Inspection on 25/04/06 for Orchid Lawns Nursing Home

This inspection was carried out on 25th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Orchid Lawns Nursing Home 12/03/08

Orchid Lawns Nursing Home 06/11/07

Orchid Lawns Nursing Home 22/05/07

Orchid Lawns Nursing Home 24/10/05

Orchid Lawns Nursing Home 30/06/05

Orchid Lawns Nursing Home 08/02/05

Orchid Lawns Nursing Home 21/09/04

Orchid Lawns Nursing Home 10/02/04

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

CARE HOMES FOR OLDER PEOPLE Orchid Lawns Nursing Home Steppingley Hospital Grounds Ampthill Road Steppingley Bedfordshire MK45 1AB Lead Inspector Sally Snelson Unannounced Inspection 25th April 2006 06:30 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 Orchid Lawns Nursing Home DS0000017684.V289487.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. Orchid Lawns Nursing Home DS0000017684.V289487.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Orchid Lawns Nursing Home Address Steppingley Hospital Grounds Ampthill Road Steppingley Bedfordshire MK45 1AB 01525 713630 01525 718624 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) Health & Care Services (NW) Limited Vacant Care Home 24 Category(ies) of Dementia - over 65 years of age (24), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (24) Orchid Lawns Nursing Home DS0000017684.V289487.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Elderly over 65 Date of last inspection 24th October 2005 Brief Description of the Service: Orchid Lawns is a purpose built nursing/care home situated in the grounds of Steppingley Hospital. Steppingley is a small village near to Flitwick town in MidBedfordshire. Flitwick has good public transport and road access but there is a limited bus service to Steppingley. The home is single storey, with accommodation separated into three wings each with it’s own living area and communal space. The home has a large garden and there is a large parking area at the front. Orchid Lawns provides places for up to twenty-four older adults with mental health care needs. All the places at Orchid Lawns are contracted to the local Primary Care Trusts (PCT) with admission via referral to a placement panel. Orchid Lawns Nursing Home DS0000017684.V289487.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place over a nine and a half hour period from 06.30 am. The manager was present throughout the majority of the inspection. During the inspection the care of three service users was case tracked, including one service user who had died recently at the home. The case tracking involved looking at the care plans and other documentation of those service users and comparing their records to the care provided. Also as part of this inspection, and to provide information for a regional project, particular consideration was given to the standard of care of a service user who had a history of falls This report also includes information from speaking to service users, staff, and visitors on the day of the inspection and information obtained from various sources since the last inspection. What the service does well: What has improved since the last inspection? Since the last inspection the home has the secured a deputy manager and an administrative assistant. Filling these vacancies was having a positive effect on the workload of the manager. The home now has a good skill mix of Orchid Lawns Nursing Home DS0000017684.V289487.R01.S.doc Version 5.1 Page 6 qualified nurses both Registered General Nurses (RGN’s) and Registered Mental Health Nurses (RMN’s) and carers in addition to domestic staff and cooks. The safety issues that had been identified by the fire service in October 2005 had been corrected and all fire doors were now closing properly. Service users finances were in order and all withdrawals of money had a receipt to balance them. Care plans were now being written for all the episodes of care provided but there was still a need for these plans to be written in more detail. The care plans were reviewed regularly and it was clear that where observations indicated professional advice and support was sought. Recruitment processes were robust and involved both the care home and the head office to ensure that all the appropriate checks were completed prior to a prospective staff member taking up post. 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. Orchid Lawns Nursing Home DS0000017684.V289487.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 Orchid Lawns Nursing Home DS0000017684.V289487.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): 6 “Quality in this outcome area could not be accurately assessed. This judgement has been made using available evidence including a visit to the service.” As the PCT had not admitted service users to Orchid Lawns since 01.07.06, it was not possible to assess how these standards were currently being met. EVIDENCE: There had been a number of changes to the staff group, the management structure, and the environment of the home. These changes would need to be included in an updated Statement of Purpose and Service Users Guide that would need to be ready for the time when admissions were once again made to the home. All of the care files tracked included admission assessments and that were now out dated and did not conform to the revised polices and procedures for the home. It would be normal practise for the inspector to track a service user who had been admitted to the home since the last inspection to assess improvements to these standards. However the inspector was concerned that it would impossible for standard three to be fully met while the admission Orchid Lawns Nursing Home DS0000017684.V289487.R01.S.doc Version 5.1 Page 9 procedure remained that the Primary Care Trust referred service users to a panel, and the panel made the decision that Orchid Lawns could meet the service users needs. The manager stated that he sat on the panel but was only one voice. It was therefore doubtful that consideration, such as the current workload, or the needs of the other service users, would be fully considered when a decision to admit to Orchid Lawn was made. The staff team was made up of qualified nurses, both Registered General Nurses (RGN) and Registered Mental Health Nurses (RMN) and care staff. Most of the staff had an interest or a qualification in dementia care. Orchid Lawns did not offer intermediate care. Orchid Lawns Nursing Home DS0000017684.V289487.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 “Quality in this outcome area was adequate. This judgement has been made using available evidence including a visit to the service.” Care plans provided sufficient information for service users needs to be met. Continuous assessment of care and well-being were in place ensuring that service users received the correct support and treatment for their conditions. The timing of medication rounds could put service users at risk of being over medicated during the day and having a long period without medication during the night. EVIDENCE: The care plans sampled were in sufficient detail for the inspector to be confident that the service users care needs would be met. However as new service users were introduced to the home with needs that were less familiar to the staff more detail in the plans would be essential. For example a service user with a diagnosis of diabetes had a plan for nutrition that stated he must Orchid Lawns Nursing Home DS0000017684.V289487.R01.S.doc Version 5.1 Page 11 have a diabetic diet. This should be expanded on and examples of alternatives to the planned menu listed. All of the care plans had been reviewed at least monthly and changes to care plans had been made as the service users condition altered. The files sampled included nutritional and tissue viability screening and blood sugar and blood pressure monitoring as necessary. In every case where there had been a significant change or a deviation from the normal there was evidence that appropriate support and advice had been sought. For example an increase in the score of a monthly Waterlow assessment had indicated the need for a pressure-relieving mattress, which had been provided. Also a service users weight decrease had prompted staff to monitor and weigh weekly and seek professional advice from a community dietician. Staff must be sure that they accurately date and sign all documentation. The inspector noted a copy of a transfer letter to the hospital that had not been dated and signed, and a file where the service users first name, middle name and preferred name were all used to head up documentation. The files indicated that community dentists, chiropodists and opticians routinely visited the service users, and if they were uncooperative on one occasion further attempts were made. None of the service users had been assessed as able to self-medicate, however there was a need for the home to consider individual medication times for some service users. The inspector noted that medications were boarded by the pharmacy to be given at 10.00, 14.00, 18.00 and 22.00 hours. This did not give sufficient spacing, particularly for those medications that need to be given four times a day. In order to increase the time between doses staff started the morning medications when all the service users who wished to be got up for breakfast were up. However many of the service users were given their medication before they had had breakfast and in some cases before they had had a drink. When staff were alerted to this all service users were given something to eat before their morning medication. This however meant the first medication round was not finished until 10.30 and the lunch time round started at 13.00hrs, again compromising the effective spacing of the medications. Medication cassettes and controlled drugs were checked and the records inspected and found to be in order. The manager must ensure that the medications for a service user who no longer requires it, or has died are disposed of quickly. Throughout the inspection service users were treated with respect and their dignity, and that of the other service users, protected as much as possible. Some of the service users were referred to by their first names while others used pet names and some Mr or Mrs and their surname, whatever they Orchid Lawns Nursing Home DS0000017684.V289487.R01.S.doc Version 5.1 Page 12 preferred. A visitor confirmed that his wife was wearing her own clothes and that the laundry systems were satisfactory. A full end of life care plan completed with relatives and the GP would ensure that the last wishes of a service user and their family were carried through and service users could die in familiar surroundings if that is what they wanted. Some care files indicted that staff had staff had taken information from families about who and when to call in the case of deterioration or sudden death. Orchid Lawns Nursing Home DS0000017684.V289487.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 “Quality in this outcome area was adequate. This judgement has been made using available evidence including a visit to the service.” A continued lack of activities left service users with little stimulation. Service users appeared to receive a balanced menu, but there was little choice offered as the meal was being served. EVIDENCE: Some care plans gave details of the service users past life and experiences but there was no evidence that this information was used to plan an activity programme that suited the service users. The displayed activity programme finished the week previously. The manager stated that a music therapist visited the home and that the Baptist Church offered a monthly service and he was looking into securing visits from a PAT dog. During the afternoon of the inspection an occupational therapist took four of the service users into a small lounge for a game of skittles and a cup of tea. She also used a pot of daffodils from the garden to stimulate conversation. However although some staff interacted with service users few spent time engaging them in meaningful activities or conversation. Orchid Lawns Nursing Home DS0000017684.V289487.R01.S.doc Version 5.1 Page 14 One carer offered the service users a magazine each. For this to be a meaningful activity a member of staff should have sat with him/her and discussed the contents. It was noted that there were periods when service users were left unattended, particularly in the morning when staff were supporting service users to get up. The manager had chaired the recent relatives meeting, which had been held during the weekend prior to the inspection. He stated that on the whole it was a good meeting with relatives main concern being the future of the home. Visitors spoken to were pleased with the care their relatives were receiving. The inspection covered breakfast and lunch. Service users were offered a choice of cereal and hot or cold milk at breakfast but very little choice was offered at lunchtime. Mid morning all service users were offered a cup of tea but no option for coffee if they preferred. The cook suggested that while the staff were getting to know a service user they offered choice but once they knew their likes and dislikes they were able to present them with their meal. At lunchtime service users were given good portions, the meal was well presented and staff were available to help service users if necessary. The cook spoke about the methods she had for increasing the calorie content of food such as the addition of butter and cream. Plate guards were available and service users were offered an apron to protect their clothes. Orchid Lawns Nursing Home DS0000017684.V289487.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): 16,18 “Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service.” The home had a robust complaints policy that safeguarded service users. The manager made himself available to talk to relatives at anytime, and held regular meetings allowing concerns and complaints to be dealt with as soon as possible. The majority of the staff were aware of the processes for keeping vulnerable adults safe from any forms of abuse. EVIDENCE: The home had a complaints procedure that was displayed in the entrance hall of the home. Relatives and visitors were encouraged to speak to staff about concerns and/or to bring up issues at the regular relative meetings. In Oct 05 the daughter of a service user had made a complaint to the Primary Care Trust (PCT) as the commissioners; the complaint went back to the care provided in 2004. This complaint had been investigated by the previous manager but not in sufficient detail. The interim manager had made a much fuller response that upheld elements of the complaint. He was also able to evidence areas of care that had changed since the time of the original complaint ensuring that other service users would not currently be at any risk. Orchid Lawns Nursing Home DS0000017684.V289487.R01.S.doc Version 5.1 Page 16 Most of the staff had attended training on the Protection of Vulnerable Adults (POVA). The manager included updates on this training for staff as part of staff meetings and foundation training. The inspector was concerned that daily care records included statements such as ‘unexplained bruise’ with no further explanation. The manager stated that this was the wrong phraseology as it referred to a bruise to a service user who was agitated and prone to wandering, but the exact cause was not witnessed. The bruise had been looked at to rule out any form of rough handling or abuse. Orchid Lawns Nursing Home DS0000017684.V289487.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21,26 “Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service.” The home was well furnished and free from any offensive odours offering service users a comfortable place to live. EVIDENCE: The home was fit for purpose, as it was a single storey building that allowed the service users to walk around their home safely. The home was divided into three areas, each with eight bedrooms and communal space of it’s own. Many of the bedrooms had been recently decorated and carpets and furnishings replaced. The communal areas of the home, including bathrooms and the bedrooms of the service users who were case tracked were clean and tidy. Service users were given the opportunity to furnish their rooms with small items from home. Orchid Lawns Nursing Home DS0000017684.V289487.R01.S.doc Version 5.1 Page 18 Those service users who required adjustable beds had these and bedsides were appropriately used. On the day of the inspection, because there were only 17 service users, all of the service users were in one lounge where there was music playing. The manager stated that they were trying out different combinations of staff and service users in communal areas to see which was the most appropriate. However, because four service users had had a disturbed nights sleep and wanted to rest and others were quiet active the lounge appeared very busy and full. Orchid Lawns Nursing Home DS0000017684.V289487.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 “Quality in this outcome area was adequate. This judgement has been made using available evidence including a visit to the service.” The skill mix of the staff on duty provided the service users with the care they required. Robust recruitment processes ensured that staff were safe and appropriate to care for vulnerable adults. EVIDENCE: The home had recently appointed a deputy manager and an administrative assistant to vacant posts. The recruitment to these posts had a positive effect on the manager’s workload. At the start of the inspection the inspector met the night staff. There was one qualified nurse and two care assistants on duty. Both of the care assistants spoke of the training they had received including induction training. On duty from 7am there were two qualified nurses and two carers in addition to the manager and domestic staff. This team were providing care for 17 service users. For the majority of the time, including lunchtime, when an additional staff member was on duty, this staff complement appeared to be sufficient. However there were times when all the staff were occupied in Orchid Lawns Nursing Home DS0000017684.V289487.R01.S.doc Version 5.1 Page 20 service users bedrooms and service users were alone in communal areas. Staff should consider a plan to ensure that there is always a member of staff where the majority of service users are. The manager stated that there was a plan to increase the staff team before new service users could be introduced into the home. The habit of the two trained staff and the two carers working together should be considered so that care staff can learn from the experience of the trained staff. Since the last inspection all of the staff, old and new, had completed the company induction and foundation course as appropriate. The manager was currently looking at the training programme and ensuring that staff had the necessary mandatory qualifications. An updated training matrix would accurately identify the need for specific training. The personal files of three staff members were viewed, including one of the new staff members. These files were all tidy, complete, and included the required references and checks. Orchid Lawns Nursing Home DS0000017684.V289487.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,37,38 “Quality in this outcome area was adequate. This judgement has been made using available evidence including a visit to the service.” The manager had made a number of changes to the home, which had had positive effects on the service users. There were no structured processes in place to ensure that the home was run in the best interest of all the service users, which could be detrimental to their care. EVIDENCE: The interim manager continued to make a number of changes to the home. Staff and visitors who had been connected to the home for some time stated Orchid Lawns Nursing Home DS0000017684.V289487.R01.S.doc Version 5.1 Page 22 that they felt the home was going into a stable period and there were some positive changes for the service users. There was no structured quality assurance process in place. The manager stated that this was not necessary because he made himself available and dealt with issues as they arose. Standard 33 requires a more detailed surveying of stakeholders that should be used to influence the development of the home. For example in addition to listening to service users and relatives concerns and problems the home should survey other stakeholders such as GP’s and the PCT and ask them to comment on the home’s success in meeting their aims and objectives as detailed in the Statement of Purpose. During the inspection the manager and the administrator were checking service users personal money against the documentation and receipts held by the home. No errors were found. Service users were not encouraged to hold money but the inspector overheard the manager discussed with one relative the possibility of a service user having some small change in his pocket when he went out on a visit so that he could feel that he was paying his way. The interim manager had re-introduced supervision. All staff had had at least one supervision since the start of the year. There was a need for supervision to be more frequent if the required six-sessions a year was to be achieved. As already mentioned staff must take care to ensure that they accurately complete any of the home’s documentation and that all forms are signed and dated as they are completed. The safety checks sampled were complete. The home had made the necessary repairs to the fire doors to ensure they complied to fire regulations. Most service users had been risk assessed for the use of call bell so that anyone who might be injured by the flex did not have one. Orchid Lawns Nursing Home DS0000017684.V289487.R01.S.doc Version 5.1 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 1 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 3 X 3 X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 1 X 3 2 2 3 Orchid Lawns Nursing Home DS0000017684.V289487.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? 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 2 Standard OP7 OP9 Regulation 13(2) 13(2) Requirement Care plans need to be expanded to give specific details of care needs. Medications must be administered to service users in equally divided doses over a 24hour period. The medication charts must also reflect this. Service users must not be given medication before they have eaten in the morning. The disposal of medication that is no longer required must be carried out as soon as possible. Service users and/or their families’ wishes concerning terminal care must be documented and carried out. Activities that meet the service users needs must be made available. Service users are offered opportunities to exercise choice. Service users must be offered a choice of meals and drinks. The manager must keep a matrix of training so that it can be identified the training staff need in order to keep themselves DS0000017684.V289487.R01.S.doc Timescale for action 15/06/06 01/06/06 3 4 5 OP9 OP9 OP11 13(2) 13(2) 12(2) 01/06/06 15/06/06 15/06/06 6 7 8 9 OP12 OP14 OP15 OP30 16(2) 12(2) 12(2) 18(1) 01/07/06 01/06/06 01/06/06 15/06/06 Orchid Lawns Nursing Home Version 5.1 Page 25 10 11 12 OP33 OP36 OP37 24(1) 18(2) 17 updated. The home must have a system in 01/07/06 place to monitor quality. Staff must receive a minimum of 01/07/06 six supervision sessions a year. Records must be accurate and 01/06/06 up-to-date and signed and dated as necessary. 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 Refer to Standard OP27 OP27 Good Practice Recommendations Staff should be distributed throughout the home to ensure that no groups of service users are left unattended for any length of time. Whenever possible trained staff should work with carers. Orchid Lawns Nursing Home DS0000017684.V289487.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Orchid Lawns Nursing Home DS0000017684.V289487.R01.S.doc Version 5.1 Page 27 - 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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