Inspection on 12/10/05 for Saxon Lodge

This inspection was carried out on 12th October 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Saxon Lodge 05/07/06

Saxon Lodge 03/02/06

Saxon Lodge 08/10/04

Saxon Lodge 07/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Saxon Lodge 30 Western Avenue Bridge Canterbury Kent CT4 5LT Lead Inspector Nicki Dawson Announced Inspection 12th October 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 Saxon Lodge DS0000023590.V254900.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. Saxon Lodge DS0000023590.V254900.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Saxon Lodge Address 30 Western Avenue Bridge Canterbury Kent CT4 5LT 01227 831737 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) Saxon Lodge Residential Home Limited Miss Wendy Richards Care Home 18 Category(ies) of Learning disability over 65 years of age (1), Old registration, with number age, not falling within any other category (17) of places Saxon Lodge DS0000023590.V254900.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. LD (E) is restricted to one (1) person whose date of birth is 24.07.1932 8th October 2004 Date of last inspection Brief Description of the Service: Saxon Lodge is a residential care home, providing care for up to eighteen people over the age of 65 years. There is a variation to the condition of registration that allows for one person with a learning disability. The home is situated in a quiet road, in the rural village of Bridge. Amenities in the village include a small supermarket, post office, newsagent, chemist, two churches and a number of public houses. Canterbury, Dover and Folkestone are all within ½ an hour drive of the home. The home is managed by Wendy Richards, who is currently on sick leave. In her absence, the registered person, Mrs Betty Richards and the deputy manager are taking on this responsibility. Resident’s accommodation is provided over two floors with a lift for easy access. All bedrooms are single rooms and six of these are ensuite. A lounge, conservatory and dinning room are the communal rooms available to all residents. There is a bathroom, shower room and three additional toilets on the ground floor and two toilets on the first floor. There is a garden to the rear of the property, which is paved in part to enable residents to walk in the garden. There are plans to extend the home to provide accommodation for an additional five residents. Saxon Lodge DS0000023590.V254900.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection commenced at 9.30am and concluded at 6.30pm. About half of this time was spent talking to residents, staff and relatives visiting the home. The inspector interviewed three care staff and spoke with five residents and two relatives. The inspector shared lunch with the residents and observed the administration of medication. The inspector was given a tour of the home. The rest of the time was spent in the office talking with the registered person, deputy manager and administrator, and looking at records. The inspector received information about the service, from the registered manager, all of the fifteen residents, eight relatives and four care managers/health professionals, prior to the inspection. 80 of residents said that they felt well cared for and 93 that staff always treated them well. 100 of relatives and health/social care professionals said that there were satisfied with the overall care provided by Saxon Lodge. What the service does well: What has improved since the last inspection? What they could do better: The home must inform the Commission for Social Care Inspection when they wish to continue to care for a resident who is outside their registration. A rolling programme of staff training needs to be in place to ensure that all staff receive training in medication, fire, health and safety, infection control, moving and handling, and induction training that meets the National Minimum Standards. The maintenance of all appliances needs to be kept up to date to ensure the safety of residents and staff. Saxon Lodge DS0000023590.V254900.R01.S.doc Version 5.0 Page 6 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. Saxon Lodge DS0000023590.V254900.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 Saxon Lodge DS0000023590.V254900.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): 4 When residents develop additional needs, the home puts systems in place to meet these needs. However, the home needs to keep the Commission for Social Care Inspection informed if they wish to continue to care for a resident outside their category of registration. EVIDENCE: The registered person confirmed that three residents have been diagnosed with dementia since moving to the home. The home is not currently registered to accommodate any person with a diagnosis of dementia and a requirement is made in this report for the home to apply to the Commission for Social Care Inspection for a variation in their registration. Just over half of the care staff team have been trained in caring for people with dementia and a third of the staff team have received training in caring for people with challenging behaviours. Staff said that a number of residents in the home have periods when they are confused and at these times, “ a calm approach” is needed since residents become “angry or cross, which can be very frightening”. Saxon Lodge DS0000023590.V254900.R01.S.doc Version 5.0 Page 9 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 and 10 The systems in place to record resident’s changing needs require some reorganisation to ensure that the most up to date information is easily accessible. Staff treat residents as individuals and continue to meet their health care needs. Safe systems are in place for the administration of medication. EVIDENCE: A selection of resident’s individual plans of care was sampled. Each plan contains a photograph of the resident, with one exception. The plans begin by giving a ‘pen picture’ of the resident, followed by information about the resident’s personal care, health care and social care needs. After each section, there is a summary detailing what action needs to be taken by staff to meet the residents assessed needs. Staff complete daily report sheets, which detail how each residents care needs are met on a daily basis. Although individual plans of care are reviewed on a monthly basis by staff and regularly by the deputy manager, this information is not transferred to the original plan of care. This can result in care plans containing out of date information and the most up to date information about a residents care needs has to be gleamed from the separate review notes. Staff had a good understanding of the care needs of residents; residents were aware that staff wrote about them; and relatives said that they were kept informed of any changes in their relatives care needs. Saxon Lodge DS0000023590.V254900.R01.S.doc Version 5.0 Page 10 Accidents were appropriately recorded and relatives had been informed. The deputy manager agreed that it is good practice to plot any bruises that residents incur on a body chart. This had not been done in respect of one resident. Staff said that residents receive regular visits from the dentist, optician and chiropodist and these appointments are recorded in each resident’s daily notes. Relatives confirmed that GP’s were accessed when needed and during the inspection the advise from the GP was appropriately sought in respect to the health care needs of one resident. Care plans contain details of each resident’s nutritional needs and daily fluid intake is recorded. A visiting health professional stated that the home was, “always keen to embrace any advice and suggestions made to assist in the management of their clients” and a care manager added that “my clients health is much improved”, since moving to the home. Selected aspects of the administration, recording and disposal of medications were inspected and found in accordance with the home’s policies and procedures. Staff, who were interviewed demonstrated that they knew what to do if any medication was given in error. All staff, with the exception of four night care staff have received training in the administration of medication. Since it is the home’s policy that two staff are responsible for the administration of medications it is important that all staff are competent in discharging their responsibilities. Staff were observed communicating with residents in an individual and respectful manner and relatives confirmed that staff always communicated with residents in this way. 80 of residents commented that staff respected their privacy at all times and 100 of relatives and health/social care professionals commented that they could visit their relative/resident in private. One relative commented that, “the manager and staff are considerate and respect my mothers age”. Saxon Lodge DS0000023590.V254900.R01.S.doc Version 5.0 Page 11 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, 14 and 15 Some activities provided for residents have currently ceased and it is envisaged that once they recommence, that they will match the interests and needs of the residents. Residents are provided with a balanced diet. Residents are generally helped to exercise choices, but the menu does not offer residents a choice of meals. EVIDENCE: 50 of residents commented that the home provides suitable activities and 44 of residents commented that suitable activities were provided only sometimes. Currently, there is no activities coordinator and the person who undertakes clay modelling with the residents, is not currently visiting due to building works. A new part-time activities person has been recruited to undertake art and craft activities. She was introducing herself to residents on the day of the inspection and some residents were looking forward to her starting her job. There was a display of origami in the conservatory that had been demonstrated to residents the previous week. Staff said that they are able to take residents out for short walks when staffing levels permit. They also said that they had time available to chat, play games with residents and enable them to listen to music. Staff said that they encourage residents to undertake daily armchair exercises. Saxon Lodge DS0000023590.V254900.R01.S.doc Version 5.0 Page 12 92 of relatives commented that staff welcomed them when they visited the home and that they were kept informed of important matters in relation to their relative. Staff said that in general they try to give residents choices and that residents generally say if they are not happy with something. 93 of residents commented that they liked the food provided by the home. A set, rotating menu is used, which provides a healthy diet for residents. The menu does not list an alternative meal at each mealtime. Also, the records of food consumed by the residents indicated that no resident had eaten an alternative meal in the last few weeks. Some residents said that they would welcome an alternative at mealtimes. The inspector joined some residents for lunch, which was an informal, social occasion. Some residents dine in the dining area and others in the conservatory. One of these residents said that they preferred to have their lunch in the conservatory, since they could take their time. Indeed it was observed that one resident was still enjoying their lunch long after all the other residents had left the dining room. Residents who require help with eating were supported in a discrete manner. Saxon Lodge DS0000023590.V254900.R01.S.doc Version 5.0 Page 13 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): 16 Complaints are encouraged in the home. In order to for the home to demonstrate that they listen to complaints and take them seriously, they need to record any complaints received and the action taken to address them. EVIDENCE: Residents and relatives said that they were encouraged to speak to staff or the manager if they had a complaint, and that they did complain if they had a problem. Staff said that if a relative made a complaint, they would record it and pass it on to the deputy or manager. All relatives stated that they were aware of the home’s complaints procedure. The registered provider stated that the home had not received any complaints and therefore did not have a dedicated book in which to record complaints. However, one relative indicated in the comment card, sent to the Commission for Social Care Inspection, that they had made a complaint. It is important to keep a record of all complaints and the action taken to address the issues, to ensure that all complaints in the home are listened to, taken seriously and acted upon. Saxon Lodge DS0000023590.V254900.R01.S.doc Version 5.0 Page 14 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, 20,21, 22, 23, 24,25 and 26 Saxon Lodge provides a comfortable environment for the residents that it accommodates. However, the individual accommodation for one resident needs to be revisited to ensure that it meets their needs. Plans are in place to undertake building work to enhance the facilities offered to residents. EVIDENCE: Saxon Lodge is situated in a quiet road, in the rural village of Bridge. Residents are provided with a lounge and conservatory to sit in during the day. There is also a separate dining room where residents take their meals. Plans have been submitted to the Commission for Social Care Inspection to build six additional ensuite rooms in what is currently the garden. Some improvement work has commenced. An ensuite has been added to one of the downstairs rooms, and the laundry, which was previously housed in the garage, has been relocated to the ground floor of the home. The ground floor hallway and bedrooms have been redecorated which has lightened the interior of the home. Resident’s rooms have been decorated according to individual needs and tastes. There is a bathroom with a hoist and an adapted toilet on the ground floor to assist those residents with mobility problems. A shaft lift provides access between floors. The inspector sounded the call-bell system from one of the Saxon Lodge DS0000023590.V254900.R01.S.doc Version 5.0 Page 15 resident’s rooms and was concerned to discover that it could not be heard from upstairs. The registered person confirmed that a call point needed to be fitted upstairs in the home. Some of the furnishings in the lounge looked tired and worn and the registered person stated that new furniture had been ordered and would be installed when the building work to the home had been completed. Generally the furnishings of the home meet the resident’s needs. There are a small number of exceptions. It was noted that two ensuite bathrooms on the ground floor need some additional tiling and that two of the downstairs toilets did not contain paper towels or soap. Also, one of the bedrooms on the first floor is quite small which results in the bed barring access to the wash hand basin in the room. The day of the inspection was cooler than the preceding days and the central heating was turned on, ensuring that the residents were sufficiently warm. Staff explained they steps that they take to ensure that residents are bathed in safety, including taking a recording of was taken of the water temperature before every bath and asking the resident if the water temperature is to their liking. These temperatures were recorded in the resident’s daily notes. Staff, who were interviewed demonstrated that they had an understanding of the importance of infection control procedures. Infected laundry is appropriately bagged and the home has a sluice and sluicing disinfector, although, not all staff were aware of whether it was working. The clinical waste bin is situated in the garden and needs to be made secure to prevent any cross infection. The majority of staff have received training in the control of infection. Gloves and aprons were available around the home. The home was clean and free from offensive odours on the day of the inspection. Saxon Lodge DS0000023590.V254900.R01.S.doc Version 5.0 Page 16 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, 28, 29 and 30 The staff team works well together to support resident’s needs. The home has a through recruitment procedure to protect residents. The home needs to ensure that all new staff receive the appropriate induction training. Once completing their induction, the home is committed to training staff to NVQ level 2. EVIDENCE: 92 of relatives and all staff commented that there were always sufficient numbers of staff on duty. There are two care staff on duty from 8am to 8pm and two waking night staff on duty between 8pm and 8am. During weekdays, the deputy manager is also on duty. The registered manager is currently on sick leave, and the registered person and deputy manager have taken over her responsibilities. In addition there is an administrator; and a part-time cleaner for 5 days of the week, including some weekends. Relatives described staff as staff are, “very caring” and a care manager stated that the home had a, “ very supportive staff”. The National Minimum Standards are that 50 of care staff should be trained to NVQ level 2 by December 2005. Currently, 35.7 of staff have achieved NVQ 2 and 14.3 of staff are awaiting their certificates, indicating that the home is in line to meet this target. In the absence of the registered manager there was some confusion as to whether the home uses the induction training to National Training Organisation specification as required by the National Minimum Standards. There is a training matrix that indicates the staff training that has been completed and Saxon Lodge DS0000023590.V254900.R01.S.doc Version 5.0 Page 17 booked for the whole staff team. This shows that not all staff had received training or been booked for training in relation to all statutory areas. An examination of personnel files showed that before an employee commences work at the home, a thorough recruitment and selection procedure is undertaken, including the necessary pre-employment checks. Staff said that they had received copies of the General Social Care Council codes of good practice. Saxon Lodge DS0000023590.V254900.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): 35, 36 and 38 Safe systems are in place for safeguarding resident’s finances. Staff need to receive regular, formal supervision from management. In order for the health, safety and welfare of residents to be fully met, there needs to be regular maintenance of gas appliances and portable electrical equipment, and the first aid box requires restocking. EVIDENCE: Where monies are kept on behalf of residents, clear records and receipts are kept of all financial transactions. The National Minimum Standards recommend that staff receive regular recorded supervision six times a year. Staff said that they had not received supervision recently and there were no records in the home to indicate that any staff had been supervised. However, staff said that if they had a problem they could approach the deputy or manager. Saxon Lodge DS0000023590.V254900.R01.S.doc Version 5.0 Page 19 An inspection of records revealed that maintenance of electrical installation, fire-fighting equipment, the lift and moving and handling equipment had been undertaken. The maintenance for gas appliances and portable electrical equipment was out of date. A record of regular fire drills that are undertaken in the home was seen. However, it does not include the names of the staff that participate in the drills and therefore it was not possible to determine whether each staff member had participated in a fire drill, twice a year as required. A system needs to be put in place to ensure that the first aid box is regularly restocked, since it contained a number of sterile dressings that were out of date. Saxon Lodge DS0000023590.V254900.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 x x x 2 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 x 3 3 2 2 2 3 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x x 1 x 2 Saxon Lodge DS0000023590.V254900.R01.S.doc Version 5.0 Page 21 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. 1 Standard OP7 Regulation Care Standards Act 2000 section 13 (3) 17 (1) (a) schedule 3 (2) 13 (2) Requirement The registered person must submit an application to vary the condition of registration in respect of three residents The registered person must ensure that a photograph of each resident is contained in their individual plan of care The registered person must ensure that all care staff who administer medication receive training from an external creditable source The registered person must review the home’s complaints procedure to ensure that it is effective in recording all complaints and acting upon them The registered person must ensure that each toilet is provided with soap and paper towels The registered person must reconsider the layout to one residents bedroom to ensure that the resident can access their washhand basin Timescale for action 26/10/05 2 OP7 23/11/05 3 OP9 12/04/06 4 OP16 22 (1) 12/01/06 5 OP21 13 (3) 12/10/05 6 OP23 23 (f) 23/11/05 Saxon Lodge DS0000023590.V254900.R01.S.doc Version 5.0 Page 22 7 8 OP26 OP30 9 OP30 10 OP38 11 OP38 12 OP38 The registered person must ensure that the clinical waste bin is made secure 18 C (i) The registered person must ensure that all staff receive induction training to National Training Organisation specificaiton 13 (6) The registered person must book 23 (4) (d) all staff on training in relation to 13 (3) health and safety, adult 13 (5) protection, fire, infection control, moving and handling Gas The registered person must have Safety the gas appliances in the home Regulation checked by a CORGI engineer s 1998 and electrical portable appliances tested; and send a copy of the certificates to the CSCI 23 (4) (e) The registered person must ensure that the name of each member of staff is recorded when they participate in a fire drill 13 (2) The registered person must put a system in place to ensure that the first aid box is always correctly stocked 13 (3) 23/11/05 23/11/05 23/04/06 23/11/05 12/10/05 12/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP7 OP7 OP14 and 15 Good Practice Recommendations The registered person should ensure that when there is a significant change to the care needs of a resident, that this information is incorporated in the residents care plan. The registered person should ensure that any bruises sustained by residents are plotted on a body map which is held in their plan of care. The registered person should ensure that residents are provided with an alternative to the main meal offered at DS0000023590.V254900.R01.S.doc Version 5.0 Page 23 Saxon Lodge 4 5 OP22 OP36 each mealtime The registered person should ensure that the call bell alarm sounds on the first floor of the home The registered person should ensure that all staff receive supervision six times a year Saxon Lodge DS0000023590.V254900.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Saxon Lodge DS0000023590.V254900.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!