Inspection on 30/05/07 for Pinetree Lodge Nursing Home

This inspection was carried out on 30th May 2007.

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

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

Other inspections for this house

Pinetree Lodge Nursing Home 29/05/08

Pinetree Lodge Nursing Home 27/06/06

Pinetree Lodge Nursing Home 22/11/05

Pinetree Lodge Nursing Home 28/07/05

Pinetree Lodge Nursing Home 11/03/05

Pinetree Lodge Nursing Home 19/11/04

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

CARE HOMES FOR OLDER PEOPLE Pinetree Lodge Nursing Home Dryden Road Gateshead Tyne & Wear NE9 5BY Lead Inspector Mr Tom Moody Key Unannounced Inspection 30th May 2007 10:00 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 Pinetree Lodge Nursing Home DS0000018176.V338477.R02.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. Pinetree Lodge Nursing Home DS0000018176.V338477.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pinetree Lodge Nursing Home Address Dryden Road Gateshead Tyne & Wear NE9 5BY 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) 0191 477 4242 0191 478 6702 Mental Health Concern Mrs Kathleen Bailey Care Home 34 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (34), Mental disorder, excluding learning of places disability or dementia (5) Pinetree Lodge Nursing Home DS0000018176.V338477.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th June 2006 Brief Description of the Service: Pinetree Lodge Nursing Home is owned by Mental Health Concern and opened in 1984. It is designed to accommodate the needs of older people with dementia care and nursing needs. The fees at the home are £634 but several grants and funding bodies pay these monies. The home is a purpose built bungalow style facility. It is divided into three units and provides nursing care for people with mental health needs, predominantly those needs associated with dementia-type illnesses, in each unit. There are a variety of lounges and dining rooms throughout the building as well as a sensory room. One lounge provides access to an internal courtyard and a sensory garden has been created. The home is situated in a residential area just off Durham Road in Gateshead. Other healthcare facilities are located in the same grounds. Public transport is within easy walking distance and this gives access to local shops and social amenities. Pinetree Lodge Nursing Home DS0000018176.V338477.R02.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 3 days. Two inspectors attended the home on the first day and one on the subsequent two days. Inspectors spoke to people using the service, staff and visiting relatives. Several residents were identified as having complex physical and mental health needs. The care they received was tracked through discussions with all concerned and by looking at the service user plans. Information supplied by the home and comment cards were used to make decisions about the quality of service although the provider’s self-assessment was not available at the time of the site visits. Pinetree Lodge provides nursing care for people with a dementia-type illness and care for people with mental health needs. Some of the people have difficulty communicating their views verbally. Therefore staff practice, attitude and approach were watched and judgements made on how well staff worked with people. During this inspection all of the key standards were checked. What the service does well: The manager is very competent and puts the interests of the residents at the centre of her practice. Relatives and said that they found the staff and manger to be very approachable and made comments such as, ‘“I am happy with everything” and “couldn’t be better” Staff work with people in a way that respects them regardless of the severity of their disability and provide “cuddles” and physical contact when this is appropriate. One relative commented that, “the staff are wonderful people.” Staff constantly talked to the residents and encouraged them to respond. Staff also used a variety of different methods to help people make decisions about the care they were receiving. Mental Health Concern’s staff training department is extremely active and all of the staff have access to a wide range of training. The type of training offered includes access to degree and masters level courses as well as secondments onto nurse training. The company encourages participation and relatives take part in Forums that improve the quality of the service. One relative said, “we are getting things done” and felt his opinions were valued by the company. Pinetree Lodge Nursing Home DS0000018176.V338477.R02.S.doc Version 5.2 Page 6 The home provides a suitable environment and it is well maintained. The home is well equipped and committed to continuous improvement strategies. The home has good contacts with the local health care services and clinical specialists visit the home to ensure service users get god health 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. Pinetree Lodge Nursing Home DS0000018176.V338477.R02.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 Pinetree Lodge Nursing Home DS0000018176.V338477.R02.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users needs are assessed by The Home Manager and professionals from Local Authorities, or Primary Care Trusts. This ensures that they are placed in a home that can meet their needs. The majority of evidence indicates service users and their relatives are given the necessary information to make an informed choice about the home. EVIDENCE: Most relatives who returned a survey form were happy about the information they received. One person remarked that they were aware they should have had information but did not receive it! Other relatives spoke of staff “knowing each person’s needs and responding accordingly”. The assessment documentation in the home has been specifically designed to give information about the needs of people with a dementia- type illness. It is a very comprehensive tool, which provides a lot of information about all aspects of people’s lives and needs. Staff have been filling these in but are examples when limited information is being recorded. Pinetree Lodge Nursing Home DS0000018176.V338477.R02.S.doc Version 5.2 Page 9 The manager has said that staff and the relatives need to fill in the form. Sometimes the information is not available depending on the service user’s circumstances. The manager also said that she would not admit service users unless the equipment was available to meet their assessed needs. Relative who were spoken to were happy with the amount of information they received from the home and indicated that staff communicated well with them. Contracts were available for all service users based on local authority or health care providers model. Pinetree Lodge Nursing Home DS0000018176.V338477.R02.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service user plans do not always reflect the care and good practices seen at Pinetree Lodge. They do contain most of the information necessary to ensure service user’s needs are met but this is not always obvious, sometimes because of their design and sometimes because of the way they are used. Equipment is appropriate to fully meet service user’s needs. The home has appropriate policies and practice to ensure service users receive their medication in a way that meets their needs. Service users are treated with respect by staff and, practice and procedures in the home should ensure their privacy. EVIDENCE: The home has appropriate policies, storage and practice to ensure service users receive their medication in an appropriate way. Recent concerns have been raised about quality of care provided at the home by student nurses placed there. These were largely unfounded but some misperceptions could have arisen because of poor documentation and inadequate preparation of the students for such a challenging environment. Pinetree Lodge Nursing Home DS0000018176.V338477.R02.S.doc Version 5.2 Page 11 The staff were seen to be using gloves and other protective clothing during the time of the site visit although the student nurses on placement said that this did not always happen. The manager told the inspector that she had received training in tissue viability and she cascaded this to her staff. Service user’s care plans and the records from other professionals support this and the type of wound care used is appropriate. In some records there appeared to be a time lapse before referring to specialist nurses. The manager explained that this was because the home felt it was unnecessary at an earlier stage. However, this should be recorded to maintain the accountability of staff. Similarly episodes of minor restraint were recounted by the manager but this was not documented. There were other instances of care being recorded the wrong section of the care plan and it was difficult to get a clear picture of the care given to some service users. Care plans include includes nutritional assessments, pressure damage risk and moving and handling assessment but some of the care goals are too general and do not make explicit the level of care that is being given. For example, the moving and handling methods that were seen in use were appropriate but the type of documentation used does not make this clear and is very unspecific. The manager says she is planning to revamp the care plans to make them a “working document” and improve recording by staff. The home has appropriate policies, storage and practice to ensure service users receive their medication in an appropriate way. Observation of the administration and storage indicated this was generally good and in line with policies. The Medicine Administrations Records for case tracked individuals was accurate and well kept. Pinetree Lodge Nursing Home DS0000018176.V338477.R02.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are very dedicated and have excellent dementia care skills, but the organisational constraints affects the level of care they are able to give. It must also be recognised that the level of dependency that service users have, also limits the social opportunities they can be offered. EVIDENCE: The comments in service users questionnaires show that the home provides a social programme that is appreciated by service users and their relatives but more could be done to provide music and trips out of the home. Comments from the relatives of service users were very positive. They said that staff, “deserve a medal”, “couldn’t be better” and that “I am happy with everything.” Relatives also spoke of being involved in forums and meeting with the provider and they spoke of being listened to and felt their suggestions were acted upon. Service users looked tidy clean and well cared for. They were wearing appropriate day time clothing. The majority of residents could not give a verbal response about the care they were receiving. One resident nodded and smiled when asked if everything was all right. One resident smiled when being “cuddled” by a member of staff. It was notable, and commendable, that staff did not avoid physical contact with service users and often gave such none-verbal assurance. Pinetree Lodge Nursing Home DS0000018176.V338477.R02.S.doc Version 5.2 Page 13 There is a member of staff in each lounge area at all times. The staff spent time talking to the residents but there was little activity involved in these interactions, however this would depend on the capacity of the service user involved. The televisions were on in each unit, one of which had the sound turned down it was not clear how this was being enjoyed by anyone. The home does use “doll therapy”. Different types of dolls were in the lounge areas and could be used by any resident able to reach them. One resident was distressed and unable to settle but by cuddling the doll she became animated and content for a little while. The home also has a people-carrier to enable residents to be taken out. Staff said this was not a planned event, as it would depend on how residents were each day. There is a quiet room with some sensory equipment available. Staff said they are able to spend time in the room on a one to one basis with residents, however, the use of this facility was not evidenced on the day of inspection. Staff have a good understanding of the individual residents needs and care was given in sensitive manner. They were very busy throughout the day attending to residents’ very complex personal and health care needs. The majority of the doors to toilets, bathrooms and bedrooms are kept locked. Most of the locks are the same and are accessed by a master key, which all staff are provided with. While it is appreciated that some autonomy must be curtailed, to prevent confused residents going into other peoples rooms, residents have to stay in the communal areas during the day cannot freely go into their own room should they wish to do so. Alternative may be possible, such as deploying alarms on bedroom doors, which would alert staff when rooms are being accessed. No menus are on display either in large print or pictorial style. None of the tables were set for the meal and no one was offered any condiments such as salt or pepper. As identified at earlier inspections, Pinetree Lodge does not have kitchen staff and care staff undertake this task as part of their daily routine. The cook-chill system meant staff regenerate all of the meals at the same time and then have to monitor service users when they were dining. This meant that they were unable to spend much time with individuals. Some visitors were supporting their relatives during lunchtime. Although this was freely and willingly given, inspectors felt the staff would have struggled to provide adequate support without this additional help. Portion sizes were adequate but the vegetables portions were small. The absence of cooking aromas also lessened the sensory impact of dining. All of the food provided was served on to the plates therefore no one could have second helpings as there was none left and no resources to make more. A large number of people require one-to-one assistance during the meals or will need to have food at different times during the day. No one has overall responsibility for monitoring the general diet residents have had on a daily basis. Comments from relatives indicated they felt the food was of good Pinetree Lodge Nursing Home DS0000018176.V338477.R02.S.doc Version 5.2 Page 14 quality. Most service users seemed happy with their diet but one was very vocal about the food saying it was “lousy” and “was hungry.” During the inspection it identified that people were not receiving five portions of fruit and vegetables a day, although it was agreed with the manager this could be rectified by giving “smoothy” type drinks. Mental Health Concern recognised that the pressures and limitations attendant to the cook-chill system prevent staff from monitoring people’s overall diet and diluted some of the service offered to people. The manager agreed to look at these problems and Mental Health Concern are to looking to providing dedicated kitchen staff for Pinetree Lodge. Pinetree Lodge Nursing Home DS0000018176.V338477.R02.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is proactive in dealing with complaints and protection issues and service users interests are safeguarded. EVIDENCE: Relatives comment cards record no concerns over this aspect of the service. The complaints procedure is made available to residents and relatives through the service user guide. Resident’s relatives felt the manager and staff listen to concerns people may have and they are confident they would act upon them. The manager actively seeks out service user’s and relatives feedback and she feels this resolves issues before they develop into complaints. During the site visit one nurse, who was in charge at the time, was not able to recount how complaints would be recorded and this may be something the company should address. Staff have received training in adult protection issues and have an awareness of this. Pinetree Lodge Nursing Home DS0000018176.V338477.R02.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a suitable environment to meet service users needs and maintain the safety of the occupants. EVIDENCE: At the time of the site visit the home was clean, tidy and free from any odours. The home is at a reasonable temperature and the manager spoke of getting portable air-conditioning for hot spells in the summer. The home has good levels of artificial and natural light. The manager, and a senior manager confirmed that the home will be provided with pressure sensitive mats to alert staff to some residents, who cannot use a call system, getting out of bed at night. The home is divided into three units and each has a keypad system. The door on the Cedars Unit was opened to let residents have more space the walk around the reception area. They could not access the other two units one of which has a pleasant conservatory leading to the garden. Doors are held open by a system that is triggered by the fire alarm although one of these devices was not working at the time of the first site visit. Pinetree Lodge Nursing Home DS0000018176.V338477.R02.S.doc Version 5.2 Page 17 The majority of the doors to toilets, bathrooms and bedrooms are kept locked. Most of the locks are the same and are accessed by a master key, which all staff are provided with. While it is appreciated that some residents may go into other peoples rooms and touch or use their belongings residents who stay in the communal areas during the day cannot freely go into their own room should they wish to do so. Many bedrooms are pleasantly furnished and some have large clocks so that the occupants may see the time There is a quiet room with some sensory equipment available. Staff said they are able to spend time in the room on a one to one basis with residents. The use of this facility was not seen on the day of inspection. There are suitable aids and adaptations to bathrooms and toilets. The home has variable height beds and pressure-relieving aids available. Pinetree Lodge Nursing Home DS0000018176.V338477.R02.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff are competent and very skilled at providing care but they may be diverted from meeting all of the service user’s needs by the domestic duties that the home’s operation places upon them. EVIDENCE: The previous inspection indicates staff are well trained and skilled. Relatives comments confirm this but speak of restrictions on outings due to “staff shortages” Another relative suggested “staggered meal breaks” which suggest staff organisation could be better. Mental Health Concern has a dedicated training department. This department provides staff with opportunities to go on a wide range of training. Mandatory training such as food hygiene is provided. More than 50 of care staff have completed NVQ training and the qualified staff are able to go on various courses including degrees and nurse training. Staff have a good understanding of residents needs and care was given in sensitive manner. They were very busy throughout the day attending to residents’ very complex personal and health care needs. Attending to the tasks, necessary to meet the mental health and general nursing needs of all residents, seemed to overtake the person centred approach to care delivery. An example was the significant number of residents required one to one support or discreet prompting either at the dining table or in their bedroom to eat the meal and at times staff could not provide one-to-one support for the people in the dining rooms and relatives assisted in this process. Pinetree Lodge Nursing Home DS0000018176.V338477.R02.S.doc Version 5.2 Page 19 After the meal care staff take the used dishes to the kitchen. They have to load the dishwasher and clear the kitchen. The care staff also provide the personal laundry service. Although the manager stated that the home is staffed to take account of this, inspectors felt that the extra demands on care staff, both day and night, to complete domestic tasks may dilute the care provision given to the residents. This was supported by relatives comments and the suggestion of staggered meal breaks was felt to be a good idea that the home should consider. Domestic staff are employed in the home. Pinetree Lodge Nursing Home DS0000018176.V338477.R02.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is very competent and endeavors to protect service user’s interests. The management systems are working effectively to protect service users and staff and to meet their needs. EVIDENCE: The previous report noted that, the manager is very competent and the management systems are working effectively and that quality in this outcome area is good. Relatives comment cards tend to support this. The manager is an experienced registered nurse with strong leadership skills and a track record of running good services. She is ethically motivated and understands the importance of providing person-centred care which she promotes to others. Pinetree Lodge Nursing Home DS0000018176.V338477.R02.S.doc Version 5.2 Page 21 The previous inspection noted that, a team of finance staff at the head quarters look after the personal allowance records. Relatives and resident’s when they need information can get this from the manager via the intranet system. Only small amounts of money are held on behalf of residents. The manager confirmed that the arrangements around service user’s finances were unchanged and remain satisfactory. Staff and manager have a good awareness of health and safety issues and staff receive up to date training. Mental Health Concern has a very comprehensive quality assurance that is repeatedly tested and amended when shortfalls are found. Pinetree Lodge Nursing Home DS0000018176.V338477.R02.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 3 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 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 2 2 3 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 3 3 3 3 3 2 3 Pinetree Lodge Nursing Home DS0000018176.V338477.R02.S.doc Version 5.2 Page 23 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 OP7 Regulation 15 (a) (b) Requirement Adequate care planning must take place including accurate risk assessment. Timescale for action 18/07/07 2. OP22 13 (4) (a) & (b) The alarm call cord system must 28/08/07 be replaced during the planned redecoration and alternative means for summoning assistance must be in place in the interim. (Requirement made at previous inspections The home must ensure there is suitable support for service users at mealtimes and the preparation, presentation and consumption of food is an enjoyable experience for all service users. 28/08/07 3 OP15 16 (2) (i) Pinetree Lodge Nursing Home DS0000018176.V338477.R02.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP24 Good Practice Recommendations Bedroom doors should be fitted with locks suited to service user’s capabilities and accessible to staff in emergencies. Pinetree Lodge Nursing Home DS0000018176.V338477.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 Pinetree Lodge Nursing Home DS0000018176.V338477.R02.S.doc Version 5.2 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!