Inspection on 19/07/06 for Seven Hills Nursing Home

This inspection was carried out on 19th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Seven Hills Nursing Home 11/11/05

Seven Hills Nursing Home 21/06/05

Seven Hills Nursing Home 23/02/05

Seven Hills Nursing Home 27/07/04

Seven Hills Nursing Home 10/02/04

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

CARE HOMES FOR OLDER PEOPLE Seven Hills Nursing Home 17 Cherry Tree Road Nether Edge Sheffield South Yorkshire S11 9AA Lead Inspector Marina Warwicker Unannounced Inspection 19th July 2006 11:00 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 Seven Hills Nursing Home DS0000021811.V304888.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. Seven Hills Nursing Home DS0000021811.V304888.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Seven Hills Nursing Home Address 17 Cherry Tree Road Nether Edge Sheffield South Yorkshire S11 9AA 0114 255 3023 0114 255 3023 none 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) Beech Lodge Ltd Anna Frans Melisse Care Home 24 Category(ies) of Dementia - over 65 years of age (24) registration, with number of places Seven Hills Nursing Home DS0000021811.V304888.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 11th November 2005 Brief Description of the Service: Seven Hills is a 24-bedded nursing centre for older people with elderly mentally infirm needs. It is a converted villa with a purpose built extension. It is a small privately owned care home. The home is situated in the residential area of Nether Edge. It lies within easy access of a regular bus service and Sheffield City Centre. There are stairs and a lift to access the two floor areas. There is a car park to the front of the building. The weekly fees are from £435 to £483. The manager explained that the fees are charged according to the dependency levels of the individuals and also according to the source of funding. The service users buy their own toiletries and pay for hairdressing and chiropody. Up to date information with regards to the service was available so that the service users and the relatives were able to make an informed choice about the home. A copy of the service user guide was on display at the entrance next to the signing in book so that visitors were able to read about the home. Seven Hills Nursing Home DS0000021811.V304888.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection of Seven Hills nursing home was carried out on 19th July 2006 between 11.00 am and 3.15 pm and a further visit was made on 20th July between 8.30 am and 10.30 am to conclude the inspection. Five residents, two relatives were consulted and ten staff were spoken to. A further ten relatives were contacted by post to obtain feedback about the service. Comments received by the Commission for Social Care Inspection will be handled appropriately and shared with the manager of the home once all of the comments are collated. The manager was informed of the comments received by the Commission for Social Care Inspection following the last inspection. The comments were mostly positive however, there were some comments with regards to a lack of activities for certain residents and the lack of training and support for care staff. The manager was informed of these comments. Time was spent observing and interacting with staff and the service users. The manager was present during the inspection. The premise was inspected, which included bedrooms of service users and the communal areas and outdoor areas of the home. A sample of records was checked. These were care plans, medication records, service reports and staff recruitment and training files. Throughout the two days the manager was informed of the findings and a brief final feedback at the end was given to the manager and the staff on duty. What the service does well: The service users are admitted only on the basis that the home is able to provide the assessed care needs by the placing authorities. The service users and their relatives are invited to visit the home before making a decision. Once admitted to the home each service user/representative is provided with a statement of terms and conditions, which informs them of their rights and the conditions of their stay. The home’s philosophy of care is based on ensuring that the resident’s privacy and dignity are preserved at all times and their rights are always protected. The staff provide a service that reflects the principles of ‘valuing people’. They achieve this by creating a homely and friendly environment. The management at Seven Hills recognise that when individuals’ reach their later life they continue to maintain their social, culture, recreational and Seven Hills Nursing Home DS0000021811.V304888.R01.S.doc Version 5.2 Page 6 occupational characteristics and when they move into the home they have their own expectations and preferences as to the lifestyle they want to lead within the care home setting. Therefore the staff ensure service users receive person centred care. The management make certain that the service users are protected from abuse, discrimination, self-harm, inhuman and degrading practices at the home by training of staff. Thus enabling the service users to live in a safe environment. What has improved since the last inspection? What they could do better: The management must make arrangements to purchase a medicine trolley to securely store the medication of the residents. The medication/treatment room should be organised to reflect its purpose. There needs to be a rolling programme of replacement of renewables such as crockery, towels, bed linen to avoid service users having to use substandard items. All care staff need to receive formal supervision at least six times a year. Seven Hills Nursing Home DS0000021811.V304888.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. Seven Hills Nursing Home DS0000021811.V304888.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 Seven Hills Nursing Home DS0000021811.V304888.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 5 The overall quality in this outcome area is: Good. The above judgement is based on the information gathered from relatives, staff and by checking the relevant documentation. There is up-to-date information available regarding the service, so that the service users and the relatives are able to make an informed choice. The service users are admitted only on the basis that the home is able to provide the assessed care needs by the placing authorities. The service users are invited to visit the home before making a decision. Once admitted to the home each service user/representative is provided with a statement of terms and conditions, which informs them of their rights and the conditions of their stay. EVIDENCE: Three care plans were checked and the staff on duty were interviewed. The service users were unable to contribute to the planning of care due to their mental disability. The relatives spoken to confirmed that there were plenty of opportunities for them to find out about the home before admitting the service users. Seven Hills Nursing Home DS0000021811.V304888.R01.S.doc Version 5.2 Page 10 One relative said that when they came to have a look around the home the staff were friendly informative and professional in the way they conducted themselves. The relatives also said that it was not easy for service users to have trial visits therefore the home gave them a settling in period and this was discussed at the review meetings. The three service users’ files checked had needs assessments. The assessments were by the social workers/care managers. There were also copies of the homes assessments prior to admission. The purchasing authorities had set up contracts between them and the home for those three service users. The home does not provide intermediate care. Seven Hills Nursing Home DS0000021811.V304888.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 The overall quality in this outcome area is: Good. The above judgement is based on the information gathered from direct observation of service users, consulting relatives, service users, staff and by checking the relevant documentation. The service users’ plans reflect the changing needs of the residents. Therefore the care plans are used as the yardsticks to judge whether the service users are given the appropriate care. The home’s philosophy of care is based on ensuring that the resident’s privacy and dignity are preserved at all times and their rights are always protected. The staff provide a service that reflects the principles of ‘valuing people’ by creating a homely and friendly environment. EVIDENCE: Three service users plans checked and four staff were interviewed. Two visiting relatives were consulted during the site visit. Direct observation of staff interactions with the service users demonstrated the support and the care and attention provided by all staff to the residents. Seven Hills Nursing Home DS0000021811.V304888.R01.S.doc Version 5.2 Page 12 The service users plans were set out in detail the action which needed to be taken by the care staff to ensure that all aspect of the health, personal and social care needs of the service users were taken care of. The care staff helped to support the service users’ own capacity for self caring in order to enable independence. There were risk assessments and how to deal with falls, tissue viability, and maintenance of continence. The residents at Seven Hills at present were incapable of self-medication therefore the nurses administer medication. The care staff said that nurses often informed them when there was a change in the medication and the effects they should be looking out for. There were records of all medicines received, administered and disposed of by the home. The supplying pharmacist continues to dispose of unwanted medicines. The latest pharmacy report was completed on 28th June 2006; the pharmacist had given advice on a) returning and re-supplying of oxygen cylinders, b) service user requiring blood checks when on medication such as long term diuretics, steroids and supplements such as Sando K. The staff were commended on the appropriate stock levels kept at the home. The service users had access to a pay telephone on the lower ground floor. However, the staff said when relatives rang they took the service users into the manager’s office and helped them have the contact. Service users were wearing their own clothes and they looked comfortable. The staff said that when the general practitioner wanted to examine the service users they were taken to their bedrooms to maintain privacy. The staff said that they had looked after service users during the end of life and have given the service users families support. They had not received any formal training on death and dying and different spiritual needs of residents. Seven Hills Nursing Home DS0000021811.V304888.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 The overall quality in this outcome area is: Good. The above judgement is based on the information gathered from direct observation of service users, consulting relatives, service users, staff and by checking the relevant documentation. The management at Seven Hills recognise that when individuals’ reach their later life they continue to maintain their social, culture, recreational and occupational characteristics and when they move into the home they have their own expectations and preferences as to the lifestyle they want to lead within the care home setting. Therefore as far as possible the staff ensure that individualised care is delivered to service users. EVIDENCE: The activities were organised by a carer since the activities person was away. The service users’ interests were recorded and the activities person said that opportunities were provided for stimulation through leisure and recreation in and outside the home e.g. a service user was provided with paints and paper since he/she liked drawing, another liked attending church. Seven Hills Nursing Home DS0000021811.V304888.R01.S.doc Version 5.2 Page 14 The staff took he/she to church at the weekends, another service user liked singing and the staff switched on the radio and he/she was observed happily singing along. On the day of inspection the service users had visitors. There was no restriction imposed by the home on visiting. The majority of the service users’ relatives handled their financial affairs. The proprietor is the appointee for two service users. Most service users had personal possessions in their bedrooms and this made their dwelling homely. All service users were offered three meals a day. Snacks and drinks were made available throughout the day. Service users were given plenty of time to eat and the staff offered help discreetly. The cook was aware of the special diets and had information on each service users’ likes and dislikes. Those service users who required monitoring of their nutritional intake had charts where staff documented the food and fluid intake. Seven Hills Nursing Home DS0000021811.V304888.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The overall quality in this outcome area is: Good. The above judgement is based on the information gathered from direct observation of service users, consulting relatives, staff and by checking the relevant documentation. The home has a robust and effective complaint procedure, which the relatives and the visitors are able to use. The management make certain that the service users are protected from abuse, discrimination, self-harm, inhuman and degrading practices at the home. Therefore enabling the service users to live in a safe environment. EVIDENCE: The open and friendly atmosphere of the home encouraged constructive criticisms and suggestions as to how things might be improved. This prevents formal complaints been made. There was written information on all the concerns made and how these were addressed. The majority of the comments were regarding clothing going missing. The manager said this has been closely monitored by herself. All staff have had training on preventing and protecting the service users from abuse and neglect and the staff who were interviewed were able to verbalise what action they would take. Seven Hills Nursing Home DS0000021811.V304888.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 24, 25 and 26 The overall quality in this outcome area is: Good. The above judgement is based on the information gathered from direct observation, by speaking to relatives, staff and by checking the relevant documentation. The location and the layout of the home is suitable for its stated purpose. It is accessible, safe and reasonably maintained. Therefore the home meets the service users’ individual and collective needs in a comfortable and homely setting. EVIDENCE: There has been maintenance and renewal work carried out. The manager forwarded a planned programme of maintenance for this year to the Commission for Social Care Inspection following the site visit. Seven Hills Nursing Home DS0000021811.V304888.R01.S.doc Version 5.2 Page 17 The grounds were generally kept tidy and safe. Old furniture and disused crates were stacked up outside waiting to be disposed of. This was also noted on the last site visit. There has been improvement made in the courtyard so that the service users are able to sit out and participate in activities. During the tour of the premise all fire escapes were kept clear, the window restrainers were in place. There were storage areas for aids and equipment. On the day of the visit some equipments was found to be dirty. Immediate action was taken by the manager by instructing the staff to clean the equipment including wheelchairs. The medication/ treatment room needs attention. The cupboards in the room need to be repaired or replaced. Wound dressings and food supplements need to be stored appropriately in the room. The pharmacy report suggested an up dated medicine trolley to be purchased and this is outstanding from the last inspection site visit. Some bed linen and towels were threadbare and were in urgent need of replacement. All bedrooms were provided with accessible call systems for assistance. Doors to the bedrooms had locks and there were risk assessments in the care plans to indicate whether the service users had the capacity to use the keys. The rooms were kept locked to prevent other service users entering. There was emergency lighting provided through out the home. On the days of inspection site visits it was very warm and the service users were provided with electric fans in the communal areas to keep them comfortable. Staff ensured that all service users were offered extra drinks to avoid dehydration. The drinking cups were stained and looked not fit for purpose. The manager said that they were purchasing new ones. An ongoing replacement plan would have avoided having to use old towels and stained cups. Laundry facilities were sited so that soiled clothing was not carried through food preparation or food storage areas. There was a sluicing disinfector and hand washing facilities in areas where infected material and clinical waste were handled. The staff had a good understanding of the steps to be taken to prevent the spread of infection. Seven Hills Nursing Home DS0000021811.V304888.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 The overall quality in this outcome area is: Good. The above judgement is based on the information gathered from direct observation of care staff, by speaking to relatives, staff and by checking the relevant documentation. Staffing numbers and skill mix of nurses and care assistants are usually appropriate to the assessed needs of the service users and the size of the home. However, the layout of the building especially during night times needs extra staff. EVIDENCE: A record of staff rota was maintained. During interviews the staff said that there were adequate staff on most days however, at the weekends staff rang in sick and gave very little time for the nurses to organise additional staff. Some comments were made, by staff working night shifts with regards to the lack of teamwork and the manager was made aware of this. They also commented that due to the layout of the building it was increasingly difficult to manage with three staff on night shift. The manager said that when staffing had been increased on nights often one staff rang in sick leaving three staff on duty and the manager had evidence to support this. There were adequate domestic staff on duty, in sufficient numbers to ensure that standards relating to food were fully met and the home was clean and free from dirt and unpleasant odours. Seven Hills Nursing Home DS0000021811.V304888.R01.S.doc Version 5.2 Page 19 Three care assistants were formally interviewed and they had completed NVQ level2 in care. The manager said that 60 of staff would be completing NVQ this year. Three care assistants’ training files were checked with the help of the manager. All three staff had attended mandatory training such as moving and handling, fire safety, health and safety, Infection control, adult protection and training on the nutritional requirements of the service users. Staff also had attended further training on Dementia awareness, challenging behaviour, care planning, end of life care and food hygiene. Staff recruitment was assessed by interviews with staff and checking staff files. The outcome was positive as almost all the information required by the regulation was outlined in the files. One staff had a gap in service and the reason for this was not documented. The manager was to rectify this immediately. Seven Hills Nursing Home DS0000021811.V304888.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36 and 38 The overall quality in this outcome area is: Good. The above judgement is based on the information gathered from direct observation of care, by speaking to relatives, staff and by checking the relevant documentation. The registered manager is a nurse who is competent and experienced to run Seven Hills nursing home. She has several years of experience being in charge of homes. Therefore the manager has systems in place to make sure that the home meets its stated purpose, aims and objectives. EVIDENCE: The manager is responsible for the day to day running of one home. She has undertaken periodic training to keep up to date with her skills and competency as a nurse. Seven Hills Nursing Home DS0000021811.V304888.R01.S.doc Version 5.2 Page 21 The manager and the nurses were familiar with the conditions and the associated illness of the service users. They support the care assistants to deliver appropriate care to the service users during the shifts. There was a commitment to equal opportunities in the organisation therefore service users’ and the staff diversity was recognised in the everyday running of the home. The relatives and the staff surveys highlighted that the management approach of the home created an open, positive and welcoming atmosphere. The proprietor visited the home most days and carried out a monthly report on his findings. Staff appreciated the contact they had with the owner on a regular basis. Staff meetings have been held and the minutes were available. Relatives commented that there was always staff about the communal areas when they visited. One relative said that the home was small enough for them to feel cosy and unlike an institution. There was an up to date insurance certificate displayed at the home. The manager handled the money belonging to individual service users and she kept records and receipts of all transactions. There were secure facilities in place at the home for the safe keeping of the valuables and money. Although supervision had been carried out this has not been at regular 6 to 8 weeks intervals. The staff said that they either did not have supervision or it was carried out infrequently. There needs to be records of all staff supervisions and staff need to know when they were having supervision and when they were having informal chats about local issues. The staff working at the home have received training on safe working practices and have access to the homes policies and procedures. The staff report to Commission for Social Care Inspection all accidents, incidents and deaths of service users without delay. There were risk assessments for safe working practice topics and fire safety. Seven Hills Nursing Home DS0000021811.V304888.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 3 2 3 2 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 2 3 3 Seven Hills Nursing Home DS0000021811.V304888.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP22 Regulation 13 Requirement The management must make arrangements to comply with the pharmacist’s requirements. Purchase a medicine trolley to securely store the medication of the residents. Previous requirement 30/12/05 The outdoor communal area must be made suitable for the use of service users. Previous requirement 27/09/05,17/03/06 and work ongoing. The cups used for drinking by service users must be replaced. The towels and bed linen must be replaced so that they are fit for use. The manager must ensure that all care staff receive formal supervision at least six times a year. Timescale for action 25/09/06 2. OP19 23 25/09/06 3. 4. 5. OP22 OP24 OP36 16 16 18 25/09/06 25/09/06 25/09/06 Seven Hills Nursing Home DS0000021811.V304888.R01.S.doc Version 5.2 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 OP22 Good Practice Recommendations The medication/treatment room should be organised to reflect its purpose. This has been an ongoing issue. Seven Hills Nursing Home DS0000021811.V304888.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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. 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