Inspection on 10/10/06 for Ridgeway Lodge

This inspection was carried out on 10th October 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ridgeway Lodge 14/05/07

Ridgeway Lodge 06/10/05

Ridgeway Lodge 30/06/05

Ridgeway Lodge 17/03/05

Ridgeway Lodge 14/09/04

Ridgeway Lodge 24/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Ridgeway Lodge Brandreth Avenue Dunstable Bedfordshire LU5 4RE Lead Inspector Leonorah Milton Unannounced Inspection 10th October 2006 09:40 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 Ridgeway Lodge DS0000014952.V315565.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ridgeway Lodge DS0000014952.V315565.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ridgeway Lodge Address Brandreth Avenue Dunstable Bedfordshire LU5 4RE 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) 01582 667832 01582 478485 BUPA Care Homes (Bedfordshire) Ltd Care Home 61 Category(ies) of Dementia - over 65 years of age (61), Old age, registration, with number not falling within any other category (61), of places Physical disability over 65 years of age (61) Ridgeway Lodge DS0000014952.V315565.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th October 2005 Brief Description of the Service: Ridgeway Lodge is a purpose built care home registered to provide for sixtyone frail adults over the age of sixty-five who may also have dementia and/or physical disabilities. The home was operated by BUPA Care Homes (Bedfordshire) Ltd. The manager had been in post for four months. An application to be registered in that position by The Commission for Social Care had not been submitted for consideration. The building had been finished to a high specification that met the National Minimum Standards and provided single room accommodation on the two levels of the home. The layout of the building had been designed to promote the ethos of small group living, each of the units having a lounge and dining area with toilets and bathrooms in close proximity. The building had an inner quadrangle type garden that was well stocked with flowers and shrubbery and provided a pleasant out look and congenial place for relaxation. The home was located in a residential suburb within walking distance of local shops. The towns of Dunstable, Houghton Regis and Luton were short car journeys away. Fees for accommodation were between £600 and £401.27 weekly. Ridgeway Lodge DS0000014952.V315565.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report sets out the significant evidence that has been collated by the Commission for Social Care (CSCI) since the last visit to and public report on, the home’s service provision in December 2005. Reports from the home, other statutory agencies, and information gathered at the site visit to the home, which was carried out on 10th October 2006 between 10.40 and 18.10, were taken into account. The visit to the home included a review of the case files for two service users, conversations with five service users, two visitors to the home, four members of staff and the manager. Much of the time was spent with service users in two lounges, where the daily lifestyle was observed. A partial tour of the building was carried out and other records were reviewed. What the service does well: What has improved since the last inspection? This inspection identified numerous shortfalls to expected standards for the operation of a care home, particularly in relation to the legal requirements for record keeping. However, the recently appointed manager explained the strategies that will be introduced to improve this situation. Examples of documentation to be used for service users case files and staff deployment were seen. These will be introduced in the near future. Ridgeway Lodge DS0000014952.V315565.R01.S.doc Version 5.2 Page 6 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. Ridgeway Lodge DS0000014952.V315565.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ridgeway Lodge DS0000014952.V315565.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3 and 6. Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. The home had failed to carry out a thorough assessment of need prior to admission for all persons living in the home to ensure that the home had the capability to care for them properly. EVIDENCE: Two case files were assessed at this inspection. The documentation in each file for the assessments of need prior to admission showed that insufficient information about service users’ needs had been obtained. One contained little information on the “personal information document” other than the service user’s name and date of birth. There was no other evidence of an assessment of need carried out prior to admission. Ridgeway Lodge DS0000014952.V315565.R01.S.doc Version 5.2 Page 9 The personal information document on the second file recorded the service users’ name, date of birth, toileting needs, that the service user had no allergies, took a high protein diet and also recorded the service user’s preferred term of address. Other sections for next of kin, religion, preferences for getting up and going to bedtimes, choice of beverages and hobbies were blank. There was no other evidence in relation to a pre-admission assessment of need. Discussions took place with the manager about the intermediate care service provided by the home. Arrangements about this aspect of the service were carried out in conjunction with other professional services. The designated team in the home worked in association with a social worker, district nurse, occupational therapist and physiotherapist. Ridgeway Lodge DS0000014952.V315565.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9 and 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Personnel were mostly reliant on information about service users’ needs that was passed on verbally rather than the written arrangements for care needs. There was therefore a risk that needs could be overlooked. Poor staff communication meant that at least two service users had not received their prescribed medication. EVIDENCE: Discussions with members of staff showed that they were aware of service users’ needs and how these historically had been met. However, the record keeping in relation to care planning and similar was not sufficiently detailed: Two care plans were assessed at this inspection and subsequently discussed with the manager, who agreed that the plans were inadequate. It was explained that the case files were under review together with all records Ridgeway Lodge DS0000014952.V315565.R01.S.doc Version 5.2 Page 11 relating to the assessment and care of service users. Indeed, the inspector noted that this process was underway. One of the plans seen made no reference to social, recreational, emotional needs or the service user’s wishes in the event of their death. Arrangements to meet service users’ healthcare needs were brief and did not include an analysis of nutritional needs or mention routine needs such as chiropody, dental and optical care. The second plan made reference to needs under three headings only, “personal care”, “continence”, and “mobility”. Individual daily records were maintained about each service user’s progress and noted when health care professionals had seen service users. There was however no sequential record on each file to record healthcare appointments, other than Doctors’ visits and therefore it was not possible to properly assess the arrangements to meet individual health care needs. Records for one service user noted that the service user had only bathed twice in two months. It was explained that the service users was reluctant to bathe. This being the case, records must be maintained to show when the service user has declined to bathe. The record for another service user showed that they had not bathed after 28th August until 11th September 2006. Records and notifications to the Commission showed that there had been a high incidence of service users sustaining injuries through falls. There had been little significant action taken to analysis the circumstances in which the falls had occurred and to introduce preventative measures if need be. However, it was reassuring to note that the new manager had begun the process to address these issues. Medicines were stored securely. Assessment of the records for the administration of medicines showed that two service users had not received some of their medication for the previous day or on the day of the inspection. It was explained that the pharmacist had omitted to supply these medicines at the monthly restocking of supplies. The medicines arrived in the late afternoon on the day of the inspection, when it was too late to administer the outstanding doses. The manager had not had the opportunity to arrange for pick up of the medicines because she had not been informed about this problem. It was noted that members of staff addressed service users by their preferred choice of name. Service users confirmed that personnel treated them with respect. Ridgeway Lodge DS0000014952.V315565.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14,15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The arrangements to provide service users with a lifestyle that met their expectations were inconsistent and meant that the wishes of some may have been unfulfilled. EVIDENCE: The inspection included the observation of the lifestyle on both the upper and the ground floor of the home. The upper floor had been designated for the care of service users who had dementia and associated conditions. It was noted that the member of staff in one of the lounges on the upper floor was making a lot of effort to engage service users in amusing pastimes. Service users who joined in activities smiled readily and appeared to be enjoying some light hearted fun. The carer was aware that the service users had short attention spans and had tailored activities accordingly. On the lower floor it was noted that service users were mainly unoccupied during the inspection. One service user remarked that there were few Ridgeway Lodge DS0000014952.V315565.R01.S.doc Version 5.2 Page 13 activities and stated that they “Sat about for most of the day”. Another said, “It is the same all the time”. The report of the review of the quality of care carried out by the home in February 2006 noted that 13 of those taking part rated the arrangements for social and recreational events as poor. There was no corresponding action plan to show how this situation was to be improved. Whilst some members of staff were observed to engage service users in friendly conversation, there was also lack of communication, as was noted when two staff were seen to put a handling belt around a service user without giving any explanation about what was going to happen. Other aspects of the service that are applicable to this section were satisfactory. Service users and two relatives confirmed that visitors were welcomed into the home. The visitors remarked on the support they had received from staff when they and their relative had been upset at the time of the transfer to the home. Hot trolleys were provided to transport meals around the home under hygienic conditions. A meal was observed in progress. The choice on the day of the inspection was quite varied to suit many palates. Staff explained about the foods provided for those requiring special diets. Service users described the food as “Alright but not like home-cooking”. Another stated that it was “ Very good”, and a third that it was “So, so”. It was noted that the physical condition of service user who had been weak, undernourished and with a poor appetite on admission had recovered well since living in the home. Ridgeway Lodge DS0000014952.V315565.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16,18 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home had robust procedures for the protection of service users and to enable them to complain. The failure however to ensure that all personnel had been briefed about protection procedures raised concerns that some service users could be at risk. EVIDENCE: Service users confirmed that they felt able to raise concerns. One said that they felt, “Any complaint would be listened to. Another said, “I can talk to this lot if I am worried.” The home’s central complaints file was assessed. Documents showed that whilst complaints during the previous management may have been investigated, the records of the same and responses to complainants were inadequate. Records since the appointment of the new manager identified that there had been an improvement in the investigation and response to complaints. Complaints had included those in March June and September 2006 in relation to a service user who had fallen. Ridgeway Lodge DS0000014952.V315565.R01.S.doc Version 5.2 Page 15 Assessment of personnel files showed that satisfactory recruitment practice, including the obtaining of references and criminal records disclosures, had taken place before staff had commenced duties in the home. During discussions with the inspector members of staff showed an awareness of protection issues. However given the number of staff and the inconsistency of training, supervision and staff meetings until recently, the organisation must ensure that service users are protected from abuse by providing all personnel working in the home with training/briefing in adult protection procedures. Ridgeway Lodge DS0000014952.V315565.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19,26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The building had been purpose built and provided a comfortable, well-adapted environment. Failure however to remove the unpleasant odour from the corridor on the upper floor had compromised the hygiene standards in the home and had meant that service users, visitors and staff had to experience this unpleasant odour when in that area of the building. EVIDENCE: Procedures were in place to ensure that the safety of the building and its equipment through regular maintenance checks and servicing by qualified contractors. Ridgeway Lodge DS0000014952.V315565.R01.S.doc Version 5.2 Page 17 The building on the whole was well decorated and furnished. Service users’ bedrooms, whilst quite uniform in layout, décor and furnishings, had been individualised by service users’ personal possessions. Many rooms had achieved homely appearance. There was an unpleasant odour in the corridor on the upper floor, which was quite pungent. It was reported that cleaning of the carpet in this area had failed to completely remove the unpleasant smell. Ridgeway Lodge DS0000014952.V315565.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29,30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Whilst many of the staff had worked in the home for a significant time and were conversant with service users’ needs, gaps in essential training had increased the possibility that service users’ needs and rights might not be met. EVIDENCE: The staffing rota was reviewed with the manager. This was a complex document that did not lend itself to a ready analysis. The manager stated that at her appointment she not been able to understand the document either. The proposed new rota was shown to the inspector and was to be introduced in the near future. The explanation of staffing arrangements given to the inspector identified that sufficient care and ancillary personnel were rostered daily to care for service users and to operate the home. An established senior team meant that at least one senior member of staff was on duty on each floor throughout the day to support members of staff. Indeed staff remarked that they felt well supported. Ridgeway Lodge DS0000014952.V315565.R01.S.doc Version 5.2 Page 19 The training record submitted for this inspection showed that, as with other aspects of the service, the planning of the provision had been inconsistent and had lead to gaps in essential training. The record showed that whilst the majority had received training in fire safety and safe moving and handling techniques, there were seven whose annual manual handling training had not been updated since 2004 and another sixteen who had not been updated since 2005. Thirteen had received medication awareness training but only four staff had received training in infection control, nine had achieved national vocational awards in care. None of the staff had received training in procedures to prevent the abuse of service users. The record gave no indication of induction training, however, a recent employee explained their induction process, which appeared to be thorough, and said that they found the guidance to very helpful. The assessment of personnel files showed that good practice guidelines had been followed to assess candidates for employment for their suitability for the job and to promote equal opportunity practice. Ridgeway Lodge DS0000014952.V315565.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35,36,37,38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The management of the home had improved at the appointment of an experienced and qualified manager. Before this, the evidence from this inspection showed there had been a deteriorating service, which had put service users at risk of injury. EVIDENCE: The recently appointed manager had previously been a registered care home manager in a home also operated by BUPA. Inspections had identified good Ridgeway Lodge DS0000014952.V315565.R01.S.doc Version 5.2 Page 21 standards of practice in that home. The manager’s application to be registered in respect of Ridgeway Lodge must be submitted to the Commission. The manager was frank and open throughout the inspection about issues that needed urgent action to improve the service. Given her experience and with the support of the organisation and her team, it is expected that the service delivery will improve within an acceptable timeframe. The inspector was shown a report on the quality assurance process carried out earlier this year. Attached to it was a letter from the regional director stating “Please use this report to examine ways to improve your service to customers.” The report indicated that this was to happen if the scores were below excellent or very good. Several of the scores fell below this benchmark. There was no action plan or similar to show how the improvements were to happen. Records indicated that visits had been carried out under Regulation 26. The reports of these visits however did not comment on the issues identified at this inspection, which were long overdue for action. Those carrying out the inspections must ensure that their reports are sufficiently detailed to inform the proprietor about issues in the home. The organisation must also fulfil its legal obligations by notifying the CSCI in writing about any changes in the management of the home. Records were seen in relation to monies held on behalf of service users. These had been well maintained. It was reported that these were subject to regular audit. Monies were held in individual bank accounts that were controlled by the organisation’s HQ. The inspector was informed that staff supervision had not happened with the frequency outlined by the standard but that action had been taken to improve this situation. Record keeping as detailed through out this report had not met standards or the legal requirements for the operation of a care home. Environmental safety aspects of the home seen at this inspection had been well managed. The purpose building had included safety features in its overall design. Regular checks on equipment and systems had been maintained. Previous inspections had identified that comprehensive guidance about safety issues was available to staff. This standard was let down by the management of falls, but as stated action was taking place to address this issue. Safety training as detailed must include regular updates on manual handling. Ridgeway Lodge DS0000014952.V315565.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 1 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 1 10 3 11 1 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 3 x x x x x x 1 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 1 x 3 x x 2 Ridgeway Lodge DS0000014952.V315565.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 12(1)(a) 14 Requirement The home must have obtained or carried out a thorough assessment of need that has been carried out by a suitably qualified person before any service user is admitted to the home. A comprehensive care plan that is based on a current assessment of need must be in place for each service user. Needs identified on the plan must include personal, health, social, recreational and emotional. There must be evidence that service users have been consulted about their care needs and the arrangements to meet them. The risk assessment for leaving medication to service users to take without staff present must be drawn up. (Previous requirement of 15/11/05 had not been met) The home must ensure that stocks of medicines are replenished so that every service user receives their prescribed DS0000014952.V315565.R01.S.doc Timescale for action 14/11/06 2 OP7 12(1)(a) 15 31/01/07 3 OP9 13 30/11/06 4 OP9 12(1)(a) 13(2) 07/11/06 Ridgeway Lodge Version 5.2 Page 24 5 6 OP12 OP18 7 8 OP26 OP30 9 OP31 10 OP31 11 OP33 medication every day. Recreational activities must suit service users’ abilities and preferences. 12(1)(a) Training/briefing must be 13(6) provided for staff in procedures for the protection of service users. 12(10(a) Action must be taken to remove 16(2)(k) the unpleasant odour from the corridor on the upper floor. 12(1)(a) The home must introduce and 18(1)(c) implement a staff development plan that has been based on an analysis of individual need. Included in the plan must be: Updates for manual handling Infection control Dementia/diseases/conditions associated with old age Care planning National Vocational Qualification in care Continence management Nutrition for older people. Skin care. CSA 2000, An application for the Part 2, registration of the person who Section has been appointed to manage 11(1) the home must be submitted to the CSCI. 12(1)(a) The organisation must notify the 8(2) 39 CSCI in writing about any changes to the management of the home. 12(1)(a) An action plan must be compiled 24 and made available to service user to show what action will be taken on issues arising from the quality assurance processes. 12(1)(a) 16(2)(m) The reports under Regulation 26 must be sufficiently detailed to inform the proprietor about the conduct of the home. Records must be maintained in accordance with the regulations for the operation of a care home DS0000014952.V315565.R01.S.doc 31/01/07 31/01/07 30/11/06 31/12/06 30/11/06 14/11/06 30/11/06 12 OP37 12(1)(a) 17 Sch 3,4 31/01/07 Ridgeway Lodge Version 5.2 Page 25 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 OP9 Good Practice Recommendations A person responsible for medication should identify the safest practice for administering liquidised medication and complete the negotiation to have medication delivered to the home in blister packs. Service users should be consulted about their wishes in the event of their death. Care plans should note any such wishes. The home’s training plan should show staff will be supported to achieve National Vocational Qualifications in care so that 50 of the home’s care staff hold this qualification. Staff should receive supervision at least six times per year. 2 3 OP11 OP28 4 OP36 Ridgeway Lodge DS0000014952.V315565.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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 Ridgeway Lodge DS0000014952.V315565.R01.S.doc Version 5.2 Page 27 - 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!