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Inspection on 01/09/06 for South Collingham Hall Care Home

Also see our care home review for South Collingham Hall Care Home for more information

This inspection was carried out on 1st September 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.

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 home is spacious and provides a comfortable environment. The manager and staff provide a good standard of care for the residents and communicate well with the residents` families. The residents feel respected and are cared for in a friendly, courteous manner. The manager monitors the care planning process carefully. She is seen as supportive to staff and relatives say she is lovely.

What has improved since the last inspection?

The hot water temperature in the sinks in residents` rooms is now at a safe level to keep residents from the risk of scalds. The recruitment of new staff has now improved and measures are in place to protect the residents from the risk of harm.

What the care home could do better:

The manager states that the contract, issued to all residents, is completed with the room number and the fees set and signed by the resident or a representative, then kept at the head office in West Bridgford. The copy seen in the care plans of residents case-tracked is blank and does not confirm the conditions that the home agrees with them. This was a requirement at the previous inspection. The requirement to produce an initial nutritional assessment for each resident and monitor their dietary needs has not been put in place since the last inspection. The external windows and doors of the home are in a poor state of decoration. The refurbishment program inside the home has not progressed any further since the last inspection. The flooring in the spacious entrance hall has been refurbished with a lightcoloured wood and makes the area light and airy. However, some of the floorboards are damaged and may be a trip-hazard. The water from the hot water tap in the specialist bath is too hot to bathe residents in and there is no cold water outlet to the bath. This must be rectified to ensure that there are enough bathing facilities available for all residents at all times. Doors are being wedged open by chairs, wooden pegs, fire extinguishers, etc. This practice is not safe or acceptable. The recommendations of the fire officer must be met without delay.

CARE HOMES FOR OLDER PEOPLE South Collingham Hall Care Home Newark Road Collingham Newark Nottinghamshire NG23 7LE Lead Inspector Vanessa Gent Key Unannounced Inspection 30th August 2006 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 South Collingham Hall Care Home DS0000024661.V303818.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. South Collingham Hall Care Home DS0000024661.V303818.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service South Collingham Hall Care Home Address Newark Road Collingham Newark Nottinghamshire NG23 7LE 01636 892308 0115 9818790 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) Broadoak Group of Care Homes Ms Gloria Brown Care Home 39 Category(ies) of Dementia (30), Old age, not falling within any registration, with number other category (39) of places South Collingham Hall Care Home DS0000024661.V303818.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. One named service user aged 48 years or older within the category LD as identified in the letter dated 17/9/04 Manager must undertake adult protection training/awareness within 4 months of the registration Old age, not falling within any other within category (OP) (39) Dementia - over 65 years of age (DE) (E) (30) Date of last inspection 23/02/06 Brief Description of the Service: South Collingham Hall is a converted and extended 1930’s country house situated on the outskirts of the village of Collingham near Newark. It is registered to provide personal care for up to thirty-nine people of both sexes over 65 years of age, with one place for a person over the age of 48 years. They can also care for people with a diagnosis of dementia. The village of Collingham has a variety of shops, doctor’s surgery with pharmacy and optician’s service, library, community hall, churches and pubs. The market town of Newark, six miles away, has a full variety of facilities and amenities available. A regular bus service passes the home, with a bus stop at the end of the home’s drive. The home is over two floors and has an annexe which has recently been refurbished. A passenger lift and wide staircase give access to the upper floor. It has one room used for double occupancy and twenty-three single rooms. Of the single rooms, nine are en-suite, five with shower or bath facilities and four with toilet and wash-basin. Communally, there are five bathrooms, one with a specialist bath, and five toilets. Only two of the bathrooms and two of the toilets are in regular use. There are no toilets specifically for disabled use or that fit a wheelchair in without difficulty. The home is surrounded by six acres of extensive gardens with views over the countryside. Residents can sit out in fine weather. There are approximately thirty car parking spaces for visitors and staff. The home’s philosophy of care is that they are firmly committed to giving the residents equal opportunities in the delivery of services. Regardless of their mental or physical infirmities or disabilities, they will receive professional and sensitive care which will be of a high standard, meeting the full range of their individual needs and personal preferences. The home has a set fee of £320 per week for all residents. South Collingham Hall Care Home DS0000024661.V303818.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit was made to the home as part of a key inspection. It started at 15.00 and lasted 4¾ hours. Information already held on file was used to plan the visit. On the day of the visit, twenty-five residents were living at the home. The main method of inspection used is called ‘case-tracking’, which involves selecting a proportion of residents, and tracking the care they receive through the checking of records, discussion with them, the care staff and observation of care practices. At the time of the visit to the home, no survey forms had been returned from residents, relatives or staff. The manager stated that the pre-inspection questionnaire that had been sent to the manager, had been returned but this has not been received at the commission office. Three residents’ assessments and care plans were examined. The home was toured and a sample of other records looked at. The inspector spoke with three of the staff on duty, at least thirteen of the residents, including those being case-tracked, and two relatives. The manager was present throughout this visit. What the service does well: What has improved since the last inspection? What they could do better: South Collingham Hall Care Home DS0000024661.V303818.R01.S.doc Version 5.2 Page 6 The manager states that the contract, issued to all residents, is completed with the room number and the fees set and signed by the resident or a representative, then kept at the head office in West Bridgford. The copy seen in the care plans of residents case-tracked is blank and does not confirm the conditions that the home agrees with them. This was a requirement at the previous inspection. The requirement to produce an initial nutritional assessment for each resident and monitor their dietary needs has not been put in place since the last inspection. The external windows and doors of the home are in a poor state of decoration. The refurbishment program inside the home has not progressed any further since the last inspection. The flooring in the spacious entrance hall has been refurbished with a lightcoloured wood and makes the area light and airy. However, some of the floorboards are damaged and may be a trip-hazard. The water from the hot water tap in the specialist bath is too hot to bathe residents in and there is no cold water outlet to the bath. This must be rectified to ensure that there are enough bathing facilities available for all residents at all times. Doors are being wedged open by chairs, wooden pegs, fire extinguishers, etc. This practice is not safe or acceptable. The recommendations of the fire officer must be met without delay. 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. South Collingham Hall Care Home DS0000024661.V303818.R01.S.doc Version 5.2 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 South Collingham Hall Care Home DS0000024661.V303818.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Completed and signed residents contracts are not available for examination. Pre-admission assessments are completed that provide a good basis for the residents’ care plans. EVIDENCE: The statement of purpose and service user guide were not seen at this visit but were reported by the manager to be current to the homes details. A terms and conditions contract was seen in each of the care plans examined but none were completed with room number and fees payable and they were not signed by the resident or a representative. The copy in the care plans does not reflect what is written in the contract itself, which the manager states are completed, sent to and kept at head office. She stated that a resident would never be moved from the room they occupied without full discussion with the resident or a representative. This is an outstanding requirement from the last inspection, for which a timescale of 30th April 2006 was given. Comprehensive pre-admission assessments are in place for the residents casetracked. These are used as a basis for creating the care plans. South Collingham Hall Care Home DS0000024661.V303818.R01.S.doc Version 5.2 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, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are comprehensive but would be more relevant and meaningful if they involved staff, residents and their representatives more fully. The residents health is well maintained by good staff teamwork, liaison with outside agencies and professionals and adequate medication practices. Residents’ privacy and dignity continues to be maintained. EVIDENCE: The care plans examined are comprehensive documents that reflect the lives of the residents for whom they are produced. A brief social history, risk assessments and separate care plan issues are dealt with appropriately. The care plans are reviewed monthly by the manager. Care staff write a twice daily account of the lives of the residents. Staff say they feel knowledgeable enough to care safely and efficiently for the residents. The residents signature was seen for some aspects of the care plans but not for general agreement with what they contain and say of the resident. One next-of-kin relative stated that she was not aware of any aspect of the care plans and had not been invited to be involved in them at any stage. South Collingham Hall Care Home DS0000024661.V303818.R01.S.doc Version 5.2 Page 10 The manager and staff liaise with other healthcare professionals, as seen in a visit sheet in each of the care plans looked at. These include the tissue viability nurse, continence advisor, chiropodist, dentist, optician, psychogeriatrician and any other professional as deemed necessary for maintaining the well-being of the resident. A district nurse attends one resident with frail skin problems. Medication practices are seen to be satisfactory. All staff who administer the medicines are trained by the pharmacist who supplies all the home’s medicines. During the previous inspection, the inspector observed a good rapport between the residents and staff. Residents’ comments and observations at this visit support those made at the last visit to the home. Residents and a relative say they are treated with dignity. The inspector observed staff handling and speaking with residents respectfully. South Collingham Hall Care Home DS0000024661.V303818.R01.S.doc Version 5.2 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, 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are given choice in most aspects of their lives in the home. However, the limited variety of activities may mean that residents do not have full choice at all times. The choice of food at some meals may be limited and there is no evidence available to confirm that residents are given a balanced, nutritious diet at all times. EVIDENCE: The activities centre mostly around major events such as entertainers, an outing to the seaside and events to which relatives are invited, for example - a recent barbecue. There is no evidence of daily group or individual activities being provided. The home does not have a specific activity organiser as one of the staff team. The manager and staff say that many of the residents are very elderly and frail and do not want regular, daily activities. Most of the residents were sitting, dozing in their chairs in the lounges. Several residents say that there is nothing for them to do except some knitting, which they like to do, and watching television, which they said, they do not always want to do. Several residents have a need to wander and move freely around the home. No South Collingham Hall Care Home DS0000024661.V303818.R01.S.doc Version 5.2 Page 12 activities are available to distract their attention and keep them occupied. There are no sensory areas where they could go when they become agitated. There were not enough staff on duty to go out into the gardens with any resident that feels restricted by having to stay inside at all times. Visitors say they are made welcome at all times and are invited and encouraged to go with the residents and staff on trips out. A church service is brought to the home monthly and a residents church minister visits weekly. Many of the residents have limited capability to make independent decisions for themselves. Some residents say that they can choose their bedtimes and what they wear but do not have much choice in other aspects of their lives. The inspector saw that residents were consulted on their wishes during the visit and some residents confirmed this. Everyone said that the “food is good, homemade and plenty of it”. Only one choice of lunch meal is offered although an alternative is provided for any resident who refuses the main choice. Residents say that fresh fruit is available and fresh vegetables are used at lunchtimes. Some residents said they would occasionally like something cooked for tea instead of sandwiches every day. A little fresh salad garnish is given with the sandwiches. They all said “the cakes are lovely”. A relative said that at teatimes, the soft diet for those who have difficulty with swallowing is usually trifle or pureed fruit or something similar. Staff and the cook say that light hot meals are usually offered at teatime on alternative days, but that some other residents want sandwiches for every teatime meal. Nutritional assessments and monitoring of dietary needs for each resident were required by the previous inspector but are not in place at the current inspection. South Collingham Hall Care Home DS0000024661.V303818.R01.S.doc Version 5.2 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, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are looked after safely and attentively by well-trained staff. They feel comfortable with the care they receive from the staff and the manager. EVIDENCE: A complaints policy is displayed in the entrance hall. A relative says that if they had any concerns or a complaint, they would feel that they could talk freely to a member of staff or the manager and that it would be dealt with. They state that they have no concerns whatsoever about the home or the care provided. They say that since being in the home, and under the good care of the staff and manager, the resident has bloomed and made progress. They said that staff always inform them of any change in the condition of the resident and discuss matters fully with them. Staff and the manager say they have attended training to safeguard the residents from harm. Staff said they would feel confident to report any treatment that would be seen as abusive. They say they work as a good team and get on well together. The manager says she has a good team of staff who care well for the residents. A relative said that the staff are very good: helpful, cheerful and caring. Residents say, the staff will do anything for you”; “They are lovely”; “I’ve got no complaints”. South Collingham Hall Care Home DS0000024661.V303818.R01.S.doc Version 5.2 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, 25, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is comfortable and homely but will look more attractive if the redecoration programme inside and out is speeded up and completed. Aspects of poor maintenance around the home may put some residents at risk of injury or harm. EVIDENCE: Outside of the home, the peeling paint of the windows and doors spoils the appearance of an otherwise attractive building. Inside, much of the communal areas has undergone some re-decoration and is now light and airy. However, many of the carpets and curtains have been in place for many years, are threadbare and are in need of replacement and modernising. The flooring of the main entrance hall has been replaced by light wood floorboards but some of these are already flaking and may cause residents, whose mobility is limited, to trip and fall. South Collingham Hall Care Home DS0000024661.V303818.R01.S.doc Version 5.2 Page 15 The water temperature in the residents’ sinks was tested and is now within safe limits. However, the water supply to the specialist bath is too hot and the cold water supply has been cut off, so the bath is unusable until the problem has been resolved. As this is the bath used for the majority of residents, this must be attended to without delay. South Collingham Hall Care Home DS0000024661.V303818.R01.S.doc Version 5.2 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, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Recruitment practices and the high level of training provide safe practice to the residents. However, the numbers of staff on duty do not necessarily reflect the current level of needs of residents, or new residents with higher needs being taken into the home. EVIDENCE: The number of staff on duty includes the manager in the caring team. During the visit to the home, there were two staff and the manager to care for twenty-five residents, many of whom have either high physical or dementia needs. This does not take into account the high dependency needs, as well as the rambling layout of the building. At the previous inspection, the inspector found that the staffing level ratio was borderline and should the number of people with dementia rise, the levels should be re-assessed. This has not happened to meet the current residents’ needs. The manager does not have enough time to adequately carry out her managerial responsibilities because she is counted as one of the care staff team at each shift. Two residents said, “The staff are good. If someone has a fall or something, staff would come straight away. They’re there when you need them.” South Collingham Hall Care Home DS0000024661.V303818.R01.S.doc Version 5.2 Page 17 The recruitment procedure of new staff has improved since the last inspection. Certificates to say that staff have been checked for any criminal records disclosures are now in place in the staff records examined. Staff say they receive a good amount of training and are up-to-date with the basic training programme needed to care appropriately and safely for the residents. This was confirmed in the training records seen and by the staff who spoke with the inspector. South Collingham Hall Care Home DS0000024661.V303818.R01.S.doc Version 5.2 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): 32, 33, 35, 36, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is run by a manager who is well thought of and who ensures that the residents’ finances are safe-guarded. The staff are well-trained and supervised, and residents receive good care and feel safe. However, there are elements of potential risk of harm in the lack of some of the facilities or provisions in the home. EVIDENCE: Residents, relatives and staff told the inspector that the manager is friendly, approachable and supportive. No reports have been received to show that the responsible individual for the home has visited, unannounced, every month, to monitor the service provided. These were, however, available and seen at the visit to the home. In future, a copy will be sent, each month, to the commission office. South Collingham Hall Care Home DS0000024661.V303818.R01.S.doc Version 5.2 Page 19 The manager says that residents’ surveys are distributed and the results sent to the company’s head office for analysis. The results are not, at present, shared with the manager. The information needs to be analysed and shared with the residents, relatives and staff to encourage more relevant practice and make sure that residents have full choice in their lives. Residents’ personal allowances are safely maintained by the manager and receipts kept for all transactions, with two signatures for each. Staff say, and the records show, that supervision is undertaken regularly. The supervision records are excellent: clearly written and signed by both the manager and the staff. They demonstrate the progress of the staff whilst working at the home. Doors are being wedged open by chairs, wooden pegs, fire extinguishers, etc. This practice is not safe or acceptable. It puts residents at risk should a fire occur at the home. South Collingham Hall Care Home DS0000024661.V303818.R01.S.doc Version 5.2 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 2 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X 2 3 STAFFING Standard No Score 27 2 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 4 3 X 3 4 X 2 South Collingham Hall Care Home DS0000024661.V303818.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP12 Regulation 16(2) Requirement Timescale for action 30/11/06 2 OP19 23(2) (b,d) 23(2)(j) 3 OP25 4 OP38 23(4)(a,c) The responsible person must make sure that activities are provided in enough quantity and variety to be suitable to meet the residents’ wishes and needs. All parts of the home, including 30/11/06 the flooring in the hall, must be maintained in a good state of repair to safeguard residents. The specialist bath must be fitted 08/09/06 with a water supply that maintains the water temperature at a level safe for use by residents. All parts of the home must be 30/09/06 able to adequately contain the spread of fire. Doors must not be prevented from closing should a fire or fire drill occur. South Collingham Hall Care Home DS0000024661.V303818.R01.S.doc Version 5.2 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP2 OP15 Good Practice Recommendations The contract given to all residents at admission to the home should state the fees payable and the number of the room to be occupied and be available for inspection. An initial nutritional assessment for each resident should be used as a baseline tool to assess the diet, appetite and weight of the residents. This should then be reviewed regularly to ensure that the residents needs are not changing. To allow the manager enough time to do all the tasks of managing the home adequately, she needs to be supernumery, that is, extra to the staffing numbers. Staffing levels need to be monitored and re-assessed as the needs and dependency status of the residents change or deteriorate. The manager must contact the local fire officer for his advice and recommendations and make sure that these are met. 3 4 5 OP27 OP32 OP27 OP38 South Collingham Hall Care Home DS0000024661.V303818.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 South Collingham Hall Care Home DS0000024661.V303818.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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