Inspection on 19/05/05 for Park House

This inspection was carried out on 19th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Park House 20/11/08

Park House 22/11/06

Park House 10/11/05

Park House 19/11/04

Park House 18/05/04

Park House 14/10/03

Park House 06/05/03

Park House 28/05/02

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

CARE HOMES FOR OLDER PEOPLE Park House James Street, Tyldesley, Wigan, M29 8JJ. Lead Inspector Lindsey Withers Unannounced 19th May 2005 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 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. Park House F06 F56 S5757 Park House V227128 19.05.05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Park House, Address James Street, Tyldesley, Wigan, M29 8JJ. 01942 882344 01942 886188 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) CLS Care Services Limited Mrs Sharon Davies Care Home 40 Category(ies) of Old Age 40, Physical Disability Elderly 8, registration, with number Dementia Elderly 3 of places Park House F06 F56 S5757 Park House V227128 19.05.05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 40 service users to include, up to 40 service users in the category of Older People (OP) 8 service users with Physical Disabilities over 65 years of age PD(E) and 3 service users in the category of Dementia over 65 years of age (DE(E)). 2. The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. 3.Three service users may be accommodated in the category of DE(E). Date of last inspection 19th November 2004 Brief Description of the Service: Park House, part of the CLS group of homes, is situated close to Tyldesleys local amenities and is well served by public transport. The Home is a single storey building, which is set in well-maintained grounds. Park House is registered to provide personal care for 40 residents of either sex over the age of 65, 8 of whom may have a physical disability, and 3 of whom may have dementia. Special arrangements had been made with the CSCI for one resident to be accommodated who was just under the age of 65. All bedrooms are offered as singles; there are no shared rooms at Park House. Park House F06 F56 S5757 Park House V227128 19.05.05 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 7.5 hours. Part of the time was spent in the office talking to the Manager, looking at care plans, staff files, and papers used to manage the Home. The remainder of the time was spent looking around the building, joining three residents for a cup of tea, and speaking at length to eight residents, two visitors, and two members of staff. Other residents were spoken to over the course of the inspection. What the service does well: What has improved since the last inspection? What they could do better: Assessments must be done for all residents coming to live at Park House, regardless of the number of times they are admitted or length of time they are going to stay. This would make sure that staff provide the right sort of care to residents. Referral to a health professional, either in the community or at the hospital, must be quicker. Care planning and risk assessing is not improving as quickly as it should be. Where there have been improvements in some areas of the paperwork, this has been at the expense of good reporting in other areas. Improvements must be made within a fixed period of time, and those improvements sustained, otherwise the CSCI may be forced to take more formal action. Better auditing of the paperwork will make sure that records are correct and up to date. Park House F06 F56 S5757 Park House V227128 19.05.05 Stage 4.doc Version 1.30 Page 6 In order for the Activities Organiser to provide activities and social events that residents want, and where they want them, some thought should be given to the way in that communal areas are used. At times when residents are more dependent on staff, e.g. when ill, through the night, or on busy mornings, the Manager should make sure that more staff are in work. This will make sure that residents receive proper care. 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. Park House F06 F56 S5757 Park House V227128 19.05.05 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Park House F06 F56 S5757 Park House V227128 19.05.05 Stage 4.doc Version 1.30 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 standard(s) 3 and 5. Pre-admission assessments were good, except in the case of a resident accessing respite care, which did not provide sufficient information to ensure good care. Residents had been able to visit the Home prior to admission. Staff were aware of the needs and expectations of residents, ensuring they provided a needs-led service. EVIDENCE: Four care plans were looked. In three, there were written records to show that a full assessment had been completed prior to admission. Signatures were seen on the records to show that the resident or their supporter had been involved in the assessment process. These residents could be assured that their needs had been properly assessed and would be met by the Home. One resident had been admitted on two occasions for respite care. An initial assessment had been done, but an assessment had not been done for the second period of respite care. Staff could not, therefore, have had full knowledge of the person’s mental and physical health care needs, or his personal expectations. Park House F06 F56 S5757 Park House V227128 19.05.05 Stage 4.doc Version 1.30 Page 9 A number of residents said they had made the decision to move into Park House; others had left the decision-making to their relatives, who had made the choice of Home on their behalf. One resident said it had taken him one visit to decide he wanted to move in. Another said she had visited the Home prior to moving in. One resident said she used to visit friends who lived at Park House, so when the time came, she did not have to think too much about moving in. A small number said they had found making the decision very difficult but that they knew it had been the right thing to do. A number of staff have received training in dementia care, and training for more staff is planned. Other specialist health care is provided via the hospital or community services. Park House F06 F56 S5757 Park House V227128 19.05.05 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9 and 10. Care planning showed some improvement but still focussed on negative aspects of care. Staff were working hard to ensure residents were treated with dignity and that their privacy was maintained. Staff knowledge in relation to the policies and procedures for the safe use of medication is better. EVIDENCE: Four care plans were looked at initially, and a further three following observations made during the inspection. For the most part, records set out the aspects of health, personal and social care needs of the resident, and showed that amendments had been made. However, care plans had not all been reviewed at least monthly and the person accessing respite care did not have a care plan written by the Home. The meaning of some entries in care plans was not clear, for example in relation to mouth sores that were “due to confusion”. Entries in the daily progress record focussed on the negative aspects of the person’s activities of daily living, rather than placing any emphasis on the positive aspects. So, for example, we may find that an individual had been incontinent several times, and had been argumentative, but we would not know that he or she had enjoyed listening to music that day or had had a pleasant conversation with a member of staff. There is too much reliance on entries that state: “X appears well” or “X fine today”. Park House F06 F56 S5757 Park House V227128 19.05.05 Stage 4.doc Version 1.30 Page 11 Such comments do not paint a picture of the resident’s life, and do not make it clear that the care plan has been followed. Risk assessments were in place on the majority of files that were looked at but, again, had not been reviewed at least monthly. Some risk assessments should have applied to all residents, for example, in relation to moving and handling, falls, and skin tissue viability. However, this had not been the case for the resident accessing respite care. This file contained blank risk assessments that had not been completed. On two files, risk assessments had been included that were specific to the individual. Again, these had not been reviewed at least monthly. Following conversation with one resident and discreet observation of her level of comfort, the Manager was asked to further assess the person’s risk assessment in relation to pressure sores, and to seek further advice from a health professional, if it was felt necessary. The entries in the daily diary for one resident made it clear that this person was deteriorating in terms of her mental health. This was impacting on the other residents living at Park House. The desired outcome set by the Social Services Department was not being achieved. The Manager was asked to request a mental health assessment to ensure that the person’s needs were being met, and that her comfort, and that of the remaining residents at Park House, was assured. Care planning had been the subject of requirements on previous reports, and, though some improvement was in evidence, further work is needed to ensure that documentation meets the standards expected by the CSCI. A good number of residents were able to describe their physical condition, which, for the most part, had been the reason why they had moved into Park House. A small number said it was difficult coming to terms with their physical frailty. Residents said that staff knew how to look after them, and made sure that they got their medication. Residents spoke about seeing primary health specialists such as GPs, District Nurse, chiropodists, opticians, etc. There had been a busy start to the day at Park House with three residents going off for hospital appointments. Ambulances had been arranged, and escort staff were on duty. It was clear that every effort had been made to ensure residents got to their appointments without undue stress and with the least fuss. Two residents returning to the Home following their appointments were immediately encouraged to relax with a hot drink and a bite to eat. One resident said that staff do whatever they can to make her comfortable. She said she was never made to feel embarrassed, for example, when using the commode. She said that only Care Team Leaders can give out medication. A visitor said that her relative was provided with “good care” and that she could get information on her relative’s health status at any time. Two Park House F06 F56 S5757 Park House V227128 19.05.05 Stage 4.doc Version 1.30 Page 12 residents had moved from Manor Fold. They said there had been no problems with the standard of care that they received at Park House. Staff were observed to treat residents with respect, knocking on doors before entering, and speaking to – not talking at – residents. A number of requirements and recommendations had been made at the last inspection by the Pharmacy Inspector. All targets set had been achieved within the given timescales. Park House F06 F56 S5757 Park House V227128 19.05.05 Stage 4.doc Version 1.30 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 standard(s) 12. While activities and social events have now commenced, effort is needed to ensure residents are offered the variety they would like, in locations they would prefer. Continued support and training for the Activities Organiser will ensure residents’ social needs are met. EVIDENCE: Prior to the new Activities Organiser commencing in post (having transferred from Manor Fold), Park House had been without anyone to arrange activities and social events for some time. Residents had been quite vocal about this at the last inspection, and were pleased with the appointment of the member of staff. In conversation, the Activities Organiser demonstrated her ability to offer a range of group and individual activities, and had a good number of ideas for trips out from Park House, and indoor social events. She was struggling for space to deliver activities and a high number of residents (and one visitor) said that they wanted more opportunities to be offered, but not necessarily just in the dining room or in one lounge. Other ideas for free and little-cost activities were explored during the period of the inspection. Park House F06 F56 S5757 Park House V227128 19.05.05 Stage 4.doc Version 1.30 Page 14 As a result of these conversations, various options were explored with the Manager, such as opening the hairdressing salon (which is only used for twice weekly) to give dedicated therapy space where residents could enjoy beauty and nail treatments in a calm, tranquil setting, away from the television. A large lounge is being used as a Visitors’ Lounge. It was suggested that this be moved to a smaller room, and this larger lounge become designated activities space. This room had the bonus of double doors that opened onto another lounge and could create good space for coffee mornings, visiting entertainers, etc. There was a lack of equipment around the Home for residents to listen to music or to watch videos or DVDs, and this, too, needs addressing as a number of residents said they get “fed up” with the TV. One resident chooses to do household chores, and prefers this to joining in activities. A recommendation is made to expand this to other residents who have a good level of independence, as they indicated that they might like to have some form of occupation that gave meaning to the day. The Manager said she had been looking at providing some form of independent dining facility for the more able residents, but that she could not find space close enough to the main kitchen. However, she was still looking to find a solution. The Activities Organiser said she was finding it difficult to provide activities to those residents who had sensory or dual-sensory disability. A recommendation was made for the Manager to contact the Sensory Team at the Local Authority for assistance and advice. Park House F06 F56 S5757 Park House V227128 19.05.05 Stage 4.doc Version 1.30 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 standard(s) 16 The Home has a satisfactory complaints system that residents and relatives were familiar with. Residents’ views are listened to and acted upon. EVIDENCE: The Home has a complaints procedure that is widely advertised throughout the premises. The main policy and procedure is a document that is devised by CLS but which can be amended so that it is appropriate to Park House. Residents said that they felt they could raise any issues with members of staff or with the Manager directly. One visitor said that if she had concerns, she would speak to a member of staff. No formal complaints had been received at Park House since the last inspection. There was evidence in care plans to show that issues raised by residents had been resolved to their satisfaction. Park House F06 F56 S5757 Park House V227128 19.05.05 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 22. The Home is being well-maintained and further planned financial investment will offer residents a better environment in which to live. Communal space is not organised to allow residents to make best use of it, particularly for activities and social events. Residents benefit from a wide range of aids and adaptations that help them to live as independently as possible. EVIDENCE: From a tour of the building, it was seen that the premises were being maintained to a good standard, both inside and out. There was evidence of redecoration and some renewal of fabric and furnishings. Further redecoration was planned over the summer, including the corridors and the dining room. Radiator covers had been delivered and were due to be installed. This item had appeared on previous inspection reports and action was long overdue. Residents said their rooms were comfortable. A good number of bedrooms were highly personalised, with items having been brought from the resident’s own home. Residents said they enjoyed being able to sit in different places Park House F06 F56 S5757 Park House V227128 19.05.05 Stage 4.doc Version 1.30 Page 17 around the Home but that they tended to sit in particular places for the most part. All lounge space was comfortably furnished. One resident said he liked the seating area at the main reception, as it is quiet and he can get “a bit of peace”, away from the general bustle of the Home. Other residents liked to sit in the sun lounge (a link corridor), from where they could see the garden and enjoy watching the birds. A visitor said this area was a “nice environment” and that it was “calm”. Some time was spent with the Manager discussing the areas of the Home that might be better for activities and social gatherings, as residents said they did not like having to sit in the dining room if they wanted to watch a video or listen to music. Discussions also took place about making best use of the communal space, particularly as there is a lot of furniture that could either be disposed of or moved to a better location. A number of aids and adaptations were seen around the Home, including hand rails, hoists, grab rails and raised seats in toilets, and hoists in bathrooms. Residents got around the building using walking sticks, zimmer frames, and wheelchairs. One resident had an electric wheelchair. His bedroom was sufficiently big so as to allow the wheelchair to be recharged overnight. Park House F06 F56 S5757 Park House V227128 19.05.05 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30. Staff morale is good, with low levels of sickness and turnover. This ensures residents are provided with care by people they know and are familiar with. The practice of retaining two staff on duty overnight needs constant review to ensure residents’ needs are met. Staff receive training so that they are competent to do their jobs. EVIDENCE: Shifts during the day comprise of one Care Team Leader and three Care Assistants. This reduces to one Care Team Leader and one Care Assistant overnight for a maximum number of 40 residents, located on one floor. This may not always be sufficient if the dependency levels of the residents living at Park House changes. The Manager said that she had not needed to include additional staff on the rota of late, but that she had authority to do so, if a resident required additional support because of illness or incapacity. The care staff team is complemented by the domestic team, which comprises a domestic supervisor, domestic assistants, cooks, kitchen assistants, an activities organiser, and a handyman. Appropriate arrangements are in place to cover holidays and sickness. One resident said that staff were good at covering for each other, and sometimes changed shifts to help a colleague out. The resident thought this was a good system because it meant residents always knew the staff who were on duty, and there was no need to have help from a stranger. Park House F06 F56 S5757 Park House V227128 19.05.05 Stage 4.doc Version 1.30 Page 19 Residents said that staff were “kind” and did what they could to make them comfortable. Staff were seen to be taking residents’ wishes into account as they went about their work, offering support, comfort, and company. The records for three members of staff were looked at. All were in good order and showed that a proper recruitment process had been followed. During a monitoring visit to the Park House, evidence had been available to confirm that a number of staff had undertaken training in relation to dementia. Training for other staff was being arranged, on a rolling programme. While this training had been a condition of registration if the Home was to accommodate people with dementia, staff had said that they could use elements of the training in their general day-to-day work, which they thought brought benefit to the care of all the residents. Park House F06 F56 S5757 Park House V227128 19.05.05 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33 and 38. The Manager is properly qualified and experienced, and manages the Home well. The Manager and staff try to maintain an open culture, where everyone is valued. Auditing systems are in place but are not always effective, so impacting on the care provided for residents. Systems are in place to ensure residents and staff are kept safe. EVIDENCE: The Manager has achieved the NVQ level Managers’ Award. She has a certificate that the National Vocational Qualification in Care. providing care to the elderly, and has been years. She is qualified to train care staff in handling, and fire safety. IV in Care and the Registered allows her to assess staff under She has extensive experience in Manager at Park House for two relation to first aid, moving and Park House F06 F56 S5757 Park House V227128 19.05.05 Stage 4.doc Version 1.30 Page 21 From observation, if could be seen that residents and staff felt able to approach the Manager. Questions were responded to, and advice given. Time was taken with the residents to engage in conversation. Park House has recently been awarded 5 Stars by the RDB. The RDB independently measures the services in a number of care homes in the Wigan area, and is one of the quality monitoring systems that the CLS group of homes employs. The Home employs a system for auditing and monitoring the qualify of the service. The records showed that there are regular audits of documentation, as well as audits of systems and procedures by a representative of CLS from outside of the Home. However, the audit of care plans needs to be more thorough if improvements are to be made and sustained. The Manager makes sure that the health and safety of residents and staff is maintained. The premises are regularly checked by the handyman, by a representative from CLS, and by companies who service fire extinguishers, the lift, hoists, the nurse call system, etc., and records are kept. On the day prior to the inspection, burning toast had caused the fire alarm to sound. This had led staff to follow fire procedures, and the fire brigade had attended. The fire log had been completed appropriately. Staff and agency staff signatures were seen in the file to show that they had read and understood what they would have to do in the event of a fire. Staff were seen to be using good moving and handling techniques. Park House F06 F56 S5757 Park House V227128 19.05.05 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 x COMPLAINTS AND PROTECTION 2 x x 3 x x x x STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 2 x x x x 3 Park House F06 F56 S5757 Park House V227128 19.05.05 Stage 4.doc Version 1.30 Page 23 YES 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. Standard 3 Regulation 14 Requirement Pre-admission assessments must be carried out on all residents, including those accessing periods of respite care. Care plans must be in place for all residents, must provide more detail, and must be reviewed at least monthly. Timescale 31.1.05 not met. Risk assessments must be in place for all residents, and must be reviewed at least monthly. Residents must be offered activities and social events of their choosing and in their preferred location. Consideration must be given to making best use of the communal space, taking into account the wishes of residents. The auditing system for care plans must be improved so that it is effective. Timescale for action 15.7.05 2. 7 15 15.7.05 3. 4. 8 12 13 16 15.7.05 1.9.05 5. 19 23 1.9.05 6. 33 24 15.7.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Park House F06 F56 S5757 Park House V227128 19.05.05 Stage 4.doc Version 1.30 Page 24 No. 1. 2. 3. Refer to Standard 12 12 27 Good Practice Recommendations Consideration should be given to providing opportunities for occupation to those residents who have a good level of independence. Consideration should be given to contacting the local Senior Team for assistance and advice in relation to activities for residents with sensory disability. Additional staff should be provided if the dependency levels of residents changes, for example, overnight or at peak periods during the day. Park House F06 F56 S5757 Park House V227128 19.05.05 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Turton Suite, Paragon Business Park, Chorley New Road, Horwich, Bolton, BL6 6HG. 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 Park House F06 F56 S5757 Park House V227128 19.05.05 Stage 4.doc Version 1.30 Page 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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