Inspection on 14/11/06 for St David`s

This inspection was carried out on 14th November 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

St David`s 15/08/07

St David`s 29/12/05

St David`s 13/07/05

St David`s 23/10/04

St David`s 29/06/04

St David`s 23/10/02

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE St David`s 65 West Hill Road St Leonards On Sea East Sussex TN38 0NF Lead Inspector Melanie Freeman Key Unannounced Inspection 14th November 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address St David`s DS0000014039.V318099.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. St David`s DS0000014039.V318099.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St David`s Address 65 West Hill Road St Leonards On Sea East Sussex TN38 0NF 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) 01424-439266 melvenia@stdavids.wanadoo.co.uk Miss Melvenia Davidson Miss Melvenia Davidson Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places St David`s DS0000014039.V318099.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. That a maximum of two service users with physical disabilities requiring nursing care over 65 years of age may be accommodated in single rooms 7 or 22 when vacant. That one service user admitted in October 2003 under 65 years of age may continue to reside in the home. That only service users aged 65 years or over on admission are admitted into the home 29th December 2005 Date of last inspection Brief Description of the Service: St. Davids Care Home is a large detached property located in a residential area of St. Leonards-On-Sea. It provides nursing and personal care for up to 23 residents of an older age or who have a physical disability. The Home is set out on three floors and a passenger lift provides access to all floors. A large lounge area with a sunroom attached provides sea views and some of the upper floor rooms also have spectacular views to the sea. At the front of the building there is a small area providing off road parking facilities. The home provides care and support to residents who are both privately funded and those who are funded by Social Services. The home’s fees as from 01 October 2006 range between £430.00- £575.00 per person per week. Additional costs are charged for hairdressing (approximately £8 for a wash and set), chiropody(approximately £10), newspapers and magazines. The homes literature states that one of its main aims is ‘the management of St David’s Nursing Home pride ourselves on offering a highly professional care service for the elderly with a personal touch’. St David`s DS0000014039.V318099.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term ‘service user’ to describe those living in care home settings. For the purpose of this report those living at St David’s will be referred to as ‘residents’. This was a key inspection that included an unannounced visit to the home and follow up contact with resident’s representatives and visiting health and social care professionals. The unannounced visit included a meeting with the registered homeowner and acting manager who facilitated the inspection process and received the inspector’s feedback at the end of the inspection. On the day of the home visit the inspector spent most of her time meeting with residents and observing practice in the home. A tour of the premises was undertaken and a range of documentation was reviewed including the homes statement of purpose and service users guide, care plans, duty rotas, medication records, and recruitment files. The care documentation pertaining to three residents was reviewed in depth along with a number of policies and procedures and records relating to health and safety. The inspector was able to eat a midday meal with the residents in the communal dining room. In addition service users surveys were given to 10 residents or their representatives and 5 staff surveys were left in the home for staff to complete and return. The inspector received all 5 service users/representatives surveys and 2 staff survey was returned, information contained in the returned surveys has been incorporated into this report. What the service does well: The home provides both prospective and existing residents, with a good level of information about what services are provided and what to expect when living at the home. St David’s nursing home provides a good level of nursing care to residents in a home like environment, and this care is delivered in a caring manner. Resident’s visitors and visiting professionals spoke very positively of the home and the service provided by staff and one comment recorded ‘absolutely St David`s DS0000014039.V318099.R01.S.doc Version 5.2 Page 6 excellent the staff are very good and kind I would not change a thing at the home’. St David’s nursing home provides a home like environment where visiting is encouraged with visitors coming to the home at all times. The care needs of residents are fully assessed before admission to ensure residents needs can be met following admission. The homeowner and acting manager are well respected and have a close relationship with residents and their relatives. Staff training is well established and residents benefit from a well trained and motivated staff group. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. St David`s DS0000014039.V318099.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 St David`s DS0000014039.V318099.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from the provision of comprehensive and well-presented documentation, which enables them to make an informed choice about whether to move into St David’s Nursing Home. All residents are assessed prior to an admission being agreed to by a competent person. Residents are only admitted to the home if their needs can be met. EVIDENCE: A copy of the service users guide and statement of purpose was displayed in the entrance area of the home. This contained useful and comprehensive information on the home and the services it provides. It did however need updating to reflect the change in the management structure and the homeowner confirmed that the new documents were at the printers. St David`s DS0000014039.V318099.R01.S.doc Version 5.2 Page 9 It was also noted that the Service users guide did not include resident’s views and how this could be achieved was discussed with the homeowner and acting manager. A review of the care documentation confirmed that pre-admission assessments are completed by either the homeowner or the acting manager prior to an admission being agreed and ensures that the needs of residents admitted to the home can be met by the staff within the homes environment. Once this assessment is completed a letter is sent to the prospective resident or their representatives to confirm that the home is able to meet the prospective residents needs and are willing to admit to the home. Discussion with a social care professional confirmed that the admission process was both clear and completed in an efficient manner. Relatives spoken to also confirmed a satisfaction with admission process and also advised that most of them had chosen this home as it had been recommended to them. Intermediate or rehabilitative care is not provided at St David’s Nursing Home. St David`s DS0000014039.V318099.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care documentation provides a framework for the provision of care it however needs to be extended to cover all care needs and promote person centred care. Resident’s care needs are met taking into account resident’s dignity with evidence of regular input from health care professionals as necessary. Procedures and practice in the home allow for the safe administration of medicines. EVIDENCE: The care documentation pertaining to three residents were reviewed as part of the inspection process and the care plans were found to provide a framework for the residents care. However specific care needs are not always documented and the care documentation had not been completed to provide a full individual assessment. St David`s DS0000014039.V318099.R01.S.doc Version 5.2 Page 11 One residents care documentation was very poor and did not include risk assessments in respect of safe moving and handling despite the fact that she was unable to weight bear and needed hoisting, her nutritional needs had not been assessed and clearly her nutritional status needed monitoring as she had not been eating a suitable amount in the past. The care documentation has been changed since the last inspection and the staff are not familiar with the new system in use and this may have compounded the care documentation shortfalls identified. The care documentation completed using the old system was of a better quality and evidenced regular review and evaluation of the care provided in the home. It was also noted that the care documentation did not promote a person centred approach to care and residents social emotional and psychological needs were not assessed or addressed within the care records. The inspector was pleased to note that the local Doctors visit the home regularly and review the resident’s health care needs. Other visiting health and social care professionals confirmed the standard of care was good and appropriate to meet the needs of the residents living in the home. All residents spoken to were very happy with the care and support provided to them and this view was echoed within the surveys received. Relatives spoken to were also very complimentary and comments made included ‘I am more than pleased with the way that the home looks after my mother I have no worries they do anything and everything. I find it an excellent service, ‘The quality of nursing is excellent professional and caring as is the administration and cleanliness, the home is always spotless and patients kept fresh and clean’. During the inspection visit staff were seen to be attending to residents needs in a respectful manner and when hoisting residents in a communal area staff ensured residents dignity by using mobile screening. The medicine records were found to be clear and accurate and the medicine administration observed was found to be completed in a safe and appropriate manner. All medicines are administered and monitored by the registered nurses working in the home and the storage area was found to provide good facilities for all medicines. The home has recently dealt with a death in the home in a very sensitive manner and provided excellent support to the family who spoke to the inspector about this support. St David`s DS0000014039.V318099.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Links with friends and relatives are encouraged and choices made are respected. Resident’s opportunities for stimulation through leisure and recreational activities are not fully developed in the home to meet individual needs. Residents receive a wholesome and appealing diet. EVIDENCE: The home has recently employed a new activities person and she has started to develop an individual social activity and entertainment programme, this however needs to be based on the assessment of individual needs. The feedback from residents and visitors confirmed that activities and entertainment had not been given a high priority in the past, two residents spoken to said that ‘there is not a great deal for the more able residents to do’. St David`s DS0000014039.V318099.R01.S.doc Version 5.2 Page 13 The homeowner and acting manager are recognising the need for further development in this area and will be working in conjunction with the new activities person. Visiting is very much encouraged and visitors seen and spoken to said that they were made to feel very welcome and that the staff were very hospitable and provided beverages. Some links with the community are maintained including links with the church if wanted and it was noted that one visitor during the inspection visit was from the local church community. The inspector was able to see that residents were given choices through the day and that when these choices were made staff responded them to. Two residents said that they were able to do what they wanted to do during the day spending time where they wanted. The meal eaten by the inspector with the residents was found to be satisfactory with individual choice being respected; one resident said ‘they always provide a special diet for me as I have specific dietary needs’. Most residents eat in the lounge area with individual tables, which can be rather cramped and does not promote a social event at meal times. The conservatory is used as a dining area although access and the temperature of this room can be problematic to ensuring an appropriate environment. The homeowner confirmed that the conservatory area is to be rebuilt and issues around its use can be addressed at this time. Residents were seen to enjoy their meal and were assisted by staff as necessary to ensure residents were able to eat as much as they wanted. Many residents were using plastic bibs to protect their clothing and the use of linen napkins for some residents was discussed with the homeowner and acting manager. Meal was eaten with residents and this confirmed that residents individual care needs are attended to. Most meals are eaten in the lounge area at individual tables and this gives an institutional feel to the home. The mealtime could be further promoted as social event and would benefit from the use of large napkins instead of bibs. Residents spoken to said they were not restricted by the homes routines saying ‘they were able to do what they wanted to do during the day spending time where they wanted to’. St David`s DS0000014039.V318099.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has suitable procedures for dealing with complaints and any allegation or suspicion of abuse made to it. EVIDENCE: The home has a detailed complaints procedure, and although there had not been any formal complaints recently, residents and relatives spoken to confirmed that they would speak to the registered nurses on duty, if they had any issues and that these would be addressed by the homeowner or acting manager as necessary. The home has a detailed adult protection procedure that is available to staff within the procedure manual. Although this identifies social services as the lead authority it needs to also confirm when the police would be contacted as a priority. Most staff have now received training on adult protection issues. St David`s DS0000014039.V318099.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in an attractive home like environment that is well maintained and clean. EVIDENCE: St David’s Nursing Home is a converted premise that has retained a home like environment. Accommodation is provided on three floors with disabled access provided via a passenger shaft lift. There is a Lounge on the ground floor with a conservatory attached, which looks out over the sea. A small patio area is accessed off this conservatory and provides an attractive seating area in good weather. A tour of the home confirmed a satisfactory level of cleanliness throughout. Resident’s rooms were found to be very personalised and individual with many having the resident’s own furniture. St David`s DS0000014039.V318099.R01.S.doc Version 5.2 Page 16 As a converted premise the home has some limitations and these include a high number of shared rooms. The homeowner confirmed that only those residents choosing to share a room are occupying these rooms although documentation to support this discussion was not available at inspection. The laundry room was found to be well equipped including a commercial washing machine with a sluice cycle and is staffed separately allowing for all laundry to be processed safely. Appropriate infection control facilities were available in the home including gloves and aprons and good hand washing facilities with liquid soap and paper towel dispensers. St David`s DS0000014039.V318099.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is sufficient staff who are suitably trained on duty to ensure that residents receive the level of care they need. The homes recruitment procedures followed were found to be robust although recent photographs are not retained by the home. EVIDENCE: At the time of this inspection 21 residents were living in the home and the staffing arrangements were found to be appropriate to meet the care needs of these residents. Residents spoken to said that staff were available to look after them, one resident said ‘the staff always respond to the bell quickly and are always willing to help day or night’. A staff rota was available for inspection and confirmed that a Registered Nurse is working in the home over the 24 hours with 4/5 carers in the morning and 3 carers in the afternoon and 1 at night. There are in addition sufficient catering and cleaning staff. The manager is not included in the direct care numbers and is therefore available at busy times but has the necessary time to manage the home and co-ordinate the training in the home. St David`s DS0000014039.V318099.R01.S.doc Version 5.2 Page 18 All feedback received from residents and visitors confirmed that the staff are well thought of ‘what impresses me especially is the loving atmosphere of the place and the respect shown to the patients by the staff’ ‘staff very good and kind. The staff are happy in the home and are never grumpy’ ‘The staff are all very sweet to her and she likes the contact with them’. Staff training is an important part of the home and the acting home manager has confirmed within the pre inspection questionnaire that 75 of care staff have completed a National Vocational Qualification in care level 2 or equivalent. . The home also accepts nurses from oversees and provides them with an opportunity to undertake an adaptation programme. The acting manager mentors them, in association with Manchester University. During the inspection there was evidence that staff training is well developed and that new staff complete induction training that is incorporating the new ‘skills for care’ standards. A training matrix is used to record and plan all staff training. The recruitment files pertaining to the three most recently employed carer staff were reviewed as part of the inspection process and identified that the recruitment practice was completed in a robust manner and included an application for referencing and both Protection of Vulnerable Adults and Criminal records checks. It was however noted that recent photographs of staff are not retained and this shortfall was raised with the homeowner for her to address. St David`s DS0000014039.V318099.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was found to be managed in an open and friendly manner, systems to monitor and demonstrate the quality of care provided need to be developed further. There are good financial arrangements for residents’ monies. The health, safety and welfare of residents and staff are well promoted. St David`s DS0000014039.V318099.R01.S.doc Version 5.2 Page 20 EVIDENCE: The current registered manager is also the homeowner and has recently appointed a new nurse manager to take on the complete day-to-day management of the home. The acting manager has applied for her registration and the homeowner is now withdrawing from her regular contact with the home. The acting manager is well known to the residents and they are comfortable with her management and said that they saw her on a daily basis. One relative said ‘If I had any concerns I would talk to the manager who is very helpful and approachable. I would not change a thing at the home. I have no problems what so ever’. The homeowner and acting manager are not included in the staffing numbers for direct care and are therefore available for regular contact with residents and their relatives. The home completes a regular audit of the services and facilities along with the use of questionnaires to gain residents and their representatives views. Although these questionnaires are not reported on they are responded to on an individual basis. The use of auditing and providing a Quality Assurance report was discussed with the homeowner and acting manager along with the need to develop the questionnaires to provide more information. Some of the residents handle their own financial affairs, but in general social services or solicitors are appointed to act on their behalf. The Home’s management team do not act as appointees for the financial affairs of any of the residents. The owner for the Home invoices residents or their appointee monthly. The fees and any sundry items or services are separated out on the invoice. The Home also holds personal monies for sundries and services not included in the fees, for those residents (or appointees) who prefer this arrangement. The systems in place for the safe guarding of residents monies held by the home are robust and were found to include accurate records and appropriate receipt keeping that is maintained by the homes finance administrator. These records however should be audited by the homeowner or manager at intervals to ensure accuracy. Records relating to health and safety in the home were reviewed and although these on the whole are full and extensive it was noted that the environmental risk assessments were not recording all the areas in a thorough and systematic way. This was discussed with the homeowner so that record keeping could be improved to reflect al areas assessed. St David`s DS0000014039.V318099.R01.S.doc Version 5.2 Page 21 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 3 X X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 St David`s DS0000014039.V318099.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15(1) Requirement That the individual plans of care are comprehensive and reflect each individuals care needs in respect of health and welfare and include the residents care and psychological care needs. That appropriate risk assessments are used to underpin the care provided and ensures the safety of residents. That the home consult with residents on their social interests and the programme of activities arranged to ensure an appropriate provision to meet individual needs. That the home obtains all the required information and documents required including staff photographs. That a full quality assurance system is established and reported on and is used to maintain and improve the provision of care and services in the home and that a report is provided to the CSCI. Timescale for action 01/01/07 2. OP8 13(5)(6) 01/01/07 3. OP12 16(2) 01/04/07 4. OP29 19 (1) 01/02/07 5. OP33 24(1)(2) 01/04/07 St David`s DS0000014039.V318099.R01.S.doc Version 5.2 Page 23 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 OP1 OP15 OP23 Good Practice Recommendations That residents and representatives views are included within the service users guide That Napkins are used instead of bibs when appropriate and that the dining facilities are reviewed to provide a more social event for residents. That residents are asked about their view on sharing a room and are given a choice in respect of this matter and any discussions are recorded. That the environmental risk assessments are developed to record clearly all areas have been thoroughly assessed. 4. OP38 St David`s DS0000014039.V318099.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI St David`s DS0000014039.V318099.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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