CARE HOMES FOR OLDER PEOPLE
Queens Park Nursing Home 37 Queens Park Parade Kingsthorpe Northampton NN2 6LP Lead Inspector
Stephanie Vaughan Unannounced 23 May 2005 13.00
rd 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. Queens Park Nursing Home DC51 C08 S12635 Queens Park V228646 230505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Queens Park Nursing Home Address 37 Queens Park Parade Kingsthorpe Northampton Northants NN2 6LP 01604 719982 01604 718696 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) Dr Ramalingam Mudalia Mr Daljit Singh Poone Mr Nigel McGill Care Home with Nursing 26 Category(ies) of TI(E) Terminally Ill - Over 65 (26) registration, with number MD(E) Mental Disorder - Over 65 (26) of places DE(E) Dementia - Over 65 (26) Queens Park Nursing Home DC51 C08 S12635 Queens Park V228646 230505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 2nd November 2004 Brief Description of the Service: Queens Park is a home registered to provide care for people over 65 years of age, with a diagnosis of Dementia or Mental Disorder. The home has accommodation for up to 26 Service Users, mostly being provided in shared rooms. The accomodation is located over three floors which are accessible by a passenger lift. The home has a large sitting room and a dining room, however there is no quiet area for residents to receive their visitors in private. The home would benefit from some redecoration. The home is close to local amenities such as shops and bus stops. Queens Park Nursing Home DC51 C08 S12635 Queens Park V228646 230505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This routine unannounced inspection was conducted over a period of four and a half hours. During which the inspector made observations, spoke to two residents, three relatives and one member of staff. A limited tour of the premises was conducted which involved viewing the communal areas and a selection of the private accommodation. Case tracking is the method used during inspection where of a sample of three residents were selected and all aspects of their care and experiences reviewed, including individual plans of care and associated documentation. A selection of staff files were viewed. What the service does well:
The service provides prospective residents and their representatives with good information to ensure that they are able to make informed choices about the suitability of the home before they decide to move in. The home conducts detailed assessments to ensure that the home is able to meet the needs and the expectations of prospective residents. Staff were seen to relate well to residents, providing gentle and patient support, guidance and care. Residents were spoken to in their preferred form of address as specified within the individual plan of care. Residents rooms are fitted with appropriate privacy locks and screening. Staff were noted to knock and await permission prior to entering residents rooms. Individual plans of care evidenced that routines are established around the needs of the individual resident with the preferred times of rising and retiring to bed and other personal preferences. Residents and their representatives are provided with information about how to complain and complaints are managed appropriately within the home. The home has access to internal and external guidance on the Protection Of Vulnerable Adults, staff have access to appropriate training and are aware of their responsibilities. The home provides Registered Nurse cover on all shifts, which is supported by the provision of adequate numbers of care staff with a ratio of one member of staff to six residents. Residents, relatives and staff confirmed that there were adequate numbers of staff to meet the needs of residents. Staff were seen to interact well with residents, providing gentle and patient support.
Queens Park Nursing Home DC51 C08 S12635 Queens Park V228646 230505 Stage 4.doc Version 1.30 Page 6 Staffing levels are calculated according to the dependency levels of residents and a staff rota is available within the office. In addition there are facilities in place within the sitting room to display the names of the staff on duty for the benefit of residents and their relatives. Staff files evidenced access to mandatory training such as induction, fire safety, first aid, safe administration of medicines, basic food hygiene and movement and handling training. In addition to training specific to the needs of residents such as dementia care. Staff spoken to were able to demonstrate a good understanding of the procedure to be followed in the event of fire. Safe working practices are generally managed well within the home. With staff trained in mandatory training associated with health and safety. Observations of good practice were made during the inspection including food hygiene and movement and handling practices. What has improved since the last inspection? What they could do better:
Although all residents have terms and conditions of residency included within their individual plan of care, the management should ensure that all the individual detail should be filled in before signatures are sought. Care plans must be improved to ensure that they contain all the required information and include assessments for falls, pressure and nutrition. Interventions associated with these assessments must also be included.
Queens Park Nursing Home DC51 C08 S12635 Queens Park V228646 230505 Stage 4.doc Version 1.30 Page 7 The individual plans of care should be developed to include guidance to staff regarding the resident’s preferences and the expected standard of attire. Medication systems must be reviewed to ensure that large quantities of liquid medication are not allowed to build up and a method developed to ensure that this medication is discarded once the prescribed time frame from first opening has lapsed. The layout of the environment should be reviewed to explore the opportunities for the provision of more privacy for the residents. Although the home have a good programme of activities many of the residents have a diagnosis of dementia and would benefit from access to informal activities and aids such as the provision of baby dolls, dusters, tea towels and magazines. One of the residents spoken to expressed some dissatisfaction with the meals provided and on examination of the menu it appeared that there is limited choice provided at lunchtime. Although alternatives are said to be available on request these are not generally known to all residents and this should be addressed. Some health and safety issues were identified and these must be addressed. They include the repair to the electrical call bell socket in the ground floor bedroom. Review and repair of the hot water system to ensure that hot water is dispensed at safe temperatures. The Registered Manager confirmed that there were no risk assessments in place or contingency arrangements in the event of the lift being out of action at critical times or for prolonged periods and this should be addressed. The building appeared to be structurally well maintained however the home would benefit from redecoration and a programme should be implemented Two staff files were viewed and one was seen to be in good order. However the second file contained major omissions. These include no references, no police or criminal records bureau clearance, and no evidence of an application form or qualifications. There was a copy of a passport included however there was no associated work permit. 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. Queens Park Nursing Home DC51 C08 S12635 Queens Park V228646 230505 Stage 4.doc Version 1.30 Page 8 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 Queens Park Nursing Home DC51 C08 S12635 Queens Park V228646 230505 Stage 4.doc Version 1.30 Page 9 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) 1,2 ,3, 4 & 5 Residents and their representatives are able to make an informed choice about whether or not the home is suitable and able to meet the individuals’ particular needs. EVIDENCE: Prospective residents and their representatives are provided with appropriate information about the service that is provided at Queens Park Parade. The Statement of Purpose / Residents Information Handbook has been reviewed since the last inspection and contains the required information specified in the Care Home Regulations 2001 Relatives spoken to confirmed that they had been able to visit the home and make an informed choice as to whether the home was able to meet the needs and expectations of the resident. All of the individual plans of care contained a copy of the Terms and Conditions of residency and these were signed either by the resident or their representative. However the forms were incomplete with omissions regarding
Queens Park Nursing Home DC51 C08 S12635 Queens Park V228646 230505 Stage 4.doc Version 1.30 Page 10 the individual information such as the room to be occupied, the trial period and the cost. Individual plans of care demonstrated that prospective residents are assessed prior to admission by the Registered manager to ensure that the home is able to provide the level and type care required. Residents and relatives confirmed that the home was able to meet the needs and expectations of residents. The home does not provide intermediate care Queens Park Nursing Home DC51 C08 S12635 Queens Park V228646 230505 Stage 4.doc Version 1.30 Page 11 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 & 10 Improvements to the care planning process and medication systems must be made to ensure that resident’s needs are met. The layout of the environment should be reviewed to improve privacy. EVIDENCE: Individual plans of care are developed based on the initial pre-admission assessment. Each care plan provided instruction to staff regarding the resident’s needs and preferences. Examples of areas covered included personal care, mental health needs, mobility, continence and movement and handling. However some omissions were noted and these included a photograph of the resident and risk assessments for falls. In addition female residents were noted to be without stockings and one to be without teeth and foundation garments. The individual plans of care should be developed to address these omissions and include guidance to staff regarding the resident’s preferences and the expected standard of attire. Care plans evidenced monthly review and the residents or their representative’s involvement.
Queens Park Nursing Home DC51 C08 S12635 Queens Park V228646 230505 Stage 4.doc Version 1.30 Page 12 Residents health care needs are addressed with in the care plan, however not all residents are assessed for the risk of pressure and although there was evidence that residents have access to pressure relieving equipment this was not evident within the care plans. Residents have access to appropriate continence aids although the individual plans of care did not demonstrate access to the Continence Advice Service. Nutritional screening is undertaken although this had not been conducted on all residents and where a need had been identified there was no record of a referral to the dietician. The Registered manager confirmed referral and access to these specialist services and agreed to ensure that this was recorded appropriately. Individual plans of care evidenced access to General Practitioners, Community Nurses, Dental, and Chiropody and Pharmacy Services. In addition residents have access to in and out patient hospital services. Medication systems were reviewed and the Medication Administration Records were seen to be in good order. A spot check was conducted and the quantity remaining seen to correspond with the appropriate record. However, the stock cupboard contained an excessive amount of liquid medication for individual residents. Once opened there was no method of ensuring that this medication would be discarded once the prescribed time frame had lapsed. The building does present some restrictions on the privacy of residents since most rooms are shared and other than the residents individual accommodation there is no quiet area where residents might receive their chosen visitors in private. Although these limitations are included within the Statement of Purpose / Residents Information Handbook, the residents would benefit from improvements in this area. Staff were seen to relate well to residents, providing gentle and patient support, guidance and care. Residents were spoken to in their preferred form of address as specified within the individual plan of care. Residents rooms are fitted with appropriate privacy locks and screening. Staff were noted to knock and await permission prior to entering residents rooms. Queens Park Nursing Home DC51 C08 S12635 Queens Park V228646 230505 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, 13, 14 & 15 Daily Life and social activities are managed well however further recommendations are made to ensure that residents needs are fully met. EVIDENCE: Residents are able to choose whether or not to participate in planned activities within the home and were seen to be involved in a gardening activity during the inspection. The home has a dedicated activities coordinator who has developed a good range of activities, which are published throughout the home and included in the Residents Information handbook. However many of the residents have a diagnosis of dementia and would benefit from access to informal activities and aids such as the provision of baby dolls, dusters, tea towels and magazines. Relatives are made welcome in the home by staff and were able to confirm that visiting times are flexible. Queens Park Nursing Home DC51 C08 S12635 Queens Park V228646 230505 Stage 4.doc Version 1.30 Page 14 Individual plans of care demonstrated that residents are supported to maintain autonomy and choice as much as they are able and rooms evidenced personalisation. The home has a seasonal rolling menu that offers three meal a day including a cooked breakfast on four days a week and a home cooked hot lunch and a choice of a hot or cold meal in the evening. Drinks and snacks are available in between meals. The lunchtime service was viewed and seen to comprise braised steak and kidney, mashed potatoes and fresh vegetables, followed by a sponge pudding. The meal appeared nutritious, well presented and of adequate proportion. Residents were noted to be supported with sensitivity and patience. One of the residents spoken to expressed some dissatisfaction with the meals provided and on examination of the menu it appeared that there is limited choice provided at lunchtime. Further discussion with staff confirmed that there were alternatives available, however residents did not usually express a wish to have an alternative to the menu. Queens Park Nursing Home DC51 C08 S12635 Queens Park V228646 230505 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 & 18 The home responds appropriately to concerns and complaints and residents are protected. EVIDENCE: The home has an appropriate complaints policy, which is made available to residents and their representatives. The policy is available within the home and also within the Residents Information Handbook. The complaints file was viewed and seen to contain a record of all complaints received, appropriate investigation and subsequent action that has been taken to prevent reoccurrence. The Commission for Social Care Inspection have received one complaint since the last inspection, which had been appropriately addressed by the Registered Provider. The home confirmed access to internal policies and external guidelines relating to the Protection Of Vulnerable Adults and staff spoken to were able to confirm access to training and knowledge of the issues involved. Queens Park Nursing Home DC51 C08 S12635 Queens Park V228646 230505 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 Improvements must be made to the environment to ensure the safety of residents. EVIDENCE: The home was registered prior to the introduction of the National Minimum Standards and as such continues to be suitable for its stated purpose. It is accessible to the local community and also has adaptations for the use of wheelchair users. The environment appeared to be generally safe with the exception of a broken electrical call bell socket in one of the downstairs rooms and the maintenance of the hot water system and boiler. The hot water was checked on the fist and second floor rooms and found to greatly exceed the recommended safe temperatures. On further investigation it was established that recent work had been undertaken on the hot water boiler and that this work remained unfinished and without a thermostatic control
Queens Park Nursing Home DC51 C08 S12635 Queens Park V228646 230505 Stage 4.doc Version 1.30 Page 17 device. An immediate requirement was made for the hot water systems to be reviewed and made safe. The passenger lift was being repaired and although this was completed during the inspection, there was no other method in place to enable very frail residents to return to their rooms in the interim. The Registered Manager confirmed that there were no risk assessments in place or contingency arrangements in the event of the lift being out of action at critical times or for prolonged periods. The building appeared to be structurally well maintained however the home would benefit from redecoration. However the home has experienced some difficulty with the reliability of maintenance workers and is currently reviewing the existing contracts. Since the last inspection security to the home has been improved with the installation of Closed Circuit Television systems, however the management is mindful that these systems are to be restricted to entrance areas only and not be allowed to intrude on the daily life of residents. The home was clean and hygienic. Queens Park Nursing Home DC51 C08 S12635 Queens Park V228646 230505 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, 29 & 30 Staffing levels and staff training are appropriate to the needs of residents. However recruitment practices must be improved to ensure the protection of residents. EVIDENCE: The home provides Registered Nurse cover on all shifts, supported by the provision of adequate numbers of care staff with a ratio of one member of staff to six residents. Residents, relatives and staff confirmed that there were adequate numbers of staff to meet the needs of residents. Staffing levels are calculated according to the dependency levels of residents and a staff rota is available within the office. In addition there are facilities in place within the sitting room to display the names of the staff on duty for the benefit of residents and their relatives. Two staff files were viewed and one was seen to be in good order. However the second file contained major omissions. These include no references, no police or criminal records bureau clearance, no evidence of an application form or qualifications. There was a copy of a passport included however there was no associated work permit. Staff files evidenced access to mandatory training such as induction, fire safety, first aid, safe administration of medicines, basic food hygiene and
Queens Park Nursing Home DC51 C08 S12635 Queens Park V228646 230505 Stage 4.doc Version 1.30 Page 19 movement and handling training. In addition to training specific to the needs of residents such as dementia care. Staff spoken to were able to demonstrate a good understanding of the procedure to be followed in the event of fire. Queens Park Nursing Home DC51 C08 S12635 Queens Park V228646 230505 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) 33 & 38 Residents now benefit from the appointment of a Registered Manager with an appropriate level of experience. Improvements to the health and safety systems must be made to ensure the safety of residents. EVIDENCE: Since the last inspection the acting manager has become the Registered Manager within the home. Residents, relatives and staff confirmed their confidence in the Registered Manager saying that he was approachable and they would feel confident in raising any concerns with him. The Registered Manager has many years of experience in the care of the elderly with mental health needs and is currently working towards the achievement of the National Vocational Level 4. There are clear lines of accountability within the home. Safe working practices are generally managed well within the home. With staff trained in mandatory training associated with health and safety. Observations
Queens Park Nursing Home DC51 C08 S12635 Queens Park V228646 230505 Stage 4.doc Version 1.30 Page 21 of good practice were made during the inspection including food hygiene and movement and handling practices. Appropriate records of accidents and incidents were maintained. However areas that must be consistently addressed for all residents include: Risk assessments for falls in general and falls from the bed. Risk assessments for Pressure Risk assessments for Nutrition Improvements to the environment must be made to ensure residents safety include: Repair or replacement of the electrical call bell socket in the ground floor bedroom. Review of the hot water system and boiler to ensure that water is dispensed at safe temperatures. Review of the recruitment processes to ensure that residents are protected from abuse A risk assessment with contingency arrangements should be developed to address the implications of the passenger lift being out of action at critical times or for a prolonged period. Queens Park Nursing Home DC51 C08 S12635 Queens Park V228646 230505 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 3 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2
COMPLAINTS AND PROTECTION 1 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x x x x x 1 Queens Park Nursing Home DC51 C08 S12635 Queens Park V228646 230505 Stage 4.doc Version 1.30 Page 23 No 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 7 Regulation sche 3 Requirement Care plans must be reviewed to ensure compliance with Schedule 3 of the Care Home Regulations 2001 Care plans must be reviewed to ensure all residents are assessed for the risk of falls in general and falls from the bed. Care plans must be reviewed to ensure all residents are assessed for the risk of pressure and that required interventions are recorded Care plans must be reviewed to enure that all residents have nurtitional assessemnts Care plans musty be reveiewed to ensure that acess to specialist services such as dieticians and continence services are recorded Medication systems must be reviewed to ensure that stock is appropriately managed The broken electrical call bell socket must be repaired or replaced. Immediate Requirement. The hot water system must be reviewed to ensure that hot water is dispensed at safe temperatures. Immediate Timescale for action 01/07/05 2. 7 & 38 13 (4) c 01/07/05 3. 8 & 38 12 (1) a 01/07/05 4. 5. 8 8 17 (1) a Shedule 3 01/07/05 01/07/05 6. 7. 9 19 & 38 13 (2) 23 (2) c 01/07/05 27/05/05 8. 19 & 38 12 (1) a 27/05/05 Queens Park Nursing Home DC51 C08 S12635 Queens Park V228646 230505 Stage 4.doc Version 1.30 Page 24 Requirement 9. 29 19 Staff files must contain the required information specified in Schedule 2 of the Care Home Regulations 2001 & 19 2004 Immediate Requirement. The information specified in requirement 9 must be submitted to the Commission. Immediate Requirement. 27/05/05 10. 29 17 (3) 27/05/05 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. 4. 5. 6. 7. Refer to Standard 2 7 10 12 15 19 19 Good Practice Recommendations All of the details should be included in the contract before the resident or their representative is asked to sign Care plans should be reviewed to ensure that staff are instructed regarding the residents preferences and expected standard of attire The layout of the premises should be reviewed to explore opportunities to improve the privacy of residents Informal activities should be developed for residents with dementia Residents should be informed about alternatives to the formal lunch time menu A risk assessemnt should be conducted to include the action that would need to be taken in the event of the passenger lift being out of action A programme of redecoration should be implemented Queens Park Nursing Home DC51 C08 S12635 Queens Park V228646 230505 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection 1st Floor, Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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