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Inspection on 07/06/06 for Southdown Nursing Home

Also see our care home review for Southdown Nursing Home for more information

This inspection was carried out on 7th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

What the care home does well

The residents in this home and their families consider that they live in a pleasant environment, which suits their needs, and all of those that were able to express an opinion were appreciative of the care that they receive. All of them looked well cared for and comfortable and comments were made that "staff were very nice" "treat us well " and that "there is always plenty of food" Staffing levels appear to be sufficient to meet the care needs of residents and many of the staff have received some training in caring for residents with dementia although, there will need to be more of a focus on this if the home is to continue to admit residents with similar healthcare needs. Staff turnover appears to be low, enabling continuity of care to be provided and more than 50% of them are educated to NVQ level 2 and above. A comprehensive pre-admission assessment ensures that the healthcare needs of residents will be met and care plans accurately reflect the care that is currently being delivered. These are regularly reviewed and input is gained from other healthcare professionals as required. Residents are often not able to contribute to these plans however input is encouraged from their relatives who sign to say that they agree with them. Some activities, suitable for the needs of the residents, are provided although recognising the importance of any form of interaction and communication with residents it is recommended that consideration should be given to increasing them. An appropriate complaints procedure is in place to protect residents and both they and their representatives expressed confidence in this. The Commission has received no complaints about the service since the last inspection.

What has improved since the last inspection?

Since the last inspection work has started to redecorate and refurbish the home and this is still ongoing. Staff training has increased and sessions are being held more frequently although it is recommended that more emphasis will need to put on caring for those with dementia. A fire safety officer`s visit occurred recently and many of the requirements have been complied with already although some still need to be introduced.

CARE HOMES FOR OLDER PEOPLE Southdown Nursing Home 5 Dorset Road Cheam Surrey SM2 6JA Lead Inspector Alison Ford Key Unannounced Inspection 7th June 2006 10:30 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 Southdown Nursing Home DS0000019123.V297928.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. Southdown Nursing Home DS0000019123.V297928.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Southdown Nursing Home Address 5 Dorset Road Cheam Surrey SM2 6JA 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) 020 8643 1639 020 8642 1369 Mr Wijayarathna Mrs M Wijayarathna Mrs Dona Konthasinghe Care Home 25 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (0) of places Southdown Nursing Home DS0000019123.V297928.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users admitted with a diagnosis of dementia does not exceed 10. A Registered Mental Health Nurse or Registered General Nurse who holds a recognised Dementia training certificate is always on duty. All staff must have dementia awareness training. Date of last inspection 1st December 2005 Brief Description of the Service: Southdown is a converted and extended house, providing nursing care for up to 25 elderly people, including up to ten who may suffer from dementia. The home is situated in a residential area of Cheam and is close to public transport links. There are fifteen single and five double rooms accommodated on two floors. Nine of the single rooms have en-suite facilities. A shaft lift provides access to the lower first floor with a stair lift serving those few bedrooms on the upper first floor. In addition to the dining room there are two communal lounges. There is pleasant back garden, which can be used by residents, and car parking is available at the front. At the time of this inspection fees range from £450 - £530 per week. Additional charges for personal items would be discussed prior to admission. Southdown Nursing Home DS0000019123.V297928.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes first inspection for the year 2006/2007 and was an unannounced visit. During this time a tour of the premises was undertaken, a sample of care plans and documentation relating to the health and safety of residents was seen. Several of the residents and four members of staff on duty were spoken with. The Registered Manager was not on duty however the homes Registered Provider arrived during the inspection. Since the last inspection there has been one concern raised about a staff member in the home which was dealt with under the local authority vulnerable adults procedure. This was dealt with very promptly and found to be not upheld. This home is registered to care for up to ten residents with dementia however during this inspection it became obvious that the home has exceeded that number. Further discussions will be held with The Registered Providers to decide the future registration of the home and the staffing structures required to support the increased healthcare needs of the residents. During this visit all of those standards considered by The Commission to be key to the inspection process were assessed. What the service does well: The residents in this home and their families consider that they live in a pleasant environment, which suits their needs, and all of those that were able to express an opinion were appreciative of the care that they receive. All of them looked well cared for and comfortable and comments were made that “staff were very nice” “treat us well ” and that “there is always plenty of food” Staffing levels appear to be sufficient to meet the care needs of residents and many of the staff have received some training in caring for residents with dementia although, there will need to be more of a focus on this if the home is to continue to admit residents with similar healthcare needs. Staff turnover appears to be low, enabling continuity of care to be provided and more than 50 of them are educated to NVQ level 2 and above. A comprehensive pre-admission assessment ensures that the healthcare needs of residents will be met and care plans accurately reflect the care that is currently being delivered. These are regularly reviewed and input is gained Southdown Nursing Home DS0000019123.V297928.R01.S.doc Version 5.2 Page 6 from other healthcare professionals as required. Residents are often not able to contribute to these plans however input is encouraged from their relatives who sign to say that they agree with them. Some activities, suitable for the needs of the residents, are provided although recognising the importance of any form of interaction and communication with residents it is recommended that consideration should be given to increasing them. An appropriate complaints procedure is in place to protect residents and both they and their representatives expressed confidence in this. The Commission has received no complaints about the service since the last inspection. What has improved since the last inspection? What they could do better: Although potential residents have a pre-admission assessment prior to being offered a place in the home it was noted that little is written about their social and personal care needs. In addition, although information about their previous lives is available for some residents, if the home is to continue to admit residents with dementia it is important that life history work is undertaken in order to understand their current behaviour patterns and preferences. There must also be more of a focus on staff training in relation to working with people with dementia to ensure that all of their healthcare needs will be met. It was recommend that more stimulation and interest for residents should be provided by increasing activities in the home and it was suggested that the introduction of picture menus would help them when they are trying to choose their meals. There were some concerns raised about the safety of residents. It was noted that unwanted medication awaiting collection was left in the office, several window restrictors were broken and the fire door in the lounge was not working again. There was no evidence that emergency lighting systems were tested, various certificates of worthiness for equipment in use were not available and a new lock is still required for the front door. Despite previous requirements concerning appropriate checks for new staff it would seem that these are still not always being carried out and formal supervision for care staff is not being undertaken on a regular basis. Southdown Nursing Home DS0000019123.V297928.R01.S.doc Version 5.2 Page 7 The absence of any quality assurance monitoring tool means that residents and their representatives are not able to comment on the service that they receive or influence the running of the home. 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. Southdown Nursing Home DS0000019123.V297928.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 Southdown Nursing Home DS0000019123.V297928.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): 3,6 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The pre-admission assessment that is undertaken ensures that residents can be confident that their basic health care needs will be met although more information about their personal and social needs would ensure that the home was the most suitable for them. This home does not offer intermediate care: this standard does not apply. EVIDENCE: The care plans of seven residents including two admitted since the last inspection were seen and these contained evidence of pre admission assessments ensuring that their basic health care needs would be met. Assessments would benefit from more detail regarding resident’s personal and social needs and preferences. This would ensure that the daily life and activities of the home would meet resident’s expectations and that they would Southdown Nursing Home DS0000019123.V297928.R01.S.doc Version 5.2 Page 10 feel confident that the home would be suitable for them and provide stimulation and activities to suit them. Southdown Nursing Home DS0000019123.V297928.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 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Residents in this home consider that they are always treated with respect and dignity and their care plans accurately reflect their assessed healthcare needs ensuring that appropriate interventions and care are given. Medication policies and procedures are in place to ensure the protection of residents. EVIDENCE: A sample of seven care plans was inspected and these are reviewed monthly to ensure that they reflect the care that is currently being provided and input is gained from other healthcare professionals as required. Where possible, residents or their representatives have been encouraged to participate in the process and they have signed the plans. Some relatives have also supplied life stories to help staff gain a greater understanding of their residents. This would benefit from being developed further especially for those residents who are suffering from dementia. Southdown Nursing Home DS0000019123.V297928.R01.S.doc Version 5.2 Page 12 Regular monitoring of residents to identify those at risk of developing pressure sores, is evident in care plans and pressure-relieving devices were in use throughout the home. The medication policy has now been updated in line with current legislation however medicines awaiting disposal must be kept locked away until they are collected. Medication administration records and storage were all in order. Staff were observed treating residents with respect and all the residents spoken with agreed that they were always kind. Personal care is delivered in resident’s own rooms and screening is provided in shared rooms Southdown Nursing Home DS0000019123.V297928.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): 12,13,14,15 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Residents would be encouraged to make choices within their limitations and abilities and visitors are encouraged to allow them to maintain relationships with families and friends. Although the meals that are served in the home are nutritious and suited to resident’s preferences, bread and milk are not keep to enable service users to have hot drinks and snack when they wish. There is a limited range of activities in the home that offer stimulation and interest to service users. EVIDENCE: Residents would be encouraged to make choices in their lives according to their remaining abilities and visitors are always made welcome. This was confirmed by the comment cards received prior to the inspection and by a visitor in the home at the time. All of those who were able to express an opinion confirmed their satisfaction with the meals served in the home and the menus were varied. Choices are offered however it was suggested that residents could be helped to choose by the introduction of picture menus. One resident has a vegetarian menu and previously the home has been able to provide ethnically diverse meals. Southdown Nursing Home DS0000019123.V297928.R01.S.doc Version 5.2 Page 14 It was noted that once again that the milk was frozen and an insufficient amount had been taken out of the freezer to allow residents to have a drink in addition to the regular times. Care must be taken to ensure that this does not continue to happen. Despite previous requirements metal cups were still in use however these were disposed of during the visit. A limited range of activities is offered in the home and it was suggested that this could be expanded. One resident that was spoken with said that he would have liked the opportunity to go out of the home more often. Southdown Nursing Home DS0000019123.V297928.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): 16,18 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. An appropriate complaints procedure ensures that residents can be sure that their concerns will be listened to and acted upon promptly and they can be confident that measures are in place to protect them from abuse. EVIDENCE: There is a complaints procedure, which was displayed in the hall. This provides information about the process although a visiting relative and the preinspection comment cards confirmed that the management team would always deal with any concerns promptly. The complaints book was seen and these showed that all concerns had been dealt with satisfactorily. One had been conducted under the local authority adult protection procedure and had been resolved and not upheld. Previous concerns relating to the Criminal Records Bureau clearance of staff have now been resolved apart from one member of staff as detailed under standard 29. Southdown Nursing Home DS0000019123.V297928.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): 19,26 Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. Residents live in an environment, which appears to suit their needs however there are concerns about their safety. EVIDENCE: The home is situated in a residential area close to public transport links and off street parking is provided. Shaft and stair lifts ensure that all areas of the home are accessible to residents and there is a rear garden for their use. A tour of the premises was undertaken. A plan of redecoration and refurbishment has started and some areas of the home have been redecorated since the last inspection and are awaiting new carpets. Hopefully this will address the problems of malodour in some areas despite recent shampooing. It was noted that the garden needs be tidied up and the furniture replaced in order to make it a pleasant area for residents to use. Southdown Nursing Home DS0000019123.V297928.R01.S.doc Version 5.2 Page 17 There were some concerns raised about resident’s safety. Several window restrictors were broken and must be repaired. Despite the fact that there was certification available to show that all automatic door closers had recently been serviced and repaired where necessary, one of the fire doors to the lounge was not operating properly. The hydraulic arm on some bedroom doors must also be adjusted to ensure that doors shut fully and offer protection to residents in the event of a fire. The Registered Provider agreed to keep the lounge door shut until such time as it is repaired. Southdown Nursing Home DS0000019123.V297928.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): 27,28,29,30 Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. Staff in this home are employed in sufficient numbers so that the needs of the residents will be met however it was not possible to evidence that the homes recruitment procedures are always sufficient to protect them. Some staff training is in place to ensure that needs of residents will be met although more training will need to be undertaken if the home continues to admit residents with dementia. EVIDENCE: On the day of the inspection there were sufficient staff on duty to care for the twenty-one residents in the home and the off –duty rotas confirmed that this was always the case. It was however noted that when the Registered Manager is on duty she is counted as the trained nurse in the home. As detailed in standard 31, in order to supervise staff and deal with the management issues in the home this role must be allocated a proportion of supernumery time. Staff training has now been increased and the home is trying to hold sessions weekly, recent topics have included abuse and dementia awareness. These are held in the home by an external trainer. In view of the fact that the majority of residents now have dementia there will need to be more of a focus on staff gaining additional qualifications in this. More than 50 of care staff have an NVQ qualification to at least level 2. Southdown Nursing Home DS0000019123.V297928.R01.S.doc Version 5.2 Page 19 Staff files were not available for inspection at this visit however; one new staff member had been employed since the last inspection. He had a National Bureau Investigation Certificate issued prior to recently leaving his country of origin and an assurance was given that this was his first job since that time. However a Criminal Records Bureau / Protection of Vulnerable Adults clearance must still be obtained. He was given a form at the time of this inspection and his working hours changed so that appropriate clearance could be obtained before his next shift in the home. Southdown Nursing Home DS0000019123.V297928.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): 31,33,35,36,38 Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service This home is run by a suitably trained and experienced person however there is currently no way for residents to influence the running of the home or comment on the service that they receive. There is no staff supervision in place to ensure that staff are competent to perform their roles and there are concerns about residents safety in the home. EVIDENCE: A trained nurse who has been in the role for some years and is very experienced in working with this client group currently manages the home. However she is frequently counted as the trained nurse for the home. In order to ensure that staff are appropriately supervised and managed a proportion of her time must be spent in a supernumery category. Southdown Nursing Home DS0000019123.V297928.R01.S.doc Version 5.2 Page 21 There is currently no way of residents or their relatives commenting on the care provided by the home or influencing it’s running. The Registered Provider must introduce some method of quality assurance to ensure that the home is meeting the needs of those using the service. The latest inspection report is displayed on the wall of the office however the Registered Provider must ensure that residents and their relatives are made aware of its existence and the fact that an inspection has recently taken place. The home does not take any financial responsibility for any of its resident’s they all have relatives or representatives who can do this for them. Although records were not available for inspection supervision of care staff is occurring but not every two months. This must be increased in line with good practice guidelines outlined in the National Minimum Standards. There was no evidence that routine safety checks on some equipment in use in the home had been undertaken although an assurance was given that this had occurred. The Registered Provider must send copies of documentation relating to electricity, gas and bacterial water analysis to the office of The Commission for Social Care Inspection. A recent fire safety officers visit had raised a number of concerns the majority of which have been complied with. Fire Training has now been booked for staff members and a risk assessment has been carried out. There must be evidence available for future inspections that emergency lighting is being undertaken every month and a new lock must be fitted to the front door, which is easily opened in the event of a fire. Kitchen records were seen and were all in order and the kitchen appeared clean and tidy. The last visit from the Environmental health Department had been satisfactory. Southdown Nursing Home DS0000019123.V297928.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 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 X X 3 2 X 1 Southdown Nursing Home DS0000019123.V297928.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 OP3 Regulation 15 Requirement The Registered Provider must ensure that information about resident’s personal and social preferences is gained prior to admission and used as apart of the assessment process. The Registered Provider must ensure that unwanted medication is kept locked away until it is collected. The Registered Provider must ensure there is always bread and milk, that is ready to use, available in the home Previous timescale 01/12/05 not met 4 OP19 23(2)(o) The Registered Provider must ensure that the garden is tidied up and garden furniture replaced. The Registered Provider must ensure that window restrictors are operational on all bedroom and upstairs windows. The Registered Provider must ensure that all fire doors are DS0000019123.V297928.R01.S.doc Timescale for action 07/06/06 2 OP9 13(2) 07/06/06 3 OP15 16(2)(i) 07/06/06 07/08/06 5 OP19 13(4) 07/08/06 8. OP19 13(4)(c) 07/08/06 Southdown Nursing Home Version 5.2 Page 24 fully operational at all times. Previous timescale 01/12/05 not met 10. OP29 19 The Registered Provider must provide evidence that all employees are in possession of Criminal Records Bureau clearance prior to starting work. The Registered Provider must provide evidence that staff will be undertaking increased training in caring for residents with dementia. The Registered Provider must provide evidence that the Registered manager is allocated sufficient time to fulfil her role effectively. The Registered Provider must provide evidence that a quality assurance tool has been introduced into the home. The Registered Provider must provide evidence that appropriate checks have been undertaken on electricity and gas services in the home. The Registered Provider must provide evidence that all care staff have formal supervision sessions at least six times a year. The Registered Provider must provide evidence that bacterial water analysis testing has been carried out. The Registered Provider must provide evidence that emergency lighting is being checked monthly. The Registered Provider must fit a new front door lock, which is easily operable in the event of a fire. DS0000019123.V297928.R01.S.doc 07/06/06 11 OP30 18(10(c) 07/10/06 12 OP31 18(2) 07/10/06 13 OP36 12(2) 07/10/06 14 OP38 13(4) 07/07/06 15 OP38 18(2) 07/10/06 16 OP38 13(4) 07/10/06 17 OP38 13(4) 07/10/06 18 OP38 13(4) 07/10/06 Southdown Nursing Home Version 5.2 Page 25 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 OP8 OP12 OP15 Good Practice Recommendations It is recommended that more attention should be given to working with residents and their representatives with regard to life history work It is recommended that more activities should be introduced into the home for residents. It is recommended that picture menus should be introduced into the home. Southdown Nursing Home DS0000019123.V297928.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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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