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Inspection on 10/04/07 for Rydal House Nursing Home

Also see our care home review for Rydal House Nursing Home for more information

This inspection was carried out on 10th April 2007.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The inspector received positive comments and commendations from the service users regarding the standard of care and service provision. Staff worked hard to deliver good standards of assistance and care to residents who expressed satisfaction with the majority of their care and service provision. All staff now receive training in Fire, Moving & Handling and Adult Protection.

What has improved since the last inspection?

The requirements made at the last Key Inspection had now all been actioned. There had been full compliance within the areas of recording assessments prior to admission ensuring that the home was able to meet the service users needs. The fire exits remain free from obstruction. Accurate accounting systems and records regarding service users money were now in place.

What the care home could do better:

The main area of concern was the staffing of the home. Sufficient care staff must be on duty each shift to ensure that all the needs of the service users are met. Sufficient staff must be on duty to ensure the home is maintained in a clean and hygienic state, free from dirt and unpleasant odours. Sufficient staff are to be employed to cover kitchen duties to ensure care staff are able to meet the needs of the service users. Sufficient staff must be employed in order for the manager to perform her managerial role. She must have sufficient time to supervise staff and review care plans. There is a limited amount of activities and these needs to be increased to meet the needs of the service users.

CARE HOMES FOR OLDER PEOPLE Rydal House Nursing Home 21 Somersall Lane Chesterfield Derbyshire S40 3LA Lead Inspector Judith Beckett Key Unannounced Inspection 10th April 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 Rydal House Nursing Home DS0000002073.V336011.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. Rydal House Nursing Home DS0000002073.V336011.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rydal House Nursing Home Address 21 Somersall Lane Chesterfield Derbyshire S40 3LA 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) 01246 569511 Mr D Chand Dr. Anjuman Diwan Chand Mrs Maureen Brown Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Rydal House Nursing Home DS0000002073.V336011.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th April 2006 Brief Description of the Service: Rydal House is situated on the western side of Chesterfield within a pleasant residential area, close to local amenities and within easy access of a main bus route. The home is a converted building, with an extension, set in its own grounds. It has separate lounges and dining rooms, on the ground floor. A conservatory has been added. The home has provision for nursing and personal care, and is registered to provide care for a maximum of 31 residents. Fees range from £308.50-480.15. Rydal House Nursing Home DS0000002073.V336011.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A visit had taken place on 6/09/06 where it was confirmed that all the requirements made at the last inspection were complied with. This unannounced inspection took place on 10th April 2007. It is the first key inspection since April 06 so all of the key standards were examined on this visit. This visit lasted for approximately five and a half hours. Discussions were held with the registered manager, 5 members of staff and 4 residents. No pre inspection questionnaire was completed as the manager had only received this the previous week. 4 completed CSCI resident surveys were available. An unannounced inspection had taken place on 9/03/07 to assess allegations made in three anonymous complaints made about the home to CSCI on 19/02/07 & 26/02/07.Five areas of concern had been raised. Following the visit two were not upheld, two partially upheld and one upheld. The partially and upheld items were relooked at and reference to these will be detailed later in the report. Inspection methods used included the examination of care records, the case tracking of 4 residents to ascertain how the service works in practice for them and direct observation of care practices. 22 residents were accommodated at the home, 8 were assessed as requiring nursing care. Staffing rotas were looked at to assess if the level of staff on each shift could meet the needs of the resident group. This was a serious area of concern and an immediate requirement notice was left indicating that action must be taken to supply sufficient care staff to ensure that all the needs of the service users were met. Records were examined to determine if the service demonstrated through their staff recruitment and training practices that the welfare and safety of residents was promoted and protected. Five members of staff were also spoken with to seek their views on the support and training provided to them. A partial tour of the home was undertaken to assess the décor, maintenance and standards of hygiene. Environmental Health had inspected on 11/12/06 their findings being satisfactory. What the service does well: Rydal House Nursing Home DS0000002073.V336011.R01.S.doc Version 5.2 Page 6 The inspector received positive comments and commendations from the service users regarding the standard of care and service provision. Staff worked hard to deliver good standards of assistance and care to residents who expressed satisfaction with the majority of their care and service provision. All staff now receive training in Fire, Moving & Handling and Adult Protection. What has improved since the last inspection? What they could do better: The main area of concern was the staffing of the home. Sufficient care staff must be on duty each shift to ensure that all the needs of the service users are met. Sufficient staff must be on duty to ensure the home is maintained in a clean and hygienic state, free from dirt and unpleasant odours. Sufficient staff are to be employed to cover kitchen duties to ensure care staff are able to meet the needs of the service users. Sufficient staff must be employed in order for the manager to perform her managerial role. She must have sufficient time to supervise staff and review care plans. There is a limited amount of activities and these needs to be increased to meet the needs of the service users. Rydal House Nursing Home DS0000002073.V336011.R01.S.doc Version 5.2 Page 7 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. Rydal House Nursing Home DS0000002073.V336011.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 Rydal House Nursing Home DS0000002073.V336011.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 & 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have the information they need to decide if this is the right place for them to live. Residents can be assured that they have their needs fully assessed before they move into the home and this includes the care to be provided. EVIDENCE: Discussions with residents, representatives and completed CSCI resident surveys indicate that enough information is received about the home before people move in, so that they can decide if it is the right place for them. 4 completed resident surveys were received, all of which said that the resident had received a contract. A Needs Assessment was in place in the 2 files examined for case tracking purposes; this covered all aspects of the persons’ health and social care needs Rydal House Nursing Home DS0000002073.V336011.R01.S.doc Version 5.2 Page 10 including a summary of their medication and any known allergies. This had been carried out prior to admission by the manager. A period of 4 weeks trial is offered to all residents. The manager advised the inspector that the home did not admit service users requiring intermediate care. Rydal House Nursing Home DS0000002073.V336011.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service It is possible that service users needs may not be met, as some care plans had not been reviewed. EVIDENCE: A sample of four service users care files were examined to assess how standards were being met. Residents gave examples about how they were consulted about their care, but were not familiar with their written plans, which were not signed as agreed with them. A range of standardised risk assessments were in place for tissue viability, nutrition and moving and handling. These were completed and only one was reviewed monthly. The remainder were last reviewed in December2006 as the manager maintained these service users conditions remained stable .She stated her limited amount of managerial time meant certain areas of the paper work were not completed Rydal House Nursing Home DS0000002073.V336011.R01.S.doc Version 5.2 Page 12 Daily entries into logs were made by staff detailing how service users had been each day. The storage and administration of medicines were not examined at his visit. A monitored dosage system is in use at the home and the supplying pharmacists visits three monthly to review practice and procedures in the home. Her reports were seen. The arrangements for the management and administration of medicines were examined, specifically for those residents case tracked and also generally. Records of receipts of medications were kept, as were records of returns. The policies and procedures in place were personalised and reflective of practice in the home. There was one service user prescribed controlled drugs. The recording of these was examined and found to be satisfactory. The healthcare of service users was met by local GP’s. Care records for service users had evidence of GP, chiropody and district nurse visits. From records there was one service user in the home with pressure sores, which the Registered Nurse on duty monitored and dressed. Residents spoken with felt that their privacy and dignity was promoted and that staff was respectful in their approaches to them. The same was observed during the inspection. Rydal House Nursing Home DS0000002073.V336011.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. A limited range of activities was offered to service users although some of these did not always appear to meet the needs of some service users. EVIDENCE: The manager informed the inspector that there was no specific person employed to undertake activities, within the home. The activities co-ordinator had left the previous summer. Care staff undertook the activities role where possible. There was a daily activity programme displayed on a notice board. The board also displayed information regarding entertainers who were to visit the home. The inspector did not observe any organised activity during the inspection. Televisions were switched on within both of the lounge areas. There was a wide range of needs abilities within the service users being cared for. The individual lifestyles of service users was respected and independence outside of the home was encouraged where this within the service users capacity. Rydal House Nursing Home DS0000002073.V336011.R01.S.doc Version 5.2 Page 14 Some of the service users, who had significant levels of confusion, were wandering the building. The inspector discussed with the service users the provision of activities. Several service users informed him that ‘they were not bothered with activities’. One service user informed the inspector that she was quite happy reading her books. The questionnaires indicated that ‘only sometimes’ were there any activities. The manager informed the inspector that entertainers did visit the home but it was difficult to stimulate many of the residents During the inspection the hairdresser was visiting. The inspector was able to establish that the service users had a choice of meal. One stated ‘she could have anything for breakfast and if she didn’t like dinner an alternative would be provided’. The manager informed the inspector that after breakfast, the cook asked each service user what was their choice for the main meal of the day. The cook remained on duty until 2.00p.m but after that the care staff had to provide tea. One resident stated that it was ‘sandwiches every day and salad on a Sunday’ One service user who was being case tracked informed the inspector that ‘There was a choice of meals and if you didn’t like it when it was presented, they would change it for you’. Another service user stated that ‘it was often cold when they received it’. They had informed the manager of this. It was observed during lunch that insufficient bibs were available for residents and some were given towels to protect their clothing. Rydal House Nursing Home DS0000002073.V336011.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service The lack of action taken following complaints has the potential to adversely affect the care given to service users. Policies and procedures are in place to protect residents from abuse. EVIDENCE: The complaints procedure was displayed, and contained the necessary information. All resident surveys and discussions with service users who were case tracked indicated that they knew how to complain and believed their concerns would be acted upon. The manager informed the inspector that she had received three complaints via CSCI.These had been investigated but because they were anonymous no response could be made. An unannounced inspection had taken place on 9/03/07 to assess allegations made in three anonymous complaints made about the home to CSCI on 19/02/07 & 26/02/07.Five areas of concern had been raised. Following the visit two were not upheld, two partially upheld and one upheld. The partially and upheld items were relooked at and these were all found to be upheld on this day. This indicates that the complaints were not acted upon to ensure service users needs are fully met. On discussing the training of staff regarding the Protection of Vulnerable Adults, the manager informed the inspector that she had now accessed such Rydal House Nursing Home DS0000002073.V336011.R01.S.doc Version 5.2 Page 16 training, and therefore all staff had attended training in Adult Protection provided by Derbyshire County Council. Rydal House Nursing Home DS0000002073.V336011.R01.S.doc Version 5.2 Page 17 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 area is adequate. This judgement has been made using available evidence including a visit to this service. The premises had not been maintained to the required standard to provide a clean, pleasant and hygienic home for services users. EVIDENCE: The home is a converted large house, which had been painted outside last year; this gave it a fresh appearance. The general layout of the rooms creates a homely appearance, which plays some part in creating a homely atmosphere. A partial tour of the building took place. The three lounges were looked at, as were four bedrooms and the laundry. Areas of the home were dirty and the carpets required cleaning, three of the bedrooms smelt of urine, as did areas in the hallway. The duty rota indicated that no cleaning hours were allocated to staff. The manager reported no permanent cleaner had been employed since before Christmas. Speaking to the care staff they inferred that these duties were left to them if time Rydal House Nursing Home DS0000002073.V336011.R01.S.doc Version 5.2 Page 18 permitted. This meant that service users could be put at risk due to the level of hygiene within the home. No disposable paper towels were in the staff toilet or in the kitchen although when requested these were produced. Insufficient time to see to these duties were indicated as the reason behind this oversight. It is essential that sufficient staff are employed to ensure the home is maintained in a clean and hygienic state and prevent the spread of infection. The laundry area had a new washer and dryer and was kept in satisfactory condition although the door was wedged open, which could present a fire hazard. A magnetic door release should be installed if this is to remain open. The kitchen door was also wedged open which also presents the same hazard. Rydal House Nursing Home DS0000002073.V336011.R01.S.doc Version 5.2 Page 19 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 area is poor. This judgement has been made using available evidence including a visit to this service. Staffing levels were insufficient and the organisation and management of staff recruitment was poor. EVIDENCE: Staff rotas available were examined from 09.04.07 for four weeks onwards and the previous four weeks. Observations were made in relation to the provision and deployment of staff, and the organisation and delivery of care. The same was discussed with staff and the residents who were case tracked. Staff felt that staffing levels were insufficient and gave clear examples of when and how this affected care and support for residents. There were three care staff on duty on the day of the inspection and throughout the day, with one Registered Nurse, this being the registered manager, for a total of 22 residents (one carer was to escort a service user for a hospital appointment later in the day). Only two carers were on duty on each shift for the following seven days. One carer was leaving at the end of the week but remained on the duty rota. This left six carers on the rota to cover all shifts. Verbal information given by the manager and staff about residents’ dependencies was consistent with written information in the care plans. 8 were assessed as requiring nursing care. One resident was nursed in bed, 8 required feeding, and 2 required hoisting and 2 were independent. Care staff were also responsible for carrying out kitchen duties after 2p.m.when the cook leaves and also any domestic duties. Residents felt that Rydal House Nursing Home DS0000002073.V336011.R01.S.doc Version 5.2 Page 20 staff worked very hard to provide them with the care and support they needed, but also felt that staffing levels were insufficient, again giving clear examples as to how this affected services provided. A laundry assistant worked each day from 7.30-11.30a.m. There was one cook working in the kitchen covering breakfast from 7.00p.m. and until 2 pm with no one working in the afternoon or evening. A handyman worked approx. 3 days per week. The qualified nurse numbers included the manager of the home, and the manager had no supernumerary management time. Staff morale was low and staff felt that they did not have any time to spend with residents to promote their interests and provide social stimulation. On examination of the staff training records, the evidence that was presented to the inspector indicated that all staff training was up to date. All staff had received Moving & Handling, Fire Safety and Adult Protection Training. Regarding NVQ training, the manager provided evidence that 5 staff had obtained their NVQ level 2, and 3 staff had obtained NVQ level 3. She went onto explain that 3 staff planned to start the NVQ level 2. Rydal House Nursing Home DS0000002073.V336011.R01.S.doc Version 5.2 Page 21 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, 36,38.Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. The home currently lacks leadership due to management arrangements being compromised, which may put service users at risk. EVIDENCE: On examination of the staff rota, the inspector established that the home was operating on minimal qualified nurse cover, with the manager and one member of staff being the permanent employees. The other qualified members of staff were employed in other establishments, i.e. other care homes or the NHS, and were providing ad hoc cover. The manager had no supernumerary days, on future rotas. The manager agreed with the inspector that she was providing ‘hands on’ care and did not have sufficient time or support to attend to Rydal House Nursing Home DS0000002073.V336011.R01.S.doc Version 5.2 Page 22 managerial issues. However she went on to explain that in her opinion the care delivered by her and her staff was of good quality. Regarding quality assurance, the manager was able to provide evidence that some monitoring did occur. The staff and visitor’s questionnaires dated January and April 07 respectively indicated positive comments. The arrangements for the management and handling of residents’ monies in the home on their behalf were discussed and were satisfactory. On raising the issue of staff supervision the manager informed the inspector that she had started the supervision, but not continued it as she had been busy providing ‘hands on’ care. Regulation 26 visits by the registered person did now occur and the inspector was able to examine the Regulation 26 documents, which the registered person had provided. Frequent staff meetings had been held last year and minutes recorded. No meetings had been held since January 07 and no minutes were recorded for that one. Evidence of regular servicing of the lift, nurse call system, fire alarm, hoists, PAT testing and electrical testing were seen. Rydal House Nursing Home DS0000002073.V336011.R01.S.doc Version 5.2 Page 23 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 1 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 3 2 X X X X X X 1 STAFFING Standard No Score 27 1 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 2 1 X 3 Rydal House Nursing Home DS0000002073.V336011.R01.S.doc Version 5.2 Page 24 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 OP12 Regulation 12 1 (a) Requirement The registered person must ensure that activities and therapy are available to meet the needs of the service user’s social, cultural, religious and recreational interests. There must be sufficient housekeeping staff on duty at the home to ensure that standards of hygiene and cleanliness are maintained. There must be sufficient housekeeping staff on duty at the home to ensure that standards of hygiene and cleanliness are maintained. There must be sufficient care staff on duty at the home at all times to meet the needs of residents and levels of staffing must be maintained at the previously agreed levels as a minimum. Sufficient staff are to be employed to cover kitchen duties to ensure care staff are able to DS0000002073.V336011.R01.S.doc Timescale for action 31/05/07 2 OP26 16(2)(j,k) ,18(1)(a) 31/05/07 3 OP27 16(2)(j, k), 18(1)(a) 31/05/07 4 OP27 18(1)(a) 31/05/07 5 OP27 16 2 (i) 18 1 (a) 31/05/07 Rydal House Nursing Home Version 5.2 Page 25 meet the needs of service users 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 OP7 Good Practice Recommendations Residents should be actively consulted about their written care plans, which should be drawn up with the involvement of the resident, be accessible to them and be agreed and signed by them as capable or their representative. There should be more variety, including a cooked option, included in the teatime menu. Sufficient bibs should be provided. The registered person must ensure that formal supervision occurs at least six times a year. Disposable towels are supplied to all hand washing areas. Regular staff meetings should be held and documented 2 OP15 3 4 5 OP18 OP26 OP33 Rydal House Nursing Home DS0000002073.V336011.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Rydal House Nursing Home DS0000002073.V336011.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. 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