Inspection on 09/02/06 for St Johns Court Nursing Home

This inspection was carried out on 9th February 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 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 Johns Court Nursing Home 08/05/08

St Johns Court Nursing Home 24/10/06

St Johns Court Nursing Home 08/06/05

St Johns Court Nursing Home 09/11/04

St Johns Court Nursing Home 02/06/04

St Johns Court Nursing Home 22/12/03

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE St Johns Court Nursing Home St Johns Street Bromsgrove Worcestershire B61 8QT Lead Inspector Jane Rumble Unannounced Inspection 9th February 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 Johns Court Nursing Home DS0000004139.V278620.R01.S.doc Version 5.1 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 Johns Court Nursing Home DS0000004139.V278620.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service St Johns Court Nursing Home Address St Johns Street Bromsgrove Worcestershire B61 8QT 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) 01527 575070 01527 576246 Somerset Redstone Trust Mrs Karen Jayne Bevis Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (44), Physical disability over 65 years of age of places (44) St Johns Court Nursing Home DS0000004139.V278620.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. The home may also accommodate a maximum of 4 people with a terminal illness (TI). The home may also accommodate a maximum of 3 people over 65 years with a dementia illness (DE/E). The home may also accommodate a maximum of 3 people under 65 years with a physical disability (PD). The home may also accommodate one person over 65 years with a mental disorder (MD/E). Only service users with low dependency care needs are accommodated on the second floor of the home. 8th June 2005 Date of last inspection Brief Description of the Service: St Johns Court is a care home providing both nursing and residential care for up to forty-four older people. Currently people receiving residential care are living on units on both the second and ground floor, whilst people receiving nursing care are living on a unit on first and ground floor. The home also provides palliative care for up to four people. It is owned by Somerset Redstone Trust, a charitable organisation. The home is located in the centre of Bromsgrove, close to shops, pubs and other community amenities. The home was extensively refurbished in 2002 and provides accommodation on three floors. There is a passenger lift providing mechanical access to all floors of the home. The home has thirty-six single and four shared bedrooms. All the bedrooms have en-suite facilities. The single rooms all measure in excess of ten square metres and the shared rooms in excess of sixteen square metres. St Johns Court Nursing Home DS0000004139.V278620.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken over 8 hours by one inspector. Thirty-two people living at the home are in receipt of nursing care and 12 are in receipt of residential care. Information was gathered from examining care and other records, talking to 4 staff, manager and deputy manager, 8 service users, 3 relatives, observation of care staff undertaking their duties and a partial tour of the home. This is the second statutory inspection for the 2005-2006 year. It is recommended that this report is read in conjunction with the previous report of June 2005. . What the service does well: What has improved since the last inspection? Since the last inspection the manager has been successful in her application to be registered. St Johns Court Nursing Home DS0000004139.V278620.R01.S.doc Version 5.1 Page 6 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. St Johns Court Nursing Home DS0000004139.V278620.R01.S.doc Version 5.1 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 Johns Court Nursing Home DS0000004139.V278620.R01.S.doc Version 5.1 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): Prospective service users are not assured that their needs will be met prior to admission. EVIDENCE: A pre-admission assessment is completed by the home prior to a service user moving in. However, following the assessment the home does not confirm in writing that their needs will be met by the home as required by the Care Homes Regulations 2001. The home does not offer intermediate care. St Johns Court Nursing Home DS0000004139.V278620.R01.S.doc Version 5.1 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): The homes recording systems do not consistently evidence that service users health care needs are met. Medication is generally well managed and administered safely. Improvements are required in respect of care planning to ensure that they include sufficient detail for staff to follow in order to meet the identified needs of residents. EVIDENCE: Each service user has an individual plan of care. Two service user plans were inspected in detail. Those inspected were not in sufficient detail to inform care staff of the actions they would need to take to ensure that all aspects of the health, personal and social care needs of the service user would be met. For example, in respect of one persons mobility the care plan stated, “encourage to do passive movements when sitting down”. No details of what passive movements or the frequency in which they should be encouraged was available. For one individual who has a sacral sore the care plan directed staff to using one particular wound dressing. However, records stated that a different would dressing was being applied. St Johns Court Nursing Home DS0000004139.V278620.R01.S.doc Version 5.1 Page 10 Repositioning charts were not completed consistently to evidence that turns were undertaken to reduce the risk of pressure damage. Turn charts did not indicate that a 30º tilt was used as a means of pressure relief was considered. Whilst the homes records do not consistently evidence that health care needs are met the home currently only has two people with pressure damage at the time of inspection. A range of pressure relieving equipment is available in the home. On person who has asthma, the care plan states “observe respiration, if peak flow low inform G.P.”. No detail was available of what a low reading would warrant informing the G.P . Records did not evidence that service users with low body mass index (BMI) nutritional needs were met. Food and fluid charts were not consistently completed. Where dietary supplements were prescribed these were not recorded consistently to evidence that they had been given. Where service users had a BMI of less than 20 the home could not evidence that a referral to a dietician for specialist advice had been made. Records for one person did not indicate that health care concerns, contributing to weight loss were followed up. The inspector was informed that only registered nurses make daily entries within service users records. However, the vast majority of personal care is delivered by care staff. A formal system of capturing the detail of the care provided should be considered, so that care records accurately reflect the care provided. A full audit of medication administration, recording, storage or disposal was not undertaken. Medication records were inspected. The pharmacist supplies 28 days of medication at a time. A record is maintained of current medication for each service user. Medication is stored securely. Generally medication records were well maintained. Some deficits were noted where medication had not been signed as administered or no code had been recorded for the reason for non-administration. The home retains some controlled drugs, these are stored securely, and an accurate register is maintained. However, it was disappointing to observe that controlled medication was still in the home for one person who had not lived at the home for approximately one month. The inspector observed a “not for resuscitation” form on the file of one service user. This had been signed during a hospital admission but not reviewed since admission to the home. The nurse on duty stated the home has a no resuscitation policy. This is unacceptable, a decision not to resuscitate must be made on an individual basis agreed with the G.P., multi-disciplinary team, service user (if appropriate) and relatives and subject to regular review. St Johns Court Nursing Home DS0000004139.V278620.R01.S.doc Version 5.1 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): Opportunities for service users to exercise choice and control over their lives needs to be further developed. Contact with family and friends is maintained. Menus need to be reviewed to ensure service users receive a diet that meets their needs and preferences. The range of leisure/recreational activities available needs to be extended to ensure activities in and outside the home suits their needs, preferences and capacities. EVIDENCE: The home employs an activities co-ordinator for 25 hours a week, Monday to Friday. However, she is required to support individual service users to eat for up to one hour a day. In addition, part of her role is to provide escort duties for individuals with hospital/clinic appointments. These additional duties impact on the amount of time available for leisure and recreational activities. The home used to have transport available for service users. This is no longer available and impacts on the opportunities for community presence and participation. Each week a music and management session takes place in the home. At the time of inspection one of these sessions was observed. Whilst participation was limited to six people – their enthusiasm and enjoyment of the session was evident. The inspector was informed that the home’s entire activities budget is St Johns Court Nursing Home DS0000004139.V278620.R01.S.doc Version 5.1 Page 12 spent on these sessions. The activities co-ordinator has to organise fund raising events to ensure money is available for other activities taking place in the home, including the prizes for the weekly bingo session, and craft materials. The weekly activities programme includes bingo, board games, quizzes, card games, skittles and movement and music. Trips to the local town, Bromsgrove are undertaken on an individual basis. However, it appears that this opportunity is limited to a small number of individual service users, rather than the service user group as a whole. There is no written justification for how it is determined how the access to opportunities is decided. A number of service users spoken to commented on the limited social/leisure opportunities available within the home, but their enjoyment of those opportunities that were available to them. Service users spoken to were not able to demonstrate that they were aware of opportunities to contribute to the running of the home – service users confirmed that they were not involved in planning the menu. A residents meeting has not taken place since 2003, to enable them formally voice their opinions. Service users were unaware if they could adjust the temperature of the room to reflect personal taste. The inspector was able to confirm that individuals were able to get up and go to bed when they wanted. Service users were unaware of any rules within the home, other than smoking. Generally people living at the home commented positively on the food provided. Areas for further development included consideration to the transport of soup and tea which was commented as not always very hot when served, and the frequency that sandwiches are offered for the evening meal. Menus were available within the dining areas, which demonstrate that a fourweek cyclical menu is available. From inspection of the menus and observation of the meals provided on the day of inspection it was not evident that five portions of fruit or vegetables are offered daily in accordance with healthy eating guidelines. It is however, pleasing that an option of a cooked breakfast is offered daily. Menus available did not indicate a wide variety of food on offer. Twice a week a roast dinner is provided with no alternative provided. For the evening meal sandwiches are always provided, and there is not always an alternative option available. Records of food provided are not retained in sufficient detail to enable any one inspecting the record be confident that service users are offered a nutritionally based diet. At lunchtime it was observed that cold drinks only were offered with the midday meal. Consideration should be given to offering hot and cold drinks at mealtimes, to enable personal preferences to be met. Observations of core practice at the mealtime highlighted some areas of concern St Johns Court Nursing Home DS0000004139.V278620.R01.S.doc Version 5.1 Page 13 • • Pureed foods were observed to be mixed together in a dish. The service user being feed was not told by the member of staff what the meal was. Two service users were observed to be fed by the member of staff who stood over them. Again the member of staff did not let the service users know what the meal was. Tables were well presented, with tablecloths, salt and pepper. However, there was no evidence of sauces or mustard being available. Service users commented on how much they would appreciate these being routinely available. It was pleasing that jugs of squash were available within individual bedrooms and communal areas throughout the home for service users to help themselves. It was pleasing that all service users spoken to were confident that their visitors would be welcome at any time. It was also stated that visitors are offered drinks when they visit. Relatives confirmed this. Service users were well presented, with attention being paid to detail. Clothing was appropriate to the weather. St Johns Court Nursing Home DS0000004139.V278620.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Systems need to be put in place to ensure that service users are aware that they can participate in the electoral process. Care staff spoken to had a clear understanding of their responsibilities for responding to allegations of abuse. EVIDENCE: Service users spoken to were unaware that they were able to participate in the political process. For example by enabling them to vote in elections. The staff spoken to were able to describe appropriate actions that they would take in the suspicion or allegation of abuse was made. The organisation has a procedure on the protection of vulnerable adults. There were a number of thank you cards on display throughout the home complimenting staff on the care afforded to relatives. St Johns Court Nursing Home DS0000004139.V278620.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The home continues to provide high quality, well maintained accommodation that provides a safe, clean environment for those living there. EVIDENCE: A full tour of the home was not undertaken at this visit. Bedrooms inspected were well furnished with residents’ personal possessions to reflect their personal taste and interest. A maintenance man is employed to ensure repairs are attended to promptly. Communal areas were clean, warm, well maintained and homely. Because of the specialist seating available the seating arrangements in the first floor lounge needs to be reviewed so that all service users can see the television if they wish. St Johns Court Nursing Home DS0000004139.V278620.R01.S.doc Version 5.1 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): Robust recruitment practices are employed, some further development is required in respect of CRB’s to ensure service users are fully protected from harm. Care staffing levels are maintained. EVIDENCE: In addition to the manager and deputy manager, who tend to work Monday to Friday there is one qualified nurse on each shift, eight care staff on the morning shift, seven care staff on the afternoon shift, in addition to ancillary staff. At night there is one nurse and three care staff. There are 32 people receiving nursing care and 12 people receiving residential care. Discussions with the nurses on duty and from inspection of nursing records, care plans, indicate that it would be beneficial if more time was available to devout to maintaining nursing records. Care staffing levels are maintained with staff undertaking additional hours, particularly at weekends. Service users commented that staff “are kind”, “look after them well” and “you can ask for anything”. The inspector was informed that nursing staff deploy care staff on a daily basis. The home is split into a number of units. Staff are not assigned to a particular unit for an extended period of time to enable them to develop a good rapport with service users, or for them to develop a sense of accountability and identify with the unit. St Johns Court Nursing Home DS0000004139.V278620.R01.S.doc Version 5.1 Page 17 Recruitment records were inspected for these members of staff. Evidence was available that all legally required records are obtained prior to staff commencing work. It was observed that the application form does not specify that at least a ten-year work history is requested. Where positive criminal records bureau checks are received the manager should complete a risk assessment to evidence their suitability to work with the client group. The inspector was informed that the induction programme is currently being revised to include the testing of an individuals understanding, and the topics required to be covered by skills for care and be completed over the first twelve weeks of employment. This is viewed as a positive development to replace the existing checklist style of induction record. St Johns Court Nursing Home DS0000004139.V278620.R01.S.doc Version 5.1 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): The manager needs to improve her management oversight of the home to ensure service users benefit from consistent care, supervision needs to be available for all staff at regular intervals to ensure that they are competent and confident to undertake their roles. EVIDENCE: On the day of inspection the home was subject to an internal financial audit to review accounts. These audits occur every quarter. Financial records were not inspected at this visit. Since the inspection of 8th June 2005 the manager has been successful in her application for registration. The manager needs to improve her overall management oversight of the home. Many areas of responsibility have been delegated, or directives given to staff. However, formal systems to check these are happening are lacking. St Johns Court Nursing Home DS0000004139.V278620.R01.S.doc Version 5.1 Page 19 Care staff supervision has been delegated to nurses. However, from inspection of records it is apparent that it is not occurring at the required frequency. The manager had not taken steps to address this. Care staff commented that they had not had a staff meeting for approximately six months. It was felt by the staff spoken to that when they occurred they were very beneficial. The home operates a key worker system. It was disappointing that service users spoken to were unaware of who their key worker was. Staff spoken to were also unsure as to who they were key worker to. The inspector felt that the current system of staff deployment does not facilitate this. Care staff do not make care record entries, it was reported that changes in individuals needs are reported verbally to nursing staff for entry into the records. This system needs to be reviewed to ensure that records accurately reflect the care provided to individuals. St Johns Court Nursing Home DS0000004139.V278620.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 2 10 X 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 2 18 3 2 X X X X X X X STAFFING Standard No Score 27 3 28 X 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X 1 X X St Johns Court Nursing Home DS0000004139.V278620.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? 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 OP4 Regulation 14(1)(d) Requirement Timescale for action 23/02/06 2. OP15 17(2)13 3. OP14 12(3) 4 OP7 15 The registered person has confirmed in writing to the service user that having regard to the assessment the care home is suitable for the purpose of meeting the service users needs in respect of his health and welfare. Records of food provided for 16/02/06 service users must be maintained in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory, in relation to nutrition and otherwise, and of any special diets prepared for individuals, including dietary supplements. The registered person shall, for 01/03/06 the purpose of providing care to service users, and making proper provision for their health and welfare, and so far as practicable ascertain and take into account their wishes and feelings. Care plans must be further 01/03/06 developed to accurately reflect service user needs in detail, and how these needs will be DS0000004139.V278620.R01.S.doc Version 5.1 St Johns Court Nursing Home Page 22 5. OP9 13(2) 6. OP7 4(2)b 7. OP27 18 8. OP15 16(2)i 9. OP36 18(2) 10. OP15 12(4)(a) 11. OP8 13(1)(b) addressed. Outstanding from June 2005 inspection All medication must be administered as prescribed and staff must sign for all medication administered or document a code to record the reason for none administration. Outstanding from June 2005 inspection The registered person shall ensure that the assessment of service users needs is kept under review, revised at any time when it is necessary to do so having regard to any change of circumstances. Where an individual is not for resuscitation an individual resuscitation plan must be available, and subject to regular review. Qualified nurses numbers per shift must be reviewed to ensure adequate numbers of nurses are available for the number and dependency of the service users accommodated. The outcome of the review must be forwarded to CSCI. The manager must ensure that sauces and mustards etc are available for residents who wish to use them at all times. . .The manager must ensure that staff receive formal supervision at least six times a year and an annual appraisal The registered person shall make arrangements to ensure that the care home is conducted in a manner which respects the privacy and dignity of service users. Service users must not be fed by staff stood over them The registered person shall make arrangements for service users to receive where necessary, treatment, advice and other DS0000004139.V278620.R01.S.doc 24/02/06 24/02/06 01/03/06 24/02/06 01/03/06 10/02/06 24/02/06 St Johns Court Nursing Home Version 5.1 Page 23 12. OP27 19 13 OP32 12(2)(3) services from any health care professionals. Referrals to Dieticians must be made for individuals with a BMI of less than 20. Where staff have positive ~CRBs a risk assessment must be undertaken as to their suitability to work with vulnerable adults. Service user consultation/meetings must be held at the home at regular intervals. 10/02/06 01/04/06 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. 4. 5. 6. 7. 8 Refer to Standard OP15 OP15 OP15 OP15 OP14 OP12 OP29 OP12 Good Practice Recommendations Consideration should be given to involving service users in menu planning. How soup and tea is transported around the home should be reviewed to ensure that all service users are offered the mean/drink at an acceptable temperature. Pureed foods should be presented to service users in an attractive manner and not mixed together. Consideration should be given to providing a choice of hot and cold drinks at mealtimes. The allocation of the activity co-ordinators hours should be reviewed to ensure all hours employed are spent on providing leisure opportunities. Seating arrangements should be reviewed in the first floor lounge to ensure that those wishing to see the television can do so uninterrupted. Consideration should be given to amending the application form so that at least a ten-year work history is required. The key worker system should be further developed to ensure service users and staff are aware of their role and responsibilities. St Johns Court Nursing Home DS0000004139.V278620.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 St Johns Court Nursing Home DS0000004139.V278620.R01.S.doc Version 5.1 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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