobility and dexterity, any history Orchard House Nursing Home DS0000045991.V326122.R01.S.doc Version 5.2 Page 9 of falls, and continence. This information is necessary so that staff can then develop a plan of care for the individual. People are invited to visit the home to look at the facilities and discuss the services before making a decision whether to move. The service users guide provides interested parties with the information that they need. The home does not provide Intermediate care. Orchard House Nursing Home DS0000045991.V326122.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. Service Users live in a home where their health and social care needs are met by caring staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service user’s health personal and social care needs are set out in an individual plan of care. Four of these care plans were looked at by the inspector. The plans were well written. They set out the actions to be taken by the care staff to ensure that all aspects of care needs are met. The care plans contained good, individualised detail, and had been reviewed regularly to reflect any changes in the care needs. The plans included risk assessment, which were in place. These assessments help to minimise risks for the service user such as falls, in order to promote as much independence as possible. Orchard House Nursing Home DS0000045991.V326122.R01.S.doc Version 5.2 Page 11 The plans are written when possible with the service user and their relative or representative. The registered manager promotes and maintains service users’ health and ensures access to health care services. Care staff maintain the personal and oral hygiene of the service users and encourage independence in this area wherever possible. There are some service users in the home however with high dependency, who receive total care from the staff. People’s nutritional wellbeing is made a priority at the home, service users are weighed at least monthly and the Malnutrition Universal Screening Tool (MUST) is in use as many of the service users with severe dementia and mental health disorders could be at risk by not taking sufficient calories. Actions are written to explain how staff help service users to maintain a healthy weight. The inspector saw staff encouraging and assisting service users to eat in a calm unhurried way. There were also frequent and regular offers of beverages and snacks. Service users also have a ‘goody box’ containing snacks and treats, which might help to stimulate the appetite, supplement the diet and encourage people to make small choices. Professional advice is sought from people like the GP, continence nurse, tissue viability nurse and community dietician when necessary. Records of these visits were seen in the care files. On the day of the inspection a visiting speech therapist was assessing a service user who had a swallowing problem. The staff at the home escort the service users when attending appointments. Two comment cards received from visiting GP’s were, in the main positive about their patients care at he home. The medication system was looked at, and a medicine round was observed. The qualified nurse reported no difficulties with the ordering and disposal of medications and said that everything runs smoothly. There is a weekly medication audit. The medication administration records looked at and were satisfactory. The controlled drugs were counted and found to be correct. Fridge temperatures in the medication room are checked every other day, staff record their findings and the inspector noted that temperatures were satisfactory. Service users are protected by a robust medication system. Service users generally were not able to tell the inspector how they are treated and so the inspector spent some time in each lounge and dining area to observe the staff ‘in action’ carrying out their work. A group of visiting relatives, and comment card cards received from three relatives all agreed with the inspector’s positive findings about care needs being met and good staff interactions with service users. Staff at the home know the service users well, and this is reflected in the calm way that they go about their work. Service users are treated with dignity, respect and their privacy is upheld. Service users looked well groomed and Orchard House Nursing Home DS0000045991.V326122.R01.S.doc Version 5.2 Page 12 cared for, wearing their own clothes and in some cases jewellery and make up. Staff use the service user’s preferred term of address and were seen knocking on doors before entering. The organisation launched a Dementia Development Service in May of 2006.In particular this service looks at improvements to the care of those with dementia and assists the home in forging networks with other individual dementia care groups. Orchard House Nursing Home DS0000045991.V326122.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): All of the above standards were looked at. Quality in this outcome area is good. Service Users live in a home where their likes and dislikes are taken into consideration, and where they have opportunities to join in varied activities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home employs an activities person who is particularly dedicated to the client group. Activities are planned ahead and are appropriate to the service users. Likes and dislikes and personal interests are recorded in the care file, which helps with the planning of activities. To help address the social cultural, religious, recreational needs and interests of the service user the varied programme of activities includes; visits from religious persons, reminiscence work, music, quizzes, board games, trips out, bingo dominoes, films, and outside entertainers. Recently an acting group performed the pantomime Aladdin and this was a great success. Orchard House Nursing Home DS0000045991.V326122.R01.S.doc Version 5.2 Page 14 Visitors are made welcome at the home by the staff. Service users can see their visitor in private if they wish and there are various areas around the home for people to sit. The home is planning the development of a ‘reminiscence’ room. This will be a parlour with features that the client group will be familiar with. Because of their condition the majority of the service users are not able to make an informed decision about how they live their lives, however staff still work in a way that offers flexibility and choice. The care staff use the information held in the care plans about preferences and routines, and service users are treated as individuals. The lunchtime meal was observed. Many service users require assistance and need encouragement, and there were enough staff available to provide this. Those service users that are restless and wish to move away from the table are helped, and the disturbance to others is minimised. Lunchtime appeared to be an enjoyable part of the day, there were three menu choices and the food looked balanced and wholesome. The dining area is pleasant. Some service users have their lunch in the sitting room and staff assisted these service users as necessary, to ensure that they had enough to eat. Orchard House Nursing Home DS0000045991.V326122.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 – 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. Service users are protected by a clear complaint procedure, knowledgeable staff and by an open style of management. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Whilst many of the service users with severe dementia will be unable to make a complaint, they are observed and changes in behaviour are noted and investigated in case of concern or changes in needs. The home’s complaints policy is available to service users their relatives and staff and a copy is displayed in the reception area. A Comment Book and questionnaire are also available for people to report a concern or complaint. The registered manager operates an ‘open door’ policy for staff, service users and relatives and takes complaints seriously. One complaint has been received by the home since the last inspection. The Commission for Social Care Inspection has been notified of another complaint (allegation), this was investigated by social services and the allegation was not upheld. Orchard House Nursing Home DS0000045991.V326122.R01.S.doc Version 5.2 Page 16 The home takes steps to ensure that staff are well trained and are alert to the possibility of abuse. Staff spoken with were sure they knew how to make a complaint, or report a concern, and were confident that they would be listened to and taken seriously by the Registered Manager. Information about abuse is given to staff through training and the policy is displayed in the staff room. Local authority guidance on how to, be aware of, and report abuse is available. Staff are checked through the Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) lists prior to taking up their posts, to make sure that they are not unsuitable for working with a vulnerable client group. Orchard House Nursing Home DS0000045991.V326122.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21 and 26. Quality in this outcome area is adequate. Service Users live in a clean home however improvements could be made which would further promote their comfort. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Improvements to some bedrooms and corridors were noted by the inspector. This work must continue so that the upstairs decoration, furnishing, and bathrooms are brought up to the same standard. A programme of routine maintenance and renewal of fabric should continue so that redecoration is done before things become shabby. The two bathrooms upstairs are not suited to their purpose. They are too small and badly laid out and there is no room for equipment to assist the staff Orchard House Nursing Home DS0000045991.V326122.R01.S.doc Version 5.2 Page 18 and service user. This means that only two assisted bathrooms are available for thirty service users, which is not enough. Plans for an assisted bath/shower room are in place and the work needs to go ahead as soon as possible for the comfort of service users. Gardens are well maintained although the path leading to the home needs attention, as potholes have developed that could become hazardous. Whilst the home was clean and free from odours there were some areas of careless untidiness that need to be addressed. The inspector found a pair of used gloves on the floor of the lift and another pair of used gloves on the floor of a bathroom. Staff must be made aware of the consequences of these actions. Also, several service users hairbrushes were left on the handrail in the lift; the registered manager arranged for these to be cleared away. Some of the downstairs toilets do not have waste bins for used hand towels. Whilst a staff member said, “well we wash the service users’ hands” they could not explain why there was no bin. Disposal of gloves and paper hand towels must be done in the correct way to prevent risks of cross contamination or infection. Laundry facilities were inspected and found to be clean and tidy, the washing machine has a ‘sluice’ facility to wash at high temperatures and therefore reduce the risks of cross infection. Soiled laundry is managed in a suitable way to minimise the risks of cross infection. The main kitchen was not inspected on this occasion as it is situated in Lake House care home, which had an inspection in November 2006. The satellite kitchen was looked at in Orchard House, and this was found to be clean and tidy. Orchard House Nursing Home DS0000045991.V326122.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): All of the above standards were looked at. Quality in this outcome area is good. Service users live in a home where there are sufficient numbers of staff, and where the staff group know their needs well. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users needs are met by the number and skill mix of staff. On the day of the inspection four care staff and two registered nurses were on duty for 30 service users. The home employs a stable staff group. They know the service users particularly well and this was showed in the way that they cared and supported them. The duty rotas submitted to The Commission show satisfactory numbers of trained staff and care assistants available for each shift. The registered manager tries not to use agency staff unless absolutely necessary, because of the adverse affect this may have on the service user. She said that the permanent staff are usually willing to help out to cover sickness and leave. Currently less than half of the care staff have their National Vocational Certificate 2 (NVQ) in care. This certificated course will provide staff with Orchard House Nursing Home DS0000045991.V326122.R01.S.doc Version 5.2 Page 20 further knowledge about their role, and enable them to better understand the needs of the service users. The recruitment system was looked at and the inspector examined four staff files. These contained the documents required by regulation, including a Criminal Records Bureau (CRB) check, two written references and an employment history questionnaire. Staff can start at the home following a protection of vulnerable adult (POVA) list check but they work under supervision until their CRB check comes back. These checks are carried out to further protect the service users by employing only suitable people at the home. The home has an organised training programme, including induction and statutory training. Staff spoken with said that they were pleased with the training that they received. Recent training includes moving and handling, care and support – death and dying, dementia awareness, elder abuse, aggression management, first aid and health and safety at work. There is both in-house and external training such as The Alzheimer’s Society ‘Yesterday, Today and Tomorrow’, which was enjoyed by staff. Staff are supported and encouraged to attend training and be better equipped to do their jobs. Orchard House Nursing Home DS0000045991.V326122.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. An experienced manager runs the home in the best interests of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The experienced Registered Manager is qualified and competent to run the home. Because of recent changes to the management and structure of Lake House and Orchard House the Registered Manager is looking after both homes with the intention that the homes are to become linked. Two deputy managers have been appointed and this system is working well. Orchard House Nursing Home DS0000045991.V326122.R01.S.doc Version 5.2 Page 22 Staff spoken with said that the registered manager is open, approachable and supportive. A quality assurance system is in place. This includes questionnaires sent out to relatives and contacts of the home. Also a relative’s ‘surgery’ is available where relatives or representatives can talk with the manager. The activities organiser also sends out a questionnaire periodically. All of these actions will help the home to seek peoples’ views about the service that is given so that they can then go on to make improvements. The home looks after small amounts of service users’ cash. This cash is stored in a safe, and a ‘wallet’ system is used with individuals’ monies stored in separate bags. The inspector examined the records of transactions and found these to tally with the cash in the wallet. Service users are safeguarded by the financial procedures at the home. The health, safety and welfare of the service users and staff is promoted and protected. The registered manager ensures training relating to moving and handling, first aid, food hygiene, infection control, and fire safety is carries out so that staff are up to date and knowledgeable about safe working practices. This is mandatory training, which all staff need, and which helps to better protect the service users from harm. A sample of service, maintenance and health and safety checks and certificates were looked at including fire fighting equipment check, environmental health officer visit, gas engineer visit, electrical wiring check, lift engineer check, and hoisting equipment check. These were all found to be in order and up to date. A random water temperature test was carried out. Several temperatures were a few degrees above the acceptable level. The homes maintenance manager, who usually monitors the temperatures as part of routine maintenance was available and rectified this immediately. Orchard House Nursing Home DS0000045991.V326122.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 X X X X X X 2 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Orchard House Nursing Home DS0000045991.V326122.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 OP19 Regulation 23 (2) (j) Requirement The registered person must make arrangements for bathroom improvements to be carried out, so that sufficient and suitable assisted bathrooms are available for all service users. Timescale for action 30/03/07 Orchard House Nursing Home DS0000045991.V326122.R01.S.doc Version 5.2 Page 25 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 OP26 Good Practice Recommendations • • • • 2 OP28 The Registered Manager should check that there are sufficient waste bins available around the home. The registered manager and staff must keep the home tidy. Gloves and paper towels must be disposed of in the correct way. Refurbishment of rooms and corridors should continue to ensure that all areas are brought up to the same standard. The registered provider should make arrangements to repair the driveway to the home. The registered manager must persist in her efforts to enrol staff on to a National Vocational Qualification (NVQ) training course and get at least 50 of care staff qualified as soon as possible to reach the target by 2008. Orchard House Nursing Home DS0000045991.V326122.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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. 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