CARE HOMES FOR OLDER PEOPLE
Rossendale Nursing Home 96 Woodlands Road Ansdell Lytham St Annes Lancashire FY8 1DA Lead Inspector
Ms Susan Dale Key Unannounced Inspection 18th September 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rossendale Nursing Home DS0000006077.V345162.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. Rossendale Nursing Home DS0000006077.V345162.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Rossendale Nursing Home Address 96 Woodlands Road Ansdell Lytham St Annes Lancashire FY8 1DA 01253 737740 01253 795702 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) Mrs Caroline Taylforth Carol Marline Griffiths Care Home 27 Category(ies) of Dementia (17), Old age, not falling within any registration, with number other category (10) of places Rossendale Nursing Home DS0000006077.V345162.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home is registered for a maximum of 27 service users to include: up to 10 service users in the category of OP and up to 17 service users in the category of DE 7th August 2006 Date of last inspection Brief Description of the Service: The Rossendale Nursing Home is registered with the Commission for Social Care Inspection to provide personal and nursing care for 27 service users of either sex aged 65 years and over. Care is offered to those with physical/medical needs and those with dementia (up to 17 service users). The Rossendale Nursing Home is a detached Victorian property, which retains many of its original features. The home is situated in a residential area of Ansdell Lytham St Annes, overlooking Grannies Bay. The home is within easy reach of shops and local amenities. It is situated on a bus route and within five minutes walking distance of Ansdell railway station. Service users accommodation is provided in nineteen single rooms and four double rooms, nine of which have en-suite facilities. Communal areas are provided in two lounges, a dining room and a conservatory. There are attractive gardens to the front and side of the home which are accessible to service users, and there are car parking facilities at the rear of the home. Rossendale Nursing Home DS0000006077.V345162.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The site visit was unannounced and focused on key standards. The inspector was able to speak to service users and staff and examine various records. Surveys were provided to service users, relatives/friends and health professionals prior to the inspection. One survey was returned from a Social Worker, two from relatives and three from service users who were assisted in the process; the results were taken into account as part of the inspection. A tour of the premises took place. A second inspector also spent a period time observing the care being given to a small group of people living at the home. The time spent observing residents daily life and care staff practices found staff to be kind and most interacted in a very positive way with the service users. Currently the fees at Rossendale Nursing Home range from £496.00 to £625.00 per week. What the service does well:
The majority of service users have dementia in one form or another and have high needs. The Rossendale has a group of staff that work well together and are keen to provide a high quality service. The home is not purpose built but every effort is made to allow service users as much freedom as possible without compromising their safety. A tour of the premises took place and the home was found to be clean and tidy. The atmosphere in the home is welcoming, relaxed and friendly. Visitors confirmed that they are always made to feel welcome. Close liaison takes place with other health professionals over the care of the service users and the records kept are up to date and comprehensive. Appropriate training courses have been provided in order to help the staff care for some highly dependant service users and new strategies are being put in place such as the sensory therapy room and hand massage. Activities and outings take place on a daily basis and two of the more dependant service users have recently enjoyed a trip out to the Sea Life Centre in Blackpool. A service user made the following comments: “I like it here as they have more activities.” Rossendale Nursing Home DS0000006077.V345162.R01.S.doc Version 5.2 Page 6 “I like to sing and dance.” “I like to sit in the back yard and have a smoke with a pot of tea.” Relatives spoken with commented on the high standard of care: “They deserve a medal they are kind and caring.” “They try to make life bearable for those who do not want to be in a home.” All staff have either a nursing qualification or a National Vocational Qualification (NVQ) and training is seen as a high priority. The induction training is linked to the Skills for Care programme. What has improved since the last inspection?
An area of the home is now a ‘sensory therapy’ space with cushions on the floor coloured lights and calming music. Staff have carried out hand massage and this has also been welcomed by the majority of service users who find it soothing. Any wishes with regard terminal illness and death are recorded and anticipatory medicine is in place for end of life care that has brought tremendous relief to both service users and family. All service users now have ‘life story books’ which in their own words detail their background and family including photographs. This has been very much appreciated by the family of service users and has been a valuable tool in calming service users as well as stimulating them. Access to the dining room has been improved with a new wide entrance to assist with wheelchairs. New carpet and blinds have been purchased for the two lounges and new chairs some of which recline. The hall has been painted and two gates purchased at the bottom of each staircase. The treatment room is now a walk in shower room. The dining room has been decorated and the kitchen has a new hot cupboard and dishwasher. Five of the bedrooms have new furniture, wardrobes, chest of drawers and vanity unit. There is a hoist on each floor and a new hoist and stand aid are to be purchased. There have been plans for sometime to have a new lift and this is due to be completed in 2008. There are also plans to extend the lounge space by building conservatories to the side of the existing lounges. The plans are currently on hold until planning permission is obtained.
Rossendale Nursing Home DS0000006077.V345162.R01.S.doc Version 5.2 Page 7 All toiletries are now put away to ensure service users do not accidentally ingest the contents. Additional staff have been employed to help care for the large number of very dependant service users including a new member of staff who is a registered mental health nurse. There are 26 staff and 14 have an NVQ qualification and 4 more are working towards gaining an NVQ. 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. Rossendale Nursing Home DS0000006077.V345162.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Rossendale Nursing Home DS0000006077.V345162.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome group was good. Information about the services provided by the home is available. An initial assessment is conducted that ensures an appropriate service is provided. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There was evidence of an initial assessment that covers all areas to ensure that the services provided are appropriate. The assessments seen showed that close liaison with other health professionals had been undertaken prior to admittance. Service users and relatives are involved in the assessment process as much as possible. The background and personal history of the service users are obtained (where possible) and taken into account. The assessment examines any areas of risk as well as potential risk with the provision of care. The home does not provide intermediate care. Rossendale Nursing Home DS0000006077.V345162.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): 7, 8, 9 10 &11 The quality in this outcome group was good. The physical and health needs of each service user are met appropriately and staff treat service users with respect and understand the importance of privacy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Individual care records are kept for each resident with a plan of care setting out in detail the action that needs to be taken by care staff to ensure all aspects of health, personal and social care needs of the residents are met. Significant events had been recorded on appropriate documentation and daily entries made setting out the care given. The documentation seen was user friendly and each care plan is reviewed on an almost daily basis because the majority of service users have high needs and any plan may have to be adapted constantly. Recordings had been kept where there was any contact with a General Practitioner (GP) or other Health professionals. Service users have their choice of own GP and the home has access to other healthcare practitioners including a community psychiatric nurse, audiologist, dietician, optician, chiropodist and physiotherapist. Liaison also takes place with a local pharmacist.
Rossendale Nursing Home DS0000006077.V345162.R01.S.doc Version 5.2 Page 11 A social worker made the comment that staff had sought advice and liaised effectively with health professionals over the care of the service users. The home has suitable storage facilities for medication and the records show that each service user has a separate sheet which details any time medication is provided or not and the reason; a photograph of the service user is attached. The registered manager confirmed that she carries out an audit of the medication record each month or more frequently. Observation of staff showed that service users are treated with respect and their privacy and dignity was maintained as much as possible. At induction staff are taught the importance of privacy and dignity. Each service user is treated as an individual and any knowledge of the service users background is used to ensure that their care and wishes are carried out as much as possible. Any wishes with regard terminal illness and death are recorded and anticipatory medicine is in place for end of life care that has brought tremendous relief to both service users and family. A relative commented: “They deserve a medal they are kind and caring.” “They try to make life bearable for those who do not want to be in a home.” “The service is run like a real home, free to use all the rooms and wander round the house as if at home; but at all times carefully supervised.” “When he has not been well I have been told at once.” The inspector observed that staff did not use footplates when moving service users in a wheel chair. There was a tendency for feet to drag on the ground and most of the service users, at that stage did not have slippers on. There is a risk of injury to the feet and when discussed with management it appears that the reasons why foot plates are not used is because the wheelchairs will not fit in the lift or beneath a table when the foot plates are in place. It was recommended that a risk assessment should be undertaken on the issues raised, to see if a better solution could be found in order to protect the service users from possible injury. Rossendale Nursing Home DS0000006077.V345162.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): 12, 13, 14 & 15 Quality in this outcome group was good. Leisure and recreational activities are provided. Contact with relatives/friends and the local community is encouraged. Meals are varied and nutritionally well balanced. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Consideration to the high percentage of residents with dementia is taken into account when activities are planned. Activities include, games, skittles dominoes; outings are undertaken when possible with trips to Fairhaven Lake to feed the ducks and trips to the illuminations. Relatives are able to visit the home and take service users out and one service user is regularly taken to the local public house. Two of the service users with a learning disability, had been to Sea Life in Blackpool the previous day and this had obviously benefited them both. The home is centrally located with shops, churches and the promenade very close by and there is good links with local transport making it easy for relatives and visitors to pop in to the home. Clergy from various local churches visit the home on a regular basis. Rossendale Nursing Home DS0000006077.V345162.R01.S.doc Version 5.2 Page 13 During observations in the quiet lounge, the majority of service users were very sleepy and there was very little interaction with each other or staff. Staff interaction was generally good, particularly when staff told service users what they were about to do when moving and handling which helped to reassure and calm any fears. Since the last inspection, there have been several changes to enhance the well being of the service users. An area of the home is now a ‘sensory therapy’ space with cushions on the floor coloured lights and calming music. This space has been beneficial and one service user with a learning disability has been noticeably more at peace and reclines on the cushions whenever possible. Staff have carried out hand massage and this has also been welcomed by the majority of service users who find it soothing. All service users now have ‘life story books’ which in their own words detail their background and family including photographs. This has been very much appreciated by the family of service users and has been a valuable tool in calming service users as well as stimulating them. The books help the staff to understand the service users better particularly where it is difficult to communicate verbally. A relative made the comment: “Each one has a life story book with photos of family and friends, these help to boost them.” Individual choice is recognised with service users able to choose when they wish to go to bed or get up and they are able to wander freely around the home while at the same time strategies are in place to ensure their safety. One of the service users prefers to eat his meals separately and this is enabled whilst at the same time careful oversight is provided. Access to the dining room has been improved with a new wide entrance to assist with wheelchairs. Meals are taken at tables attractively laid out in a separate dining room. There is an emphasis on nourishing meals with fresh vegetables. Many of the service users require ‘soft’ food and where meals are liquidised they are made to be as attractive as possible. There are now three cooks who provide meals on a rota basis. There are a number of service users who have to be fed and this was seen to be done as discreetly as possible either in their own rooms or the lounges. Service users made the following comments: “I like it here as they have more activities.” “I like to sing and dance.” “I like to sit in the back yard and have a smoke with a pot of tea.” Rossendale Nursing Home DS0000006077.V345162.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): 16 & 18 Quality in this outcome group was good. A suitable complaints procedure is in operation and policies and procedures are in place that ensures service users are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a suitable complaints procedure in place and relatives confirmed that they are aware of the procedures. Where a complaint has been received there has been a thorough investigation and the details are recorded. Two concerns have been raised and sent to the Commission for Social Care Inspection; on both occasions an investigation has taken place and any discrepancies have been noted an acted upon. One of the concerns investigated thoroughly by the management of the home was not substantiated. The home has a procedure in place for dealing with allegations of abuse. The manager and staff spoken with had a good understanding of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect. There is training provided that addresses issues of physical and or verbal aggression and inappropriate behaviour displayed by service users. A whistle blowing policy is in place and staff are made aware of this via training. Rossendale Nursing Home DS0000006077.V345162.R01.S.doc Version 5.2 Page 15 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): 19 & 26 Quality in this outcome group was good. The home is clean and safe and a maintenance programme is in operation. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is not purpose built and has a very homely atmosphere with many of the rooms large, spacious and full of character. Some of the rooms have good views overlooking Grannies Bay. A tour of the home took place and all parts of the home were clean, tidy and hygienic. New carpet and blinds have been purchased for the two lounges and new chairs some of which recline. The hall has been painted and two gates purchased at the bottom of each staircase. The treatment room is now a walk in shower room. As previously mentioned there is new access to the dining room, which has opened up the space and made it easier for both service users and staff. The dining room has been decorated and the kitchen has a new hot cupboard and dishwasher.
Rossendale Nursing Home DS0000006077.V345162.R01.S.doc Version 5.2 Page 16 One of the conservatories has become a sensory space and additional features are gradually being purchased to enhance this facility. Five of the bedrooms have new furniture, wardrobes, chest of drawers and vanity unit. There is a hoist on each floor and a new hoist and stand aid are to be purchased. There have been plans for sometime to have a new lift and this is due to be completed in 2008. There are also plans to extend the lounge space by building conservatories to the side of the existing lounges. The plans are currently on hold until planning permission is obtained. It was observed that there were no small tables to place drinks on in the lounges and that this could be a hazard as some of the service users were trying to put their drinks down in an inappropriate place. The management of the home stated that they have provided tables in the past and it has not been successful and usually a member of staff stays within the lounges when they are having drinks. A recommendation was made that this should be reviewed. All toiletries are now put away to ensure service users do not accidentally ingest the contents. Relatives made the following comments: “I always find it fresh and clean.” “The patients are all suffering from considerable dementia and are incontinent but are always very clean and sweet smelling.” Rossendale Nursing Home DS0000006077.V345162.R01.S.doc Version 5.2 Page 17 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): 27, 28, 29 & 30 Quality in this outcome group was good. Service users are looked after suitably recruited and trained staff in order to protect and care for the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been some recent issues with regard to the number of staff on duty; the majority of service users have high dependency needs and this has to be taken into account when planning the staffing rota. Currently there are 22 service users and there were adequate numbers of staff on duty at the time of the site visit. According to the manager staffing levels have increased and because the number of service users has decreased recently, this has improved the situation. If there was an increase of highly dependant service user the staffing levels may have to be reviewed. The manager confirmed that the situation should be further improved by the commencement of a new member of staff who is a registered mental health nurse. This will assist the manager in caring for service users with a learning disability or mental health issue/dementia. The home does not use agency staff. A Social worker commented that she had observed a lack of staff on occasions and that there was a need to train staff on the correct approach to be taken
Rossendale Nursing Home DS0000006077.V345162.R01.S.doc Version 5.2 Page 18 particularly with regard to personal care. This had been brought to the attention of management at the time. All staff have either a nursing qualification or a National Vocational Qualification (NVQ) and training is seen as a high priority. The induction training is linked to the Skills for Care programme. The registered manager is an NVQ Assessor and this has supported the high numbers of staff achieving an NVQ qualification. There are 26 staff and 14 have an NVQ qualification and 4 more are working towards gaining an NVQ. All staff have to study the home’s individual policies and procedures and they are checked on their knowledge and sign a document confirming that they have been provided with the information and understand its content. Specialised training on the subject of Dementia has been provided to all staff. There are plans being made for all staff to attend the Learning Disability Award Framework training. Staff spoken with confirmed that they are encouraged and supported to attend training. The recruitment of new staff has been improved and strengthened. References are now written and appropriate and do not say ‘To whom it may concern’. Checks have been undertaken with the Criminal Records Bureau (CRB) and the Protection of Vulnerable Adults (POVA) Register. As recommended previously a record has been kept of each stage of the application with a date. There still appears to be a gap between the application for a POVA First check and the date received back. According to the registered provider the checks are undertaken by an outside agency; no staff commence until they have been checked on the POVA register and are supervised until the CRB check has been returned and is acceptable. Rossendale Nursing Home DS0000006077.V345162.R01.S.doc Version 5.2 Page 19 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): 31, 33, 35 & 38 Quality in this outcome group was good. The health, safety and financial interests of the service users are protected and both service users and staff benefit from the leadership skills of the current management of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Both the registered manager and the registered provider are appropriately qualified having completed the Registered Managers’ Award. The staff and service users spoken with said that the management team were helpful and approachable. Routines within the home are devised with the wishes and needs of the service users in mind. None of the residents in the home completely manage their finances. All fees and expenses are paid either by relatives or via a solicitor. Rossendale Nursing Home DS0000006077.V345162.R01.S.doc Version 5.2 Page 20 The manager is looking at ways for service users and relatives to make their views known about how the home is run. Staff confirmed that staff meetings take place once a month as well as one to one individual supervision; records are kept of all meetings. The Deputy Matron is registered with the Commission for Social Care Inspection as manager and the registered provider/owner is concentrating on looking at quality issues and carrying out audits on the existing systems and devised a Business Plan. Risk assessments are carried out in all areas including the environment and all aspects of care. Policies and procedures are in place with regard to health and safety and regular maintenance of equipment takes place. Regular fire drills take place and fire equipment is regularly serviced. Fire training is covered within induction. All accidents and incidents are recorded appropriately. Rossendale Nursing Home DS0000006077.V345162.R01.S.doc Version 5.2 Page 21 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Rossendale Nursing Home DS0000006077.V345162.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 Refer to Standard OP20 OP22 Good Practice Recommendations Consideration should be given for some small tables for service users to place drinks on in order to avoid any accidents. A risk assessment should be carried on the practice of not providing footrests on wheelchairs to ensure that there is no risk of injury. Rossendale Nursing Home DS0000006077.V345162.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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
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