Inspection on 20/04/05 for Primrose House Nursing Home

This inspection was carried out on 20th April 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

Primrose House Nursing Home 01/10/08

Primrose House Nursing Home 02/10/07

Primrose House Nursing Home 27/04/06

Primrose House Nursing Home 13/10/05

Primrose House Nursing Home 03/12/04

Primrose House Nursing Home 06/05/04

Primrose House Nursing Home 15/05/03

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Primrose House 765-767 Kenton Lane Harrow Weald Middlesex HA3 6AH Lead Inspector Judith Brindle Unannounced 20 April 2005 9.40am 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. Primrose House Version 1.10 Page 3 SERVICE INFORMATION Name of service Primrose House Nursing Home Address 765-767 Kenton Lane Harrow Weald Middlesex HA3 6AH 020 8954 4442 020 8954 5376 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) Mr Hassam Cader Mr Hassam Cader CRH (N) 23 Category(ies) of OP 23 registration, with number DE(E) 4 of places Primrose House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. Maximum of 23 elderly persons over the age of 65 years in need of general nursing care. 2. Minimum staffing notice applies. 3. Service users admitted to any of the four dementia care places must be offered a single room located on the ground or first floors only. Date of last inspection 3/12/04 Brief Description of the Service: Primrose House Nursing Home provides nursing care for up to 23 elderly persons. The care home is registered to provide places for up to four service users needing dementia care. The home was first registered in September 1994. Mr H Cader, who is also the registered manager, owns the nursing home. Mrs Cader is a trained nurse, and works most days in the registered care home. The home is a large detached house close to Harrow Weald. There is parking for several cars on the forecourt of the care home. The home has three floors with lift access. There are 17 single rooms and 3 shared rooms. There are bedrooms on each floor. The proprietor has agreed that service users with the diagnosis of dementia are offered single rooms on the ground and first floor only. Four bedrooms have either an ensuite toilet or an ensuite toilet and bath. Communal rooms are located on the ground floor. The home has a large accessible enclosed garden. Primrose House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over 6.5 hours during a day in April 2005. There was one service user vacancy at the time of the inspection. A partial tour of the premises took place. Care records, and staff personnel documentation were among a variety of records inspected. The registered manager was on duty during most of the inspection. Seven service users, four staff and two visitors kindly spoke with the inspector. Most of the requirements from the previous inspection had been met. Staff were supportive in assisting with the inspection process. What the service does well: What has improved since the last inspection? What they could do better: Despite some décor improvements, the homeliness of the care home could be further improved. Activities and entertainments both inside and outside the home could be further developed, and particular attention paid to those service users with particular health needs and changing needs. Primrose House Version 1.10 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Primrose House Version 1.10 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 Primrose House Version 1.10 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) 1,3, 5 (6 is not applicable) The documentation and information in regard to the service needs to be accessible to service users/significant others. The admission procedure ensures that there is proper assessment prior to people moving into the care home. Service users are encouraged to visit the home prior to their admission. EVIDENCE: The recently reviewed statement of purpose and service user guide information and documentation was not available for inspection. The accessibility of this documentation was discussed with Mrs Cader. A copy of the service user documentation was supplied to the Commission for Social Care Inspection, following the unannounced inspection. This documentation included comprehensive detailed information in regard to the service provided. The admission policy/procedure was inspected during the previous inspection and was found to be comprehensive. The admission procedure is recorded in the service user guide documentation. Records, (which included care plan documentation) and information from the registered person confirmed that service users receive assessment of their needs prior to moving into the Primrose House Version 1.10 Page 9 service, and that ‘wherever possible the person in charge will visit the service user prior to their admission’, particularly if the service user is unable to visit the care home prior to admission. A care plan inspected confirmed that a service user participated in the assessment process and had completed a questionnaire in regard to their preferences and needs. There is a recorded emergency admission procedure. Care plans inspected informed the inspector that service users referred through Care Management arrangements have their needs assessed by the relevant purchasing authority. Records confirmed that service users admitted from hospital received hospital discharge assessment, prior to their admission to the care home. A service user spoke of having visited the care home prior to moving into the home. Another service user said that she did not visit the home but that her relative did. It should be documented as to the reasons why a service user did not visit the care home prior to their admission. The four care plans inspected recorded that the assessed needs were regularly reviewed. Staff who spoke with the inspector, and observation during the inspection informed the inspector that staff had awareness and understanding of service users varied needs. Primrose House Version 1.10 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) 7,8and 10 Arrangements are in place for meeting service users health care and personal care needs. There needs to be further development in some recorded guidance to ensure that all needs are clearly identified and that this information is easily accessible by staff. Advice and support from specialist healthcare services is obtained as needed to ensure that all service users assessed health needs are met. Service users’ privacy and dignity is respected. EVIDENCE: All service users have a plan of care. Four care plans were inspected. There was recorded evidence that service users’ health and personal care needs were generally identified. This includes nutritional assessment, risk of pressure sores, risk of falls, and mobility risk assessment. Some staff guidance for identified health needs was recorded. There needs to be further development in the identification of some needs, i.e. a service users’ particular care needs when receiving assistance with personal care due to their diagnosed medical needs. This was discussed with Mrs Cader. A senior staff member informed the inspector that the care plans were in the process of being reviewed to ensure that the information including staff guidance was easily accessible by staff. This should be actioned by the registered person. Primrose House Version 1.10 Page 11 The care plans recorded evidence of having been regularly reviewed. Service users spoke of having access to specialist medical services, and optician, dental and chiropody services. All service users are registered with a GP. It needs to be documented and agreed with the service user (service users relative/significant other if the service user is unable to communicate their view) if the service user does not wish to wear a hearing aid. There was recorded and observed evidence that equipment was provided to assist in the prevention of pressure sores. The senior staff member reported that there were no service users with pressure sores. Mrs Cader reported that new weighing scales have been ordered, to ensure that service users weight can be monitored as and when required. Daily records are maintained of service users individual progress, and of any changing needs. Service users should be given the opportunity of participation in regular/daily exercise sessions. Service users preferred term of address was recorded in a care plan inspected. There is an accessible payphone. Staff were observed to respect service users’ privacy and dignity during the inspection. Primrose House Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14, and 15 Arrangements are in place for providing opportunities for service users to participate in activities, but these need further development to provide creative, varied and interesting activities for people living in the care home. Service users are supported in maintaining contact with family/friends. The meals are varied and wholesome. EVIDENCE: Records confirmed that some service users participated in activities. A service user spoke of ‘not doing much’ and of ‘not wanting to do much’. Activities recorded included bingo, music sessions and a sing a long session. There needs to be further development in regard to the provision of a choice of interesting and creative, varied activities for service users to participate in. Ways of motivating service users should be examined. Particular dementia care needs of service users need to be addressed in regard to leisure activities. Records need to identify choice, in regard to recording when service users have chosen not to participate in an activity and as to what alternative activity is offered. This was discussed with the registered person. The home has a visitors’ policy. This is recorded in the service user guide. Service users received visitors during the inspection. A visitor informed the Primrose House Version 1.10 Page 13 inspector that they visited their relative at a variety of times of the day. A service user went out with a visitor during the inspection. The registered person informed the inspector that at present service users do not manage their financial affairs, and that relatives/significant others do this. Four weeks menu was available for inspection. Recorded meals were found to be varied and wholesome. A service user spoke of enjoying the meals provided. Two cooks are employed. A cook who spoke to the inspector had knowledge and understanding of service users particular dietary needs including cultural dietary needs. She confirmed that the menu was explained to service users on a daily basis. Staff were aware of encouraging service users choice in regard to food provided, and reported examples of this. It needs to be recorded on the menu that a choice of meal is offered. The inspector was informed that the menu was to be reviewed. Staff were observed to offer assistance to service users with their meals. Records and guidance were in place in regard to meeting particular dietary needs of service users. Primrose House Version 1.10 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Complaints are handled objectively, and service users and visitors are confident that their concerns will be listened too. There needs to be development in the homes’ adult protection procedure to ensure that a proper response to any suspicion or allegation of abuse. EVIDENCE: The home has an accessible complaints procedure. A service user who spoke to the inspector said that they would speak to a registered nurse if they had a ‘concern’ or complaint. There has been one complaint received by the CSCI since the last inspection. Records and information from the registered person confirmed that the complaint was being taken seriously and that appropriate action was being taken to investigate the issues and to put in place an appropriate action plan. The CSCI was kept informed of action taken in regard to the complaint allegation. Staff should be given a copy of the grievance procedure. The care home has a protection of vulnerable adults procedure/policy. Staff who spoke to the inspector were aware of the appropriate action that would be needed to be taken in response to an allegation of abuse. The registered person needs to amend the adult protection procedure, to ensure that it links with the Local Authority protection of vulnerable adults policy/procedures. This was a previous requirement. Service users financial risk assessments need to be in place. Records confirmed that staff had received in house training in regard to abuse awareness. The content of this training needs to be recorded. The registered person informed the inspector that further external training in respect protection of vulnerable adults was planned for him and for other staff. There Primrose House Version 1.10 Page 15 was accessible information and documentation in regard to abuse awareness. Three personnel records of care staff confirmed that they had received a Criminal records Bureau check, the personnel record of a cook confirmed that they did not have a CRB check. Domestic staff and the employed cooks need to have completed a satisfactory Criminal Record Bureau check. Primrose House Version 1.10 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, 20,26 Limited improvements to the décor have been made. There are areas of the home that lack ‘homeliness’. There are some on going improvements to the furnishings and fittings, but there are outstanding matters to be met to ensure that people living in the home have more comfortable, homely surroundings. The home is clean. EVIDENCE: Since the last inspection the home has continued with the redecoration programme, which included repainting of some communal areas, including some areas of the kitchen. The inspector was informed that new carpets were planned for the communal areas including the sitting room, dining area and corridor areas. This should be actioned by the registered person. Efforts should be made to make the communal areas more homely. Work had commenced to install a shower on the ground floor of the care home. A number of other areas require attention: • Broken tiles, damaged worktops and a damaged kitchen cupboard doors need repair/replacing. Primrose House Version 1.10 Page 17 • • A worn and wobbly footstool located in a service users’ room needs replacing. There needs to be an extractor fan in the laundry facility. A service user spoke of accessing the garden. The garden should receive maintenance. The registered person reported that a shed was being put up in the garden area. The registered person needs to ensure that there is risk assessment in regard to possible risk to service users during the erection of the shed. Service users were observed to freely access communal areas. The home was clean during the inspection. Domestic staff are employed. The laundry facility is located away from food storage and food preparation areas. The inspector was informed that a new dishwasher had been installed. There was an offensive odour in a service users’ room. This odour was removed during the inspection. There were some stains on this carpet in this service users’ room. The registered person needs to have the carpet thoroughly cleaned or replaced. This was discussed with Mrs Cader. Some armchairs in the communal areas need cleaning particularly in regard to the head rest areas. The inspector was informed that infection control training for staff was planned. Primrose House Version 1.10 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) 27,29 and 30 Arrangements are in place to ensure that the number and skill mix of staff on duty during the day enable needs of service users to be met. It is unclear as to whether there is always sufficient staff on duty at night to ensure that service users preferences, and changing needs are met. The procedures for the recruitment of staff are generally robust and provide the safeguards to offer protection to people living in the care home. Staff receive varied appropriate training to develop their skills to meet the needs of service users. EVIDENCE: During the day there are generally four care staff and a registered nurse and a cook and domestic staff. Mr and Mrs Cader are generally on duty during the week. There needs to be recorded confirmation that staffing numbers at night are adjusted to ensure that there is sufficient staffing to meet the needs and changing needs of service users at night. The dementia care needs of service users need to be particularly considered. This was discussed with the registered person. The inspector was informed that there are nurse students on secondment/placements for periods of time in the home. Some guidelines from the agency supplying these students were accessible. The registered person needs to ensure that there are ‘in house’ guidelines developed and in place in regards to seconded students. Primrose House Version 1.10 Page 19 The four staff files inspected contained required information and documentation. Criminal Records Bureau checks are required for some staff (see Standard 18). Documentation and staff confirmed that staff receive appropriate training. Records of foundation induction training were available for inspection. Staff training from an external trainer took place during the inspection. The responsible individual informed the inspector that two staff were in the process of doing an NVQ level 2 course in care and that several other staff were due to commence this course within the next few months. The cooks need to have completed certified statutory food and hygiene training. This was a previous requirement. The registered person and documentation confirmed all staff were planning to receive statutory certified training in food and hygiene. The registered responsible individual informed the inspector that staff had received ‘in house’ food and hygiene training. Records in regard to varied ‘in house’ training were available for inspection. The content of these training sessions should be recorded. Staff were in the process of completing risk assessment training. Several training certificates were displayed in the care home. Service users who spoke to the inspector said that staff were helpful and caring. Staff were observed during the inspection to interact with service users in a positive and respectful manner. Staff responded promptly when service users communicated the need for assistance. The registered person showed the inspector documentation that confirmed that he had taken action in regard to informing and obtaining agreement from relatives/significant others and the GP in respect of service users who are assessed as not being able to manage a call bell. Primrose House Version 1.10 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, 33, 36,38 There is leadership, guidance and direction to staff to ensure that service users receive consistent quality care. There are arrangements in place to ensure that staff are appropriately supervised. There are systems in place to promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: The registered manager has managed the home for several years. His wife is the responsible individual, and works most days within the home, sometimes as shift leader. Mr and Mrs Cader are both registered nurses. Mrs Cader informed the inspector that she had recently completed NVQ level 4 in management, and that the registered manager and Mrs Cader were both NVQ assessors. Records confirmed that they provide staff with in house training. There was documented evidence that the registered manager undertakes periodic training. The registered person and documentation confirmed that Primrose House Version 1.10 Page 21 there were plans for all staff to receive statutory certified training in food and hygiene. Staff, visitors, and service users who spoke to the inspector were aware of the lines of accountability and management within the care home. Service users and visitors made positive comments in regard to the staff team. Recent completed questionnaire documentation received from several relatives in respect of their views of the service were available for inspection. These were complimentary of the service. There was evidence of quality assurance monitoring systems being in place, which included staff training, maintenance, review of care plans, and environmental redecoration. There was evidence that some policies had been recently reviewed and that staff had signed that they had read some. Records confirmed that staff supervision takes place. The inspector was informed that registered nurses would complete some formal staff supervisions. There should be recorded evidence that these staff have received supervision training. It needs to be recorded when service users cannot manage to use a call bell, and staff guidance in place to ensure that staff can respond quickly to service users needs even if they are unable to manage a call bell. Fire equipment is regularly inspected. Fire training had recently been carried out. Documentation in regard to a recent inspection of the premises by the local fire service was recorded as being satisfactory. The employers liability insurance was up to date. Primrose House Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 3 x x x x x 2 STAFFING Standard No Score 27 2 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 x 3 x x 3 x 2 Primrose House Version 1.10 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 1 Regulation 4 (1)(c ) Requirement The number and sizes of rooms need to be recorded in the statement of purpose.Timescale of 1/4/05 not met. There needs to be further development in the identification of some particular care needs i.e. a service users’ particular care needs when receiving assistance with personal care due to their diagnosed medical needs. . It needs to be documented and agreed with the service user (service users relative/significant other if the service user is unable to communicate their view) if the service user does not wish to wear a hearing aid. There needs to be further development in regard to the provision of a choice of interesting and creative, varied activities for service users to participate in. Particular dementia care needs of service users need to be addressed in regard to leisure activities Records need to identify choice, in regard to recording when service users have chosen not to Version 1.10 Timescale for action 1/9/05 2. 8 12,14, 15 1/8/05 3. 8 12, 15 1/9/05 4. 12 12,16(n) 1/10/05 5. 12 12,16 1/10/05 Primrose House Page 24 6. 15 12(1)(a) 13(4) 7. 8. 15 18 16(i) 13 (6) 9. 10. 18 18 13(6) 13(6)19 11. 19 13(4) 12. 19 23 13. 26 23 participate in an activity and also of what alternative activity is offered. The cook needs to have a certified statutory food and hygiene training qualification.Timescale of 1/3/05 not met. It needs to be recorded on the menu that a choice of meal is offered. The adult protection poicy needs to record the need to follow the Local authority protection of vulnerable adult procedures following an allegation of abuse, prior to an investigation. Timescale of 1/3/05 not met. The content of the staff abuse awareness in house training needs to be recorded. Service users financial risk assessments need to be in place. Domestic staff and the employed cooks need to have completed a satisfactory Criminal Record Bureau check. The registered person needs to ensure that there is risk assessment in regard to possible risk to service users during the erection of the shed. There needs to be an extractor fan in the laundry facility. · Broken tiles, damaged worktops and a damaged kitchen cupboard doors need repair/replacing. · A worn and wobbly footstool located in a service users’ room needs replacing. The registered person needs to have the carpet in a service users room thoroughly cleaned or replaced. Some armchairs in the communal areas need cleaning particularly in regard to the head Version 1.10 1/8/05 1/9/05 1/8/05 1/9/05 1/8/05 1/7/05 1/9/05 1/8/05 Primrose House Page 25 rest areas. 14. 27 14(2)18 (1)(a) There needs to be recorded confirmation that staffing numbers at night are adjusted to ensure that there is always sufficient staffing to meet the needs and changing needs of service users (including those with dementia care needs) at night. The registered person needs to ensure that there are ‘in house’ guidelines developed and in place in regards to seconded students. It needs to be recorded when service users cannot manage to use a call bell, and also recorded staff guidance in place to ensure that staff can respond quickly to service users needs even if they are unable to manage a call bell. 1/8/05 15. 27 13(4)(6) 1/8/05 16. 38 12,13(4) 1/8/05 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. Refer to Standard 5 7 12 Good Practice Recommendations It should be documented as to the reasons why a prospective service user might not visit the care home prior to their admission. The format of the care plans should continue to be reviewed. Ways of motivating service users to participate in activities should be examined. An activity staff role should be considered. Service users should be given the opportunity of regular exercise sessions. The garden should receive further maintenance. New carpets and further redecoration should be actioned to improve the homeliness of the care home. The content of all in house training sessions should be recorded. There should be recorded evidence that staff who give Version 1.10 Page 26 4. 5. 6. 7. 19 19 30 36 Primrose House staff supervision have received supervision training. Primrose House Version 1.10 Page 27 Commission for Social Care Inspection 4th Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 Primrose House Version 1.10 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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