Inspection on 07/06/07 for Paisley Court

This inspection was carried out on 7th 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

Paisley Court 11/05/06

Paisley Court 01/02/06

Paisley Court 07/09/05

Paisley Court 25/02/05

Paisley Court 13/07/04

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

CARE HOMES FOR OLDER PEOPLE Paisley Court 36 Gemini Drive East Prescott Road Liverpool Merseyside L14 9LT Lead Inspector Mrs Julie Garrity Key Unannounced Inspection 7th June 2007 10:25 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 Paisley Court DS0000025191.V332473.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. Paisley Court DS0000025191.V332473.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Paisley Court Address 36 Gemini Drive East Prescott Road Liverpool Merseyside L14 9LT 0151 230 0857 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) manager.paisleycourt@careuk.com Community Health Services Limited Mrs Jayne Allison Kennie Care Home 60 Category(ies) of Dementia - over 65 years of age (60) registration, with number of places Paisley Court DS0000025191.V332473.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. That the service is varied to accept the admission of one named service user under the age of 65 years. Two places aged 55 for respite care accommodated on the respite unit 11th May 2006 Date of last inspection Brief Description of the Service: Paisley Court is situated in a residential area in the outskirts of Liverpool and is easily accessible by public transport and close to local shops. At the front of the building there is a large car parking area and at the rear of the property there is an enclosed garden, which residents can easily access. The gardens are divided into different seating. Paisley Court is a care home providing nursing care for 60 older residents who have mental health or behavioural support needs. Accommodation is divided into four units, two units on each floor. One of the units is for residents who only stay for a short time. One of the units is for gentleman only and the other two units have people living there who stay for a long time and are of either sex. Each unit has its own dining rooms and lounge areas. All bedrooms are single and have en-suite toilet facilities. All the places at Paisley Court are contracted to Liverpool Health Authority as part of continuing care, resulting in all referrals made to the home being through the team of consultants at the hospitals. Care Uk, which has several other care services through out the country, owns the home they have experience in providing care services to vulnerable people. The manager has worked in the home for several years and is supported by a deputy and senior staff team. Paisley Court DS0000025191.V332473.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over two days. Many of the residents have very complex needs, four relatives, six residents and eight staff were spoken with. Two hours observation over the two days, concentration on meal times was used to observe staff interactions with residents. Discussions were held with the manager and deputy manager. The inspector completed the inspection by a site visit to Paisley Court, a review of records available in Paisley Court, which included medication records, staff files, training records, cleaning schedules, menus, activities, computerised care plans and records in CSCI offices. A tour of the premises and the garden was also undertaken. Copies of records were submitted to CSCI for review in this inspection. The inspector followed an inspection plan written before the start of the inspection to ensure that all areas identified in need of review were covered. All of the Key standards were covered in this inspection, these are detailed in the report. The arrangements for equality and diversity were reviewed throughout the visit and are detailed in this report. Particular emphasis was placed on the methods that the home used to determine individual needs and the practices that they put into place into meeting those needs. Feedback was given to the manager and the deputy during and at the end of the inspection. What the service does well: Paisley Court cares for residents with complex needs. There is good information available within the home that assists residents, relatives and stakeholders to understand the care that will be provided. The home has started a number of new initiatives including, end of life, nutrition, activity based care, essence of care and sensory garden. Staff are progressing these and will be given the training and support to impact positively on the care of the residents. Staff were complimented by relatives who expressed that the residents were “well cared for” and that they were “welcomed” to visit the home. There is a variety of training available designed to assist staff in developing good skills to care for residents. Residents are very well protected with thorough recruitment practices that checks staff suitability before they start working and good information that enables residents, relatives, visitors and staff to raise any concerns. All Paisley Court DS0000025191.V332473.R01.S.doc Version 5.2 Page 6 concerns are thoroughly investigated. The home treats all incidents as a learning opportunity and uses them to increase the quality of care. 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. Paisley Court DS0000025191.V332473.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 Paisley Court DS0000025191.V332473.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): Standards reviewed are 1, 2 and 3. Standard 6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is enough information and support to prospective residents and their families to help them decide if Paisley Court can meet their needs. The assessments done before residents move in helps the home decided if they can meet the needs of the residents. EVIDENCE: Paisley Court has an information guide that has a lot of details included in it. A copy of terms and conditions of being a resident is outlined in the information given to potential residents, this includes things such as what the fees cover as an example. All residents in the home are assessed before the move in with the exception of emergency admissions on those occasions the home has assessments from social services and these are faxed through to the home before the resident is Paisley Court DS0000025191.V332473.R01.S.doc Version 5.2 Page 9 admitted. This practice allows the home to be aware of the residents needs and to start to plan to meet those needs. The assessment process is decided on by Care UK head office and generally assess physical needs. The manager and deputy manager try to incorporate the psychological, spiritual and mental health needs of the residents within the standard form. Each resident is allocated a key worker. The home attempts to make sure that the key worker is available on duty when the resident arrives. This provides continuity of care and a point of contact for residents and their relatives. Paisley Court DS0000025191.V332473.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): Standards reviewed are 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. Medication management has significantly improved, but needs further development to make sure that sufficient stocks are available to meet the residents needs. Resident individual health, personal and social care needs are not always clearly recorded and as such do not provide the staff with clear information and guidelines as to the appropriate action they need to take to care for the residents. EVIDENCE: All of the residents have a care plan in place these are on computer. They are not printed out and can be accessed via a password on the computer. One relative spoken with was unaware of the contents of the plan for her parent. The key nurse reviews the care plans every month and the system alerts the nurse if they are not done. On examination of the care plans needs clearly identified by the staff were not recorded and although reviewed on a monthly basis four of the five care plans were significantly out of date and no longer Paisley Court DS0000025191.V332473.R01.S.doc Version 5.2 Page 11 described accurately the care needs of the residents. Some of the plans for certain areas were identical from one resident to another and were not personal to the individual needs. The deputy manager and manager did not think the care plans were “good enough. Further examples included medications prescribed on a per required needs basis, were not explored within the care plan as to when to give. Staff spoken with found that they were easily able to update care plans on a daily basis. This had previously resulted in good clear daily records, however this good practice was not seen in the care plan of those residents viewed at this site visit. The daily records did not contain any information as to how the home had met these individual care needs. Records were kept after visits from external professionals such as doctors, consultants, dentists and opticians. This generally described the purpose of the visit and any recommendations for the staff to carry out, however they did not update the care plans with this information. Care plans are audited to see if they have been reviewed but not to determine if the care plans are of any quality and relevant to the needs of the resident. The home has a policy and audit in place for managing medications, this has impacted positively on the management of medications, which were audited and found to be given as prescribed. The home does not manage medications sufficiently to prevent some residents not having enough medications available. Care staff applied external preparations. There were no instructions available to care staff as to how, when or where they were to be applied. Staff observed were generally very courteous and addressed both the residents and their families in an appropriate manner. A number of the bedroom doors within the home remain open at all times, residents could be observed from the main corridors whilst in their beds. One of the residents was in bed and had kicked the covers of, this did not protect the individuals dignity. Paisley Court DS0000025191.V332473.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards reviewed are 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. The home has increased its range of activities and nutritional opportunities and has included staff in promoting this. Staff have a wide range of knowledge regarding residents choices and preferences however none of this is recorded and relies on staff providing accurate verbal information. On occasion’s residents personal choice are not meet as staff strive to complete a task such as managing mealtimes. EVIDENCE: Relatives spoken with were generally complimentary about the care that the home provided. Relatives meetings are available and relatives are welcome to attend as they see fit. The manager operates an open door policy, which enables resident’s relatives to approach her at any time. The majority of the residents are not presently able to express their personal point of view. The computerised system available within the home has a good section in which to record resident’s personal preferences and choices. A questionnaire regarding care and choices has been circulated to relatives and Paisley Court DS0000025191.V332473.R01.S.doc Version 5.2 Page 13 some responses have been received. However neither the questionnaire nor the computerised records have been utilised to influence residents choices, preferences or decisions. Of the computerised records viewed none had been completed. Staff have over time acquired a great deal of knowledge regarding personal preferences of residents. This is relevant to long stay residents but is ineffective for residents on the respite unit as they stay for a very short time and staff do not have the same opportunity to explore the residents preferences. The menu within the home offers choices however these choices are not discussed with the residents or their families nor is information on resident’s personal preferences used to write the menus. A member of staff was observed to serve identical meals to the residents in her care. On no occasion were the residents asked what they would like. These meals were left on a trolley in the dining room uncovered with the last meal served some 15 minutes after being put on a plate. As the trolley was not heated nor the meals covered the last one would have been significantly colder than when first put on the plate. Staff spoken with detailed that they made the choices for residents depending on what they knew what the resident’s personal preferences were. As none of this is recorded staff run the risk of making inappropriate choices. Over lunchtime some of the residents were supported to eat four of these residents were observed over this period, the staff supporting them sat next to the residents, which is good practice. However they did not communicate well with the resident failing to explain what the meal was or what they were serving to the resident at this time. The home has started a number of good practice initiatives such as activities and nutrition. Staff have been given training and positive encouragement to take these forward. As these are in the early stages they have not been fully put into place but contain several excellent ideas such as developing the outdoor space, providing meals that are flexible throughout the day and developing activities adapted to meeting the needs of individuals with confusion and memory loss. Once completed these ideas will have a very positive effect on maintaining resident’s independence and personal choices. Paisley Court DS0000025191.V332473.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards reviewed are 16 and 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has policies, procedures and training that clearly undertakes to protect residents and assist staff in raising concerns. Staff have had training in this area but are not detailing all the concerns raised with them to the manager in order that concerns can be addressed properly. EVIDENCE: The home has a wide range of policies and procedures that include whistle blowing (a way for staff to raise concerns), raising complaints and protection of vulnerable adults. Staff spoken with had been shown all the policies within this area. Staff were updated regularly about how to protect vulnerable adults and how to raise any concerns that they may have. Complaints are recorded and thoroughly investigated and the responses sent to the person raising their concerns. Staff spoken with all had a clear understanding of how to raise concerns. The manager and deputy have appropriately dealt with several complaints. Some questionnaires sent by the manager had raised concerns the manager had spoken to the individuals to determine what their concerns where and how to resolve them, however none of this was treated as a complaint or formally dealt with. Paisley Court DS0000025191.V332473.R01.S.doc Version 5.2 Page 15 Relatives spoken with were aware of the policy and how to raise concerns. One relative had raised concerns regarding the care of their parent, this information had not been passed to management, who had therefore not been able to address these concerns. This had lead to the relative loosing confidence in the homes ability to appropriately support their relative. The manager arranged to meet the relative and all of these concerns were addressed and dealt with. Staff had, had concerns about one residents safety and had taken action that was not care planned and was inappropriate to meeting the residents needs, supporting their rights or keeping the relative informed. No member of staff had viewed this as inappropriate and reported it to the manager despite them receiving training in raising concerns of a serious nature. This was addressed and dealt with by the manager and deputy with a proper care plan put in place that looked at other options to support the resident in a more appropriate manner. Paisley Court DS0000025191.V332473.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): Standards reviewed are 19, 20, 21, 23 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offers a variety of dining rooms, lounges areas and garden area that meets the resident’s needs. There are some minor maintenance issues that are being addressed. Residents are encouraged to make their bedrooms feel welcoming and familiar to them. EVIDENCE: The outside garden space is being divided into areas of specific use, one section has already been turned into a beach garden with a mural painted on the wall. It is in a nice sunny spot and is well used by the residents. Other areas will be turned into outdoor bowling and a gardeners club. The home is divided into four separate units. Each unit has a lounge and a dining room available for the residents. Each of the residents were offered an Paisley Court DS0000025191.V332473.R01.S.doc Version 5.2 Page 17 opportunity to personalise their own private space. This has included furniture and photographs. Some areas in the home are now in need of redecorating and there are plans to do this and replace some of the furniture, new chairs were purchased but developed a fault and the manager is addressing this. There are also plans to make some areas of the home a little more homely as some of the decoration and flooring is not as you would find in an individuals own home. There are ample bathrooms for the use of the residents. Two of the units contained a smell, which was not present at the last inspection. This was contained to the communal areas and was not present in any of the bedrooms. Paisley Court DS0000025191.V332473.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): Standards reviewed are 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All staff are checked to make sure that they are suitable to work in the home before they start. Staff training has been increased and made very easy for staff to keep their knowledge and skills up to date. EVIDENCE: The home has full recruitment and policies. A number of staff files were reviewed, these evidenced that all staff had undergone full and proper recruitment including references, police checks, and suitability to work with vulnerable adult’s an explanation for any gaps in their working history. The recruitment is done taking into account the equality and diversity needs of potential staff. Some parts of training has now been put onto a computer system, there are standard items that all staff must complete and the system shows if they have not done so, this includes specific items such as fire training. There is also an on-line learning programme that staff can access from work or from their own homes. Two staff were seen using this during the day. A student nurse spoken with was also able to review the training and found it “very useful”. Paisley Court DS0000025191.V332473.R01.S.doc Version 5.2 Page 19 The home had a full assessment of the residents needs to determine the correct staffing level about two years ago. This is good practice but should be continued on a regular basis as the resident’s needs may have changed. Relatives and staff spoken with said that there was sufficient staff available. One resident said, “ staff are lovely, nice and pleasant”, a relative said, “staff are very professional”. Paisley Court DS0000025191.V332473.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): Standards reviewed are 31, 32, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Management strives to develop quality at all times and are aware of the need for residents and their relatives to be involved in the management of the home. Progress is being made in several areas including medications, training, activities and nutrition. Communication within the home is not always sufficient to make sure that the management are kept informed of all issues. EVIDENCE: The home has its own quality assurance scheme in place that is done by the head office of the company. Recently they have decided to change the way they do this and a new scheme is to be introduced that recognises the strengths of the home and finds ways to increase the quality of the areas that Paisley Court DS0000025191.V332473.R01.S.doc Version 5.2 Page 21 need developing. Questionnaires have been sent to relatives as to their perspective of the care received and some to residents. Although replies are low some raised concerns that the manager has addressed. The majority were complimentary of the care received. The manager is registered with CSCI and has extensive experience. She is qualified as a mental health nurse and has a deputy with qualifications in general nursing. Several of the bedroom doors had door gates that were used to stop other residents from accessing bedrooms. None of these were mentioned in residents care plans, risk assessed or any alternatives considered. The homes overall risk assessment, which includes a fire risk assessment, did not detail the use of door gates. This was not mentioned in the homes overall risk assessments. None of the residents pay for their care and as such the home does not hold personal allowances for the residents and therefore is not appointee for any of the residents. An account is held in head office, which contains resident’s funds deposited by relatives and a small amount is available in the home. Access to the small amount on site is to be available at all times to make sure that residents are not restricted from accessing their own money. Certificates of maintenance were available and all up to date, maintenance records clearly detail all maintenance issues addressed. Health and safety training is available for staff and they are monitored to make sure that they complete the appropriate health and safety training. Paisley Court DS0000025191.V332473.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 3 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 3 3 X 3 X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Paisley Court DS0000025191.V332473.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 (1) Requirement The registered person must ensure that care plans reflect the identified needs of the resident and how the home is to meet those needs. Outstanding from 25/09/06 The stocks of medications in the home need to be monitored to make sure that the residents always have their medications available. Further development must be undertaken to make sure that residents’ personal choices are obtained, used to influence the home and recorded in the system provided. Timescale for action 24/07/07 2. OP9 13 (2) 24/07/07 3. OP14 12 (2) 24/07/07 4. OP18 13 (6) Outstanding from 11/10/06 The management team needs to 24/08/07 be informed of all concerns raised in order that they can deal with them appropriately. Staff need to be able to recognise actions that restrict residents rights and take appropriate action to prevent this. DS0000025191.V332473.R01.S.doc Version 5.2 Page 24 Paisley Court RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. Refer to Standard OP7 OP12 OP15 OP27 OP30 OP38 Good Practice Recommendations Daily records need to clearly explain what care has been provided to the residents that day. Staff need to complete the section in the care plans that detail residents personal preferences, choices and what daily activities they like to take part in, Staff should inform residents of the food that is on offer before assisting them to eat. Staffing levels need to be regularly reviewed to make sure that there is enough staff at all times to meet the residents needs. The training record should reflect all training undertaken e.g. application of external preparations. Further exploration such as appropriateness, risk of falls and fire risk assessment, should be done with regard to the door gates in the home. Paisley Court DS0000025191.V332473.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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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