Inspection on 09/11/05 for Rugby Care Centre

This inspection was carried out on 9th November 2005.

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

Rugby Care Centre 17/04/07

Rugby Care Centre 26/04/06

Rugby Care Centre 06/09/04

Rugby Care Centre 27/04/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Rugby Care Centre 53 Clifton Road Rugby Warwickshire CV21 3QE Lead Inspector Sue Houldey Unannounced Inspection 9th November 2005 09:30 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 Rugby Care Centre DS0000004292.V263412.R01.S.doc Version 5.0 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. Rugby Care Centre DS0000004292.V263412.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Rugby Care Centre Address 53 Clifton Road Rugby Warwickshire CV21 3QE 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) 01788 542353 01788 567941 Exceler Healthcare Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places Rugby Care Centre DS0000004292.V263412.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th June 2005 Brief Description of the Service: Rugby Care Centre is an established care home providing personal care for up to 29 residents. The home is a detached dwelling near to the town centre of Rugby. The main shopping centre is only a few minutes walk from the home. Appropriately trained staff provide the care. Rugby Care Centre admits service users for respite and long term care. The care staff are supported by the benefits of a large well-established organisation. An activities co-ordinator is employed at Rugby Care Centre to provide activities to service users. Accommodation is mainly single room over two floors. Some shared accommodation is available. There are two main lounges and two dining rooms. Service users are provided with three meals a day taken in either of the dining rooms or if they choose in their own room. District nurses visit the home to provide nursing care for service users in need of wound care or other nursing needs. Rugby Care Centre DS0000004292.V263412.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector arrived at the home at 9.40am and left at 5pm. A tour of the home was undertaken, and the inspector spent periods of time, including a mealtime meeting and talking with residents, and observing staff undertaking their duties. A number of records were examined which included care records, daily records, staff files and maintenance logs. The inspector was assisted throughout by the homes manager and talked informally with a senior carer on duty. What the service does well: What has improved since the last inspection? The home has a comprehensive pack which contains a statement of purpose and service user guide. This gives detailed information for prospective service users on what the home has to offer. Security of the garden has been improved, this has ensured the safety of those residents who are prone to wandering. An activities programme is in place, and residents can choose whether or not to take part in a range of activities within the home. Rugby Care Centre DS0000004292.V263412.R01.S.doc Version 5.0 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. Rugby Care Centre DS0000004292.V263412.R01.S.doc Version 5.0 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 Rugby Care Centre DS0000004292.V263412.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 Residents are provided with adequate information on which to base their decision about the suitability of the home in meeting their needs. A comprehensive assessment prior to admission ensures the home only admits those residents whose needs can be met. The lack of staff training in dementia care and cognitive dysfunction may put residents at risk of not receiving the level of care or supervision that they require. EVIDENCE: The home has a comprehensive statement of purpose and service user guide which is available within individual bedrooms. This enables the service user and their families to make an informed choice about the suitability of the home. Rugby Care Centre DS0000004292.V263412.R01.S.doc Version 5.0 Page 9 The inspector examined a file of a newly admitted residents. This showed that a comprehensive assessment had been made prior to admission and that this had been subject to periodic review to ensure that the home was able to continue to meet their individual needs. One resident told the inspector about her first visit to the home, and the information she had been given, which assisted her to reach a decision about the suitability of the home. From this she had made a decision to stay and felt this was the right decision. She said that the home had met her expectations based on the information she had been given and continues to be very happy with the care offered. Rugby Care Centre DS0000004292.V263412.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Staff respect the privacy and dignity of service users. The lack of clear documentation in daily records, and lack of risk assessment, and completion of turning charts place residents at risk of their care needs not being fully met or change in their care needs being identified. Current medication practices place residents at risk of not receiving the medication they require and their condition deteriorating. EVIDENCE: The inspector observed medication being dispensed to residents this was done discreetly and staff observed residents taking medication. On a tour of the building it was noted that two residents still had medication in pots, which they had not taken. The inspector discussed this with the manager who indicated that staff went back to check later if these residents had taken their medication. At lunchtime the inspector found a tablet under the dining table, this indicates that residents are at risk of not taking their tablets unless observed by staff, and therefore may not be receiving the treatment prescribed. Rugby Care Centre DS0000004292.V263412.R01.S.doc Version 5.0 Page 11 Records in the home indicate that health issue are monitored and that should it be required advise of a GP is sought. Any visits to GP or consultant are documented to ensure that staff are aware of any changes to needs or residents well being. The inspector observed staff attending to a small cut which one resident had sustained to her leg. Prompt attention to such matters ensures that residents are at less risk of skin deteriorating and needing further medical intervention. A turning chart for a resident needing to be turned at night, to prevent pressure sores had not been completed. Lack of attention to such care could lead residents to be at risk of the development of pressure sores The home has responded to requirements of the last inspection to ensure that care plans are reviewed, thus ensuring that all staff respond to service users changing needs. Daily records maintained in the home lack detail, this could lead to changes in care needs of residents not being fully documented or acted upon. Night time records had not been maintained since mid October. Discussion with a senior member of staff indicated that this had been raised with night staff. The inspector was told that residents are checked at night, but the frequency of these checks is not based on the assessed risk and does not take account of residents expressed wishes. For instance the inspector was told that staff frequently check one resident in case she falls out of bed. When asked staff could not say how long ago this residents last fell out of bed, but it was not within the last 2-3 months. One resident is checked at night despite her express wish that she not be checked. Clear risk assessment of residents night time needs and documented checks will ensure residents receive the care they require and the home responds to their express wishes in this respect. Residents told the inspector that staff respect their privacy when they are in their own rooms. Personal care is offered in such a way that they feel their dignity is maintained as far a possible. All of the residents spoken to said that their clothing was well care for, and that staff assist with hair care. The inspector observed that residents were well presented which promotes their personal dignity. Rugby Care Centre DS0000004292.V263412.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15 Residents receive a nutritious and wholesome diet, with staff assisting in a discreet manner to special needs. This assists residents to maintain a healthy lifestyle, and will contribute to overall wellbeing. Residents have a range of activities available which help them to stay stimulated. Residents are also assisted to maintain links with family and friends contributing to their quality of life and mental well being EVIDENCE: The inspector saw an activities board which detailed activities available on a daily basis. On the day of the inspection the activities organiser was of sick, residents told the inspector that a volunteer helps with activities, which they can choose to take part in if they wish. The inspector saw minutes of residents meetings, and joint resident/relatives meeting where residents were able to contribute their views on the running of the home. Residents spoken to felt that staff are very receptive to any request made. Rugby Care Centre DS0000004292.V263412.R01.S.doc Version 5.0 Page 13 Residents told the inspector that they are able to receive visitors when they wish, which enables them to maintain contact with those people who are important in their lives. Residents were unanimous in their praise of the food offered in the home. They especially liked the introduction of a choice on the menu. The inspector joined residents for lunch, which was a choice of roast beef or roast pork, carrots, peas, Brussel sprouts and roast and mashed potatoes. Stuffing and applesauce was available for those who like this. The pudding was profiteroles and chocolate sauce. Residents were seen to eat well and those who required prompting, assistance or specific preparation were attended to discreetly by staff. The practices observed ensure that residents receive a nutritious supply of wholesome food. The inspector enquired why the menu on display did not reflect the actual meal to be served, and was informed that this was due to a last minute change to the menu. None of the residents spoken to minded this, as they indicated that the food was always so good. Residents were observed to be offered a range of drinks and snacks throughout the day, in the afternoon the biscuits on offer were all broken which was not at all appealing, and detracted from the overall good impression of food on offer. Rugby Care Centre DS0000004292.V263412.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 The lack of staff training in issues of protection could place residents at risk of abuse whether deliberate or through negligence or ignorance. EVIDENCE: Five staff files were examined; only one of these indicated that the member of staff had received training in the area of protection of vulnerable adults. Lack of effective training and staff understanding in this area could place service users at risk of abuse, or may mean that staff do not fully understand how to respond to allegations made. Rugby Care Centre DS0000004292.V263412.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 24, 25, 26 The environment in the home requires improvement to ensure that residents benefit from a homely atmosphere which is maintained to a level which ensures their safety and contributes to a good quality of life. EVIDENCE: A tour of the building highlighted a number of concerns about the environment and maintenance. These included holes in bathroom and toilet floors and taps which had been disconnected in a bathroom as the water temperature is too high and residents may be scalded as no thermostatic valve has been fitted.. One bathroom had a bolt fitted, which could not be opened from the outside in an emergency, should a resident have a fall. There was an odour evident in many areas of the home, the manager indicated that replacement carpets had been requested but funding had not been made available. Some of the bedrooms require re-decoration, the home tends to do Rugby Care Centre DS0000004292.V263412.R01.S.doc Version 5.0 Page 16 this when rooms become vacant, but this and the lack of appropriate furniture has the potential to reduce the quality of life of residents. The landing carpet is rucked, and could present a trip hazard to residents. Some fire doors were wedged open, this may cause serious harm to residents and staff in the event of fire. This was raised at previous inspections and the home has failed to fit appropriate door closing devises as required. The nurse call system is very old and has broken down on a number of occasions recently. The manager told the inspector that a quote for replacement had been received and sent to head office for approval. No date has been given for its replacement, and this could place residents at risk of not being able to summon assistance from staff when required. A shower cubicle and shower chair were seen which had not been cleaned. The shower chair had what appeared to be faeces on it. Light cords in bathrooms were seen to be dirty. Lack of attention to hygiene matters can place residents at risk of infection and detracts from an overall good quality of life. Residents bedrooms were seen to be personalised, and all of the residents spoken to said they liked their bedrooms, and can have a key to maintain privacy if they wish. Some bedrooms had broken lampshades, and some do not have the required furniture, in particular a piece of locking furniture to store valuables. Residents told the inspector that one of the lounges had recently been repainted and they liked the new colours, but the carpet was seen to be heavily stained, in some areas having significant amounts of paint on it. On the day of the inspection the dining room was being redecorated. Which will improve the quality of the environment for residents. Steps have been taken to improve the security of the rear garden, which means that residents can be fee to wander the grounds without fear that they could place themselves at risk by exiting the home into the street. Rugby Care Centre DS0000004292.V263412.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29,& 30 Resident’s needs are met by the numbers of staff on duty in the home. The lack of mandatory training could place residents at risk of not receiving the care or support they require to remain safe and healthy. Staff recruitment procedures and records ensure that staff working in the home are of good character, and do not place residents at risk of abuse. EVIDENCE: The inspector saw copies of rotas, which indicated that the home employs care staff, domestic and housekeeping staff as well as a cook. Staffing levels appear from observations on the day and reports from residents to be adequate and ensure that resident’s needs are met promptly. The recruitment records of five staff were examined. This demonstrated that the home has taken all appropriate steps to ensure they recruit staff who are of good character which ensures the protection of residents from potential abuse. Staff training records for five staff were examined. The home has failed to ensure staff receive the required training. Shortfalls identified included fire, basic food hygiene and dementia. Failure to provide staff with adequate and suitable training could mean that staff are not fully competent to carry out their roles and that residents do not receive the appropriate level of care, which could place them at risk. Rugby Care Centre DS0000004292.V263412.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 34, 36, 38 The direct management of the home is proactive in trying to ensure residents are protected and enjoy a good quality of life. Lack of action by the provider to attend to matters relating to health and safety and ongoing maintenance places residents at risk and detracts from the quality of life. Development of staff supervision and review of essential risk assessments and risk management strategies will ensure that residents are not placed at risk through ignorance or negligence. EVIDENCE: The manager of the home has recently handed in her notice. She indicated to the inspector that this was due to the owner’s lack of action on issues, which she raises and impact upon the quality of life and safety of residents.. In particular the lack of financing to ensure that essential works are carried out Rugby Care Centre DS0000004292.V263412.R01.S.doc Version 5.0 Page 19 has been frustrating and led the manager to believe that she cannot effectively discharge all of her duties. The inspector considers that the manager has done everything possible to discharge her responsibilities as manager, but appears to have lacked the support and essential financial input from the provider. The inspector sampled 5 staff files, these contained supervision records. One supervision session had been a group one, at which issues, which were common to a group of staff were discussed. The content of this discussion reflects the issues which the inspector noted as requiring attention, such as recording. Increased frequency of supervision would ensure that staff practice matters are addressed promptly, and that residents receive a better quality of service, and better protection through development of the quality of recording The home has on display a certificate of employers liability insurance, which indicates that residents have adequate protection in the event of something untoward occurring. The inspector examined a range of records, which relate to health and safety matters these included: Fire, electrical safety, water, temperature, building matters and wheelchair checks. All of the records examined indicated that resident’s safety was addressed by thorough periodic checks being undertaken, but that the owners had failed to act on ongoing issues of concerns such as thermostatic vales and call bell system.. The inspector discussed risk assessment and management with the manager. In particular these discussions related to night time practice within the home. The manager agreed to undertake a baseline assessment of needs at night, which will be used to inform staff, practices which will ensure that residents are protected, and privacy and residents wishes respected. Rugby Care Centre DS0000004292.V263412.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 2 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 2 X 2 X X 2 2 2 STAFFING Standard No Score 27 3 28 3 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X 2 X 2 X 2 Rugby Care Centre DS0000004292.V263412.R01.S.doc Version 5.0 Page 21 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 OP4 Regulation 12(1) & 14(1) Requirement The manager must ensure that staff are fully aware of the needs of residents who have dementia or cognitive dysfunction (Outstanding requirement from last inspection – timescale of 31.08.05 not met.) Daily records require development to ensure that they are sufficiently detailed The needs of service users at night must be determined through risk assessment. Evidence that checks have been carried out at the required frequency must be documented. Service users views must be accounted for in any determination of these checks The home must ensure that staff complete turning charts which are in place for those service users at risk of developing pressure areas The home must ensure that staff take all appropriate steps to ensure that residents take prescribed medication, or DS0000004292.V263412.R01.S.doc Timescale for action 09/01/06 2 3 OP7 OP7OP38 17(1) Schedule 3 13(4) & 15 09/12/05 09/12/05 4 OP8 17(10 schedule 3 13(2) 15/11/05 5 OP9 15/11/05 Rugby Care Centre Version 5.0 Page 22 6 OP19 23(2) 7 8 9 10 OP19 OP19 OP21 OP21 16(2) 23(2) & 16(2) 23(2) 23(2) & 13(4) 11 OP24 16(2) & 23(2) 12 13 14 OP24 OP24 OP25 16(2) 16(2) 13(4) 15 OP25 23(20 n 16 OP26 23(2) document their refusal of such The flooring in the bathroom containing the parker bath and toilet 5 have holes in and must be replaced The landing carpet must be replaced, or refitted to ensure trip hazards are removed The lounge carpet must be cleaned to remove paint and other marks or replaced The wash hand basin in the bathroom with the parker bath must be functioning Suitable locks must be fitted to all bathroom, which enable access in the case of emergency. Bolts which do not allow access must be removed The registered provider and manager must ensure that all of the residents bedrooms are to an acceptable standard and carpets are changed where required. (Requirement made at last Inspection) All bedrooms must be fitted with a suitable lock Broken lamps in bedrooms must be replaced The registered provider must ensure that all thermostatic mixing valves are replaced where they do not work. It is not acceptable for wash hand basins in bathrooms not to be working because valves are not fitted (Outstanding requirement from last inspection) The registered provider must ensure that the call bell system is updated. (requirement made at last inspection) Shower cubicles, shower chairs and light cords in bathrooms and DS0000004292.V263412.R01.S.doc 09/01/06 09/01/06 09/01/06 09/12/05 09/12/05 09/01/06 09/12/05 09/12/05 09/12/05 09/01/06 15/11/05 Rugby Care Centre Version 5.0 Page 23 17 18 19 20 OP26 OP26 OP26 OP26 23(2) & 16(2) 16(2) & 23(2) 16(2) & 23(2) 16(2) 21 OP30 18(1) & 23 (4) 22 OP36 18(2) 23 OP38 23(4) & 13(4) toilets must be clean. Action must be taken to find the cause and remedy the odour of damp in toilet 5 Bed bases, which are stained, must be replaced. Bedding, such as pillows, which have become misshaped due to laundering must be replaced The registered provider and manager must ensure that the home is free from offensive odour (Requirement made at last inspection- Timescale 31.08.05 not met) Staff must receive training appropriate to their role. This must include: (a) Basic food hygiene (b) Protection of vulnerable adults (c) Fire The registered manager must ensure staff receive regular documented supervision at least 6 times per year Fire doors must not be propped open. Where it is deemed that doors should be able to stay open, suitable closers which are linked to or triggered by the fire alarm system must be fitted 09/12/05 09/12/05 15/11/05 09/12/05 09/01/06 09/12/05 15/11/05 Rugby Care Centre DS0000004292.V263412.R01.S.doc Version 5.0 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP15 Good Practice Recommendations Attention should be paid to ensuring the menus which are displayed accurately reflect the choices available. Attention should also be paid to the quality of snacks on offer to residents Rugby Care Centre DS0000004292.V263412.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rugby Care Centre DS0000004292.V263412.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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