Inspection on 22/06/07 for Osbourne Court Care Home

This inspection was carried out on 22nd June 2007.

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

Osbourne Court Care Home 07/05/08

Osbourne Court Care Home 18/08/06

Similar services:

Claremont House

Oak Ridge

Coopers Mill Ltd

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Paradise Lodge

Bilney Hall

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

CARE HOMES FOR OLDER PEOPLE Osbourne Court Care Home Park Drive Baldock Hertfordshire SG7 6EN Lead Inspector Claire Farrier Key Unannounced Inspection 10:30 22 & 26th June 2007 nd 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 Osbourne Court Care Home DS0000068298.V342680.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. Osbourne Court Care Home DS0000068298.V342680.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Osbourne Court Care Home Address Park Drive Baldock Hertfordshire SG7 6EN 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) 01462 896966 01462 896967 Four Seasons Homes (No 4) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Andrew Williams Care Home 69 Category(ies) of Dementia - over 65 years of age (34), Learning registration, with number disability over 65 years of age (1), Old age, not of places falling within any other category (69), Physical disability over 65 years of age (69) Osbourne Court Care Home DS0000068298.V342680.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. This home may accommodate 69 older people with physical disability who require personal care. This home may accommodate 35 older people who require nursing care. This home may accommodate 34 older people with dementia who require personal care. This home may accommodate 69 older people who require personal care The home may accommodate one named service user with a learning disability. This condition will no longer apply once the service user ceases to reside at the home. 18th August 2006 Date of last inspection Brief Description of the Service: Osbourne Court is owned and operated by Four Seasons Homes Ltd, and it is registered to provide personal care and accommodation for 69 older people. The ground floor accommodates 34 residents who may also suffer from dementia, and the first floor accommodates 35 residents who need nursing care. Osbourne Court is a purpose built two-storey building situated in a residential area close to the centre of Baldock. It is adjacent to a health centre and a large superstore, which provide good access to medical and shopping facilities. Accommodation is provided in single rooms. All rooms have an en-suite toilet and washing facilities and there are a number of assisted bathrooms throughout the home. The first floor is served by a passenger lift. There is ample car parking space at the front of the building. There are two small gardens with patio areas to the rear and side of the home. The Statement of Purpose and Service Users Guide provide information about the home for referring social workers and prospective clients. The current charges range from £408 per week for residential care to £630 per week for nursing care. Osbourne Court Care Home DS0000068298.V342680.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over one day. The focus of the inspection was to assess all the key standards. Some additional standards were also assessed. We talked to as many of the people who live in the home as we were able to. We also talked to some of the staff. Nine people completed Have Your Say surveys before the visit to the home, and we have used some of their comments in this report. We also received comments from two GPs and a care manager. The manager sent some information about the home to CSCI before the inspection. When we were in the home we looked at the home’s records, care plans and staff files, and we made a tour of the premises. We made a second visit to the home a few days later so that we could talk to the manager about what we had seen during the inspection. What the service does well: What has improved since the last inspection? There has been some improvement in the provision of dementia care. The carpets have been replaced and the corridors have been decorated in distinct colours, and pictorial signs are in place on the bathrooms and toilets. Most of the care staff have had training in person centred dementia care. All equipment is now serviced regularly, and the home was clean, with no noticeable odours. One person said that they can’t see, but the home smells clean. “My daughter said it’s clean, and she’s very fussy.” Staff records and health and safety records are complete and up to date, and all personal information is stored securely. Osbourne Court Care Home DS0000068298.V342680.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Osbourne Court Care Home DS0000068298.V342680.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 Osbourne Court Care Home DS0000068298.V342680.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 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has sufficient information on the needs of the people who live in the home, and access to appropriate services to enable them to meet their needs. EVIDENCE: We looked at the files of four residents, and each one contained a full assessment that was completed before the resident was admitted to the home. Care plans are written from the information in the assessments, and the assessments and care plans provide appropriate information so that the staff can meet each person’s needs. The assessments include risk assessments for moving and handling and the risk of falls, and other assessments are also carried out when appropriate, for example for pressure area care and for nutritional needs. Contracts are in place for private clients. The care manager who completed a Have Your Say survey for this inspection said that the home’s assessments always ensure that accurate information is gathered and that the right service is planned for each person. She said that she placed a married Osbourne Court Care Home DS0000068298.V342680.R01.S.doc Version 5.2 Page 9 couple in the home, as one needed nursing care and the other needed residential care. They were happy, and the six week review showed that their needs were met. The staff have the experience and training to meet most of the residents’ needs. Sufficient qualified nurses are employed to meet the needs of residents who require nursing care, and the care plans that were seen contained appropriate information on health care needs and how they should be met. Many of the care staff have had training in person centred care since the last inspection, which has improved their understanding of the individual needs of people with dementia. The activities available have improved, but there was no evidence of individual activities that are meaningful for people with dementia (see Daily Life and Social Activities). Osbourne Court Care Home DS0000068298.V342680.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 adequate. This judgement has been made using available evidence including a visit to this service. People in the home may be at risk because the information in the care plans is confusing, and the recording of medication is not accurate. EVIDENCE: We looked in detail at the care plans of four people who live in the home, and we checked some information in a sample of other care plans. All the care plans seen contain clear and easily accessible information on the resident’s health and personal care needs, with comprehensive procedures for meeting the needs. There is a regular audit of all the care plans, which makes sure that each one contains all the information needed for each person, and that they are reviewed properly. The care plans are reviewed every month, and any changes that are needed are noted on the record of the review. In some of the care plans that we saw, the reviews made major changes in the way that care was provided, but the care plan was not rewritten. For example, one person had a risk assessment for the risk of falling that stated that they can walk with the aid of a Zimmer frame. The review stated that this person now stays in bed Osbourne Court Care Home DS0000068298.V342680.R01.S.doc Version 5.2 Page 11 most of the time, and they are not mobile. The care plan stated that bed rails were in place, but a review stated that bed rails should be longer be used. This information is contradictory and confusing, and a new care plan should be written that provides accurate information. The language used in some care plans is inappropriate. For example, for people who may leave the home, the terms “absconding” and “escaping” were used. In one care plan the daily record stated, “X quietened down after I told her I would be letting management know what happened.” This may indicate that the person is being threatened with a punishment. The care plans for people with dementia include specific risks, such as risks of falls and risks of behaviour, with measures to address the risks. The care plans are person centred and emphasise each person’s abilities, to maintain independence and to make decisions through ‘best interest’ discussions. The people who live in the home have appropriate access to medical care and to chiropody and other treatments. The home employs enough qualified nurses to meet the needs of the residents who need nursing care. The GPs who completed Have Your Say surveys for this inspection said the home usually asks for appropriate medical advice, and usually meets each person’s health care needs. On GP commented that it depends on individual staff. “Some are exceptionally good as they have previously been involved in health care.” There is appropriate monitoring of nursing procedures such as pressure area care, and regular assessments take place for moving and handling and nutritional needs. However in some cases the recording could be improved. In one care plan there was no action plan for treatment of a pressure sore. Food intake charts are completed for people who are at risk of poor nutrition, but the staff complete them at the end of the shift, not at the time of each meal. Everyone who completed a Have Your Say questionnaire for the inspection said that they receive the care and support that they need. In the dementia unit the staff were observed to have a good relationship with the residents. They spoke to them while assisting them, and were patient and caring. The staff spoken to said that they have time to spend with individual residents. The residents spoken to were happy and sociable, and evidence of general well being was observed. On the nursing unit one person said that they are very happy at Osbourne Court, and the care is very good. This person had an electrically operated reclining chair, but there was no risk assessment to make sure that it was used safely. The home has generally good procedures for administering medication. It was reported that each person’s medication is audited regularly to make sure that there are no errors. However we found several errors when we checked a sample of medication records on the first floor. In two cases the medication did not tally with the record. In one case it is likely that the medication record was signed, but the medication was not given to the person. In the other case the person should have 2½ tablets of Warfarin, but on one occasion only one tablet was given. One person had paracetamol when they needed it, but the reasons why it was given were not recorded. The care plan for one person Osbourne Court Care Home DS0000068298.V342680.R01.S.doc Version 5.2 Page 12 states that they should have their medication covertly. There is no reason for this, no agreement for the procedure from a GP or pharmacist, and no procedure to make sure that each medication is administered safely. Osbourne Court Care Home DS0000068298.V342680.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): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a range of activities to suit the needs of most of the people in the home, but there are insufficient activities for people with dementia. EVIDENCE: There is a weekly programme of activities in the home, with a choice of organised activities each morning and afternoon during the week. On the day of the inspection there was keep fit in the morning, and in the afternoon a clothes supplier visited the home so that people could buy clothes for themselves. Some people from the dementia unit join in the organised activities, but there are no activities specifically for them. The activities coordinator has worked in the home for eight years as a senior carer and night carer. She is filling in as activities co-ordinator until a new permanent coordinator is appointed. When time permits, she provides individual support for people who are not able to join the group activities. Some people go to the street market in Baldock High Street, or to the near by Tesco store. The people who completed Have Your Say surveys for this inspection said that there are usually activities arranged that they can take part in. Two people said that Osbourne Court Care Home DS0000068298.V342680.R01.S.doc Version 5.2 Page 14 they know about the activities, but they are not interested. One person said that they were aware that there had been some visiting singers in the home. Families and friends are welcomed into the home, and family members are consulted about the resident’s care. The home promotes the residents’ autonomy, and all the bedrooms seen contained evidence of the resident’s own furniture and decorations. Residents with dementia are enabled to maintain independence and to make decisions through ‘best interest’ discussions. Most of the residents said that the food provided is good, and that they have a choice of what they wish to eat. There is a four week revolving menu that provides a varied and balanced choice of meals. Hot and cold drinks are available at all times, and the staff were seen encouraging residents to drink. Osbourne Court Care Home DS0000068298.V342680.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. This judgement has been made using available evidence including a visit to this service. Policies and procedures are in place to safeguard the residents from abuse, and allegations of abuse have been investigated and dealt with appropriately. Residents and relatives are confident that any complaints will be properly investigated EVIDENCE: The home has a satisfactory complaints procedure in place. Residents and their relatives are encouraged to make their concerns and complaints known. A new complaints record has been put in place since the last inspection. It includes the process of investigation, the response to the complainant, and any actions taken as a result of the complaint. Recent complaints include concerns about laundry and the state of the garden. The home has comprehensive procedures for prevention of abuse. Training in protection of vulnerable adults has been provided for all the staff, and the staff spoken to were aware of their responsibilities for whistle blowing. There have been four referrals concerning safeguarding vulnerable people since the last inspection. They were all reported and investigated appropriately. One did not concern the staff in the home. Two investigations found no concerns, and one resulted in a referral to the POVA (Protection of Vulnerable Adults) list. Osbourne Court Care Home DS0000068298.V342680.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally well maintained and provides a safe and comfortable environment for the residents. EVIDENCE: Osbourne Court is a purpose built two-storey building. It is situated in a residential area close to the centre of Baldock. The home is generally well maintained. Access to the first floor roof terrace has been closed until a trellis is erected and it can be made safe, and it has not been available for the residents on the first floor for two years. There is a small enclosed garden with access from the ground floor lounge, but the frail residents on the first floor are not able to sit in the open air during warm weather. It was reported that there are plans to create a sensory garden in the enclosed central courtyard on the ground floor. Osbourne Court Care Home DS0000068298.V342680.R01.S.doc Version 5.2 Page 17 Some changes have been made in the dementia unit to ensure that the environment can promote independence and well being for the residents. The carpets have been replaced and the corridors have been decorated in distinct colours, and pictorial signs are in place on the bathrooms and toilets. However further improvements are needed. The lounges and dining room provide no objects for people to use for stimulation or familiarisation. The home appeared to be clean throughout, and appropriate procedures are in place for the control of hygiene. Osbourne Court Care Home DS0000068298.V342680.R01.S.doc Version 5.2 Page 18 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): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff numbers in the home are below the level that is sufficient to ensure that all the residents’ needs are met. Good recruitment procedures and staff training make sure that, as far as possible, the residents are supported and protected in the home. EVIDENCE: During the last inspection it was reported that on the first floor there should be two registered nurses and five care assistants on each shift during the day, and on the ground floor there should be two senior care assistants and three care assistants. On this occasion the staffing levels are 6 staff in the morning and 5 in the afternoon on the first floor, and a ratio of 1:6 on the ground floor. During the afternoon there was only one care assistant in the main lounge on the ground floor. This was a locum worker, and it was the first time they had worked in the home. This is inadequate provision for supporting people with dementia. Several members of staff commented that there are not enough staff in the home to meet the needs of the residents. Some of the people who live in the home also commented on the shortage of staff, particuarly on the first floor. The manager has carried out an audit of the levels of dependency in the home, and this was due to be discussed on the day following the inspection. Osbourne Court Care Home DS0000068298.V342680.R01.S.doc Version 5.2 Page 19 All the members of the care staff and domestic staff spoken to during the inspection were enthusiastic about their work in the home. The company provides a comprehensive training programme that covers all the statutory training, and other training as required for the specific needs of the service users. Since the last inspection most of the care staff have had training in person centred dementia care. One person spoke very enthusiastically of how much they had learned from this course, and this was evidenced by our observations of their relationship with the people in the dementia care unit. All the care staff are encouraged to undertake NVQ qualifications, and there is an expectation that new staff will register for the qualification. Six of the 28 care staff currently have a NVQ in care at level 2 or level 3, five are working towards the qualification, and four are waiting to start the training course. The home has robust policies and procedures for recruitment. Three staff files were seen for recently recruited members of staff. They contained most of the required information, including good references and a satisfactory CRB (Criminal Record Bureau) disclosure. Osbourne Court Care Home DS0000068298.V342680.R01.S.doc Version 5.2 Page 20 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 adequate. This judgement has been made using available evidence including a visit to this service. Appropriate records are maintained for the effective management of the home and monitoring of health and safety procedures, measures are needed to make sure that the environment is safe. EVIDENCE: The manager has worked at the home for over two years, and has been registered by the CSCI. He has completed the Registered Managers Award (RMA). The manager’s qualifications and style of operation of the home ensures that the home is run in the best interests of the residents. Four Seasons Healthcare has established a new clinical governance department. The home carries out self audits for all aspects of care provision Osbourne Court Care Home DS0000068298.V342680.R01.S.doc Version 5.2 Page 21 and record keeping and the regional manager makes regular monitoring visits to the home. It was reported that a customer survey of the people who live in the home has just been completed, but the analysis and results of this have not yet been made available. The arrangements for management of residents’ money were inspected and appeared to be accurate. Money is stored safely and adequate records are maintained in order to protect service users from financial abuse. The home maintains appropriate records for the health and safety of the residents and staff in the home, and staff follow the home’s policies and procedures. All fire equipment is checked regularly and the home has procedures for protecting the residents from the risks of fire. However the door of one bedroom on the ground floor was held open by a bed table, which could cause a risk to the resident. The window of the smoking lounge on the first floor was wide open and does not have a restrictor fitted for the safety of the people who use the room. Osbourne Court Care Home DS0000068298.V342680.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 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 2 Osbourne Court Care Home DS0000068298.V342680.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15(2) Requirement All people who live in the home must have a care plan that is up to date. This will ensure that they receive the care that meets their current needs. Appropriate and adequate risk assessments must be put in place for all residents, including assessments for the use of equipment such as reclining chairs. The manager must make sure that appropriate care plans and recording are in place for all the residents’ health care needs, and in particular for the management of pressure area care and nutritional care. Measures must be put in place to ensure that medication is audited effectively, and that any errors in medication are noted and rectified without delay. Timescale for action 30/09/07 2. OP7 13(4) 30/09/07 3. OP8 12(1)(a) 31/12/07 4. OP9 13(2) 30/09/07 Osbourne Court Care Home DS0000068298.V342680.R01.S.doc Version 5.2 Page 24 5. OP12 12(2) & (3) Activities suitable to meet the needs of the all the people in the home must be provided in a manner and form suitable to need, including specific activities for people with dementia. 31/12/07 6. OP19 7. OP27 8. OP38 9. OP38 Records of activity engagement to be recorded. Previous timescale of 31/10/06 partially met. 23(2)(a) Measures must be taken to ensure that that the environment of the dementia unit meets the needs of the residents. This could include the use of colours and textures for differentiation, and visual aids to orientation. Previous timescale of 31/10/06 partially met. 18(1)(a) The registered person must ensure that sufficient staff are available at all times to meet the needs of the residents. Previous timescale of 31/11/06 not met. 13(4)(a) Appropriate restrictors must be & (c) fitted to all first floor windows, so that there is a safe environment for the people in the home. 23(4)(c)(ii The registered person must i) consult the fire authority concerning adequate precautions against the risk of fire, in particular with regard to the use of door wedges on bedroom doors, and take action on any subsequent recommendations. Previous timescale of 31/11/06 not met. 31/12/07 30/09/07 26/06/07 26/06/07 Osbourne Court Care Home DS0000068298.V342680.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. 2. Refer to Standard OP10 OP19 Good Practice Recommendations The manager should promote the use of suitable language in care records, which respects the dignity of the people in the home. Everyone in the home should be able to have access to safe outdoor areas. Osbourne Court Care Home DS0000068298.V342680.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI - 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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