Inspection on 21/01/06 for St Mary`s Nursing Home

This inspection was carried out on 21st January 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.

Other inspections for this house

St Mary`s Nursing Home 11/03/09

St Mary`s Nursing Home 12/03/07

St Mary`s Nursing Home 19/09/05

St Mary`s Nursing Home 20/12/04

St Mary`s Nursing Home 26/07/04

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 Mary`s Nursing Home Montilo Lane Harborough Magna Rugby Warwickshire CV23 0HF Lead Inspector Suzette Farrelly Unannounced Inspection 09:30 21 January 2006 st 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 Mary`s Nursing Home DS0000004410.V279653.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 Mary`s Nursing Home DS0000004410.V279653.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service St Mary`s Nursing Home Address Montilo Lane Harborough Magna Rugby Warwickshire CV23 0HF 01788 832589 01788 832216 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) Mr Simon Northover Mrs Beatrice Gooch Francine Parry Care Home 77 Category(ies) of Dementia - over 65 years of age (28), Old age, registration, with number not falling within any other category (49) of places St Mary`s Nursing Home DS0000004410.V279653.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The Registered Manager must undertake and complete the Registered Managers Award by January 31st 2007. The Registered Manager must attend some accredited dementia training by December 31st 2005. 19th September 2005 Date of last inspection Brief Description of the Service: St Mary’s care home is set in its own grounds near to the village of Harborough Magna, 5 miles from Rugby. The care home has been developed from the old maternity hospital, and retains some of the character. St Mary’s care home is registered for frail elderly, and older people with dementia. The accommodation is over two floors with all rooms being single en-suite. The home offers all services where possible to meet the needs of the service users. Care is provided by qualified nurses and care staff that have received training in dementia care. There is a small terrace from the dining room, where service users can sit out, looking across open land. Due to the rural situation the nearest village is approximately 1 mile away. Public transport to the home is limited. St Mary`s Nursing Home DS0000004410.V279653.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second inspection for 2005/06 and was unannounced taking place on a Saturday. The assistant manager was available in the home for most of the inspection and all staff co-operated throughout the visit. A tour of the environment took place and care records were examined. Other records related to health and safety and the maintenance of equipment were assessed. What the service does well: What has improved since the last inspection? What they could do better: There are a number of areas that need to improve to ensure that all areas of care are met and that the residents have a good experience of living in the home. Care planning remains insufficient, information related to the care of the residents is incomplete and this may lead to omissions in care or poor practices. There are insufficient activities available and two residents stated that they are board at times. The staff stated that there was little time to do activities with the residents and on the unit for those with dementia there is nothing to do and many residents were wandering around aimlessly. St Mary`s Nursing Home DS0000004410.V279653.R01.S.doc Version 5.1 Page 6 Policies and procedures related to the use of restraint were incorrect and from discussion it was confirmed that it did not reflect the practices in the home. There were unpleasant smells in the dementia care unit and many of the communal areas and bedrooms require re-decoration and some furniture looks tired and old. A good quality assurance and monitoring system is still required for most areas to ensure that the registered provider and registered manager recognise areas where improvement to the service provided is required. 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 Mary`s Nursing Home DS0000004410.V279653.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 Mary`s Nursing Home DS0000004410.V279653.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): 3 Residents have a full assessment prior to moving into the home ensuring that the staff can meet their needs EVIDENCE: Six residents records were full examined and all have a pre-assessment completed and those funded through social services also had a Care Manager’s Report with care plans devised by the allocated social worker. The home’s pre-assessments were not dated nor signed making it difficult to ascertain the exact date of completion. This would make auditing difficult. It was seen that initial care plans are developed from these assessment. St Mary`s Nursing Home DS0000004410.V279653.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): 7 & 10 The resident’s health, personal and social care needs are not fully set out in individual care plans, which could result in poor care practices and oversight of care provision. Residents feel that they are treated with respect and their right to privacy is mainly up held. EVIDENCE: Six care profiles were examined and the information did not reflect all the care required by the residents. One resident is artificially feed and there was no mention in her care plans to inform staff on the proper regime to keep her mouth clean and moist. On visiting this resident it was noted that the resident had excessive saliva and suctioning was used to assist in keeping their mouth clear. There was no care plan or instruction on the use of suctioning and the care to be given. The Nurse attending described the care in full. This omission of care plans relies on the memory and verbal communication of staff and is insufficient in ensuring consistency of care. St Mary`s Nursing Home DS0000004410.V279653.R01.S.doc Version 5.1 Page 10 Another resident who has a pressure ulcer had a care plan which suggests that the resident would require turning while in bed, the plan failed to state how frequently the resident should be turned or how long they could remain out of bed. There was also no mention of pressure relieving equipment. A chart was seen in the resident’s bedroom stuck to the bathroom door. This is an inappropriate place to keep information and contravenes confidentiality. In the same profile there is a risk assessment that states that the resident is now immobile and a hoist must be used to assist with mobility. The care plan states that this resident is mobile and staff must encourage mobility . As the risk assessments and care plans are kept is separate folders this could result in the wrong care and injury to the resident and/or staff. Other care plans contained insufficient information and left much of the decision making to the member of staff such as: ‘ J is able to make some choices allow where possible’ – this could result in the wrong choices being offered or no choices. The daily records made no mention of choices being offered. Another resident with swallowing difficulties had been seen by the Speech and Language Therapist and prescribed thickening agent to be added to all drinks. The care plan discussed a soft diet but made no mention of the thickening agent. This could result in harm to the resident. Overall not all care issues were recorded appropriately in the care plans, prescribed care from other professionals was omitted. Changes in health and physical ability were not always recorded in new care plans. The above could result in poor care provision and potential harm to the residents. There is one public phone in the home that can be plugged into telephone sockets throughout the home. The residents and their visitors may use the home’s phone system if required. Residents wear their own clothes and their relatives or the home staff labels these for easy identification. Clothes are stored in individual wardrobes and draws. Staff were seen chatting to residents and were polite and caring. Three residents stated that the staff always refer to them with the right name and are respectful. Staff were seen to knock on bedroom doors before entering. All personal care and examination are conducted in privacy. St Mary`s Nursing Home DS0000004410.V279653.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): 12, 13, & 15 There are insufficient activities and community contacts and the residents’ lifestyle experiences do not always meet their needs. Residents receive a wholesome appealing and balanced diet. The dining areas are dull and institutional. EVIDENCE: The home employs two activity organisers (AO). Each is allocated to a unit and work three days per week . The AO for the elderly frail unit has been away from work for a long period of time, so there are minimal activities available, most of these are individual activities carried out by staff when they have the time. The AO organiser for the dementia unit has developed minimal activities and the assistant manager confirmed that this is an area that requires development. Care staff do not carry out any activities on the dementia care unit and it was confirmed that this is in part due to a lack of time and also a lack of knowledge. St Mary`s Nursing Home DS0000004410.V279653.R01.S.doc Version 5.1 Page 12 It was noted that there are no books, magazines or other materials that can be read. There was also a lack of items related to the emotional and social care of those with dementia such as doll therapy. The dining areas and lounges lacked a homely feel and contained only the minimum furniture required. Residents’ families and friends can visit at any reasonable time and are made welcome by the staff. One relative spoken to stated that the staff are always kind and offer drinks and made them feel welcome. Visiting can take place in the any of the lounge or dining areas, the resident’s bedroom or the small lobby area. Information about visiting is available in the homes booklet. There is limited community contact, in part due to the home’s location. The local Catholic Church visits for communion. Some residents do go out with their relatives and when the weather is good the home take some residents out to local parks and shopping areas. The home offers three meals a day and four residents stated that they had enough to eat and the food was nice. A choice is offered on most days except Sunday when all residents have a roast dinner. The cook stated that if a resident did not like or want a roast dinner another meal could be made available. The meals are served on the first floor from a hot trolley ensuring that the food is kept at the optimum temperature. The food for the ground floor is served from the kitchen hatch into the small kitchenette. The staff were seen to assist residents in a quiet and professional manner allowing the resident time to eat their meal at their own rate. Aids to assist residents to eat independently were seen in use. Drinks and snacks are available at all times during the day and night and are served from the individual kitchenettes on each unit. The home supplies specialist diets for three diabetics and a number of residents who require soft or liquidised foods. The menus require up dating, as the information available does not reflect the choices available. The cook stated that some choices had been changed, as the residents did not like them. It is important that the written menus reflect the actual food available. The menus were not available in other formats and there was no information on the units to inform staff or residents what choices there were. St Mary`s Nursing Home DS0000004410.V279653.R01.S.doc Version 5.1 Page 13 A tour of the kitchen took place and records related to food, fridge and freezer temperatures and cleaning schedules were examined. The kitchen was found to be well organised, clean and tidy with a good stock of fresh and frozen food stuffs. All records required were available and up to date. St Mary`s Nursing Home DS0000004410.V279653.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): 18 Residents are largely protected from abuse b through the home’s policies, procedures and training. EVIDENCE: The home’s policies and procedures were examined. These were found to contain suitable information. The policy related to restraint did not completely reflect the actions taken in the home. One item discussed the use of recliner chairs for residents who persisted in standing and were at risk of falling. The assistant manager stated that this is not the case and recliner chairs are only used for residents who are no longer able to sit in normal seating safely. This policy should be up dated. There have been no reports of any abuse in the home and three staff spoken to were aware of their role in preventing abuse. Abuse training for all staff is up to date. St Mary`s Nursing Home DS0000004410.V279653.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): 19, 20, 21, 22, 23, 24, 25 & 26 Residents live in a safe environment that requires some refurbishment to bring it to an acceptable living standard. Residents live in safe bedrooms that require further decoration and refurbishment to bring them to an acceptable standard. The home is not completely clean, pleasant or hygienic. EVIDENCE: A tour of the home took place examining the communal areas and residents private bedrooms. Other areas such as the laundry, bathing facilities, toilets and store areas were seen. The dementia care unit had an unpleasant smell of urine and faeces. On entering the unit the staff were changing a resident, however the smell continued for the duration of the inspection. Other areas on the unit did not smell. On further investigation it was found that dirty laundry is stored in a St Mary`s Nursing Home DS0000004410.V279653.R01.S.doc Version 5.1 Page 16 small sluice near to the dining area. This area had a very strong unpleasant smell. All other areas of the home were free of unpleasant smells. The dining areas and lounges in both units require re-decoration and it was seen that there are holes in the walls in some places and that the paintwork was flaking. Some of the bedrooms seen also require re-decoration. Some carpets appear to have been changes, however, the corridor carpet on the dementia care unit was dirty and stained in places. The dining room tables require re-staining and varnishing and some furniture in the lounge areas look tired and worn. The area surrounding the caged bird on the first floor was untidy and required cleaning. In the shower room on the first floor it was noted that the handrail by the toilet was rusty and the metal around the shower hose was becoming detached. The home storage is disorganised and untidy, various rooms not designated as storage space are used, such as shower rooms and toilets. It was confirmed that these areas have not been used for their intended purpose for a long time. Items were stored in baths and over toilets and sinks preventing flushing of standing water. It is advised that if these areas are to be used for storage the areas should be cleared of the original items and made safe for storage. A number of beds were old, some new beds were available and these had been allocated to residents who spend long periods in bed. There were no door locks and the residents did not have a facility to lock personal item away in there own room. There are sufficient bathing and toilet facilities and all bedrooms are en-suite. The home has handrails in all the corridors and in the toilets and bathrooms. The baths are assisted to enable easy use of this facility. Three residents spoken to were hard of hearing, the home does not have a Loop system to assist those who wear hearing aids. The laundry is on the first floor and is reached from the main corridor of the elderly frail unit. It is small and contains one industrial washing machine and tumble drier. This area was untidy, there was a dirty knife, washcloth and St Mary`s Nursing Home DS0000004410.V279653.R01.S.doc Version 5.1 Page 17 paper towel were in the hand washbasin, and there was no liquid soap suggesting that staff do not wash their hands after handling dirty laundry. A large amount of table clothes that had been washed but were not folded and were in the same area as the dirty washing. There is no clean area designated for laundered clothes. The baskets seen by the machines were not marked and it would be difficult to determine which should be used for the dirty and clean laundry. There was no infection control policy and procedure available in the laundry and when the laundry person is not available the care staff carryout the laundry in between caring for the residents. This may increase the risk of cross infection. St Mary`s Nursing Home DS0000004410.V279653.R01.S.doc Version 5.1 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 The numbers and skill mix of the staff meet the residents’ needs. EVIDENCE: Through discussion and records it was confirmed that there is one qualified nurse allocated to each unit over a 24-hour period. There are sufficient care staff on duty to meet the needs of the residents. The laundry person works only mornings and is not always available at the weekends. During these times the care staff on the first floor carryout the laundry and also care for the residents. There is a cook 7 days per week and a kitchen assistance is available five days during the week; due to this there is no choices of meals at the weekend. St Mary`s Nursing Home DS0000004410.V279653.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 & 38 The is not run in the best interest of the residents The health, safety and welfare of service users and staff are promoted and protected. EVIDENCE: The home does not have a suitable quality assurance and monitoring system and there were no records to indicate that the home consults with the residents regarding their daily lives. The health and safety records were examined and it was found that all equipment in the home is serviced as required. The staff have received up to date training in all areas related to health and safety and practices observed in relation to manual handling were appropriate. St Mary`s Nursing Home DS0000004410.V279653.R01.S.doc Version 5.1 Page 20 The home does not ensure that all standing water pipes that are not used are flushed every seven days in accordance with the management of Legionelleas. This is in part due to some of these areas being used as storage. St Mary`s Nursing Home DS0000004410.V279653.R01.S.doc Version 5.1 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 2 2 3 2 3 X 3 2 STAFFING Standard No Score 27 2 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X X X X 2 St Mary`s Nursing Home DS0000004410.V279653.R01.S.doc Version 5.1 Page 22 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 OP7 Regulation 15 S. 3 Requirement The registered manager must ensure that changes in care are clearly recorded in the care plans and that current care needs are also clearly recorded. Timescale for action 15/03/06 2 OP12 15 16 Carried from the inspection in September 2005. The registered manager must 31/03/06 ensure that there are suitable activities for the residents on both units and these are available daily and clear records are maintained. Carried from the inspection in September 2005. 31/03/06 The registered person and manager must ensure that the menus available reflect the meals served and alternative ways of presenting the menu must be made available to suite the needs of the resident groups. The registered person and manager must ensure that the policy and procedure concerning restraint is accurate and reflects DS0000004410.V279653.R01.S.doc 3 OP15 16 4 OP18 13 S. 3 18/03/06 St Mary`s Nursing Home Version 5.1 Page 23 practice in the home. Carried from the inspection in September 2005. 5 OP19 16 23 The registered person and 15/03/06 manager must deal effectively with the unpleasant smells on the dementia care unit. An action plan with time scales must be forwarded to the Commission. Carried from the inspection in September 2005. 6 OP20 23 The registered person and manager must ensure that the door to the kitchenette areas on each unit is fitted with an appropriate door closure that will react to the fire alarm and close automatically. The door must also be closed when not in use. Carried from the inspection in September 2005. 7 OP22 23 The registered person and manager must ensure that the shower lead is either repaired or replaced. The registered person and manager must ensure that there is a lockable facility in each bedroom for the storage of creams and residents’ valuables. Carried from the inspection in September 2005. 9 OP24 12 The registered person and manager must ensure that all bedroom doors have suitable locks enabling residents who wish to lock their rooms to have this facility. An action plan with time scale to meet this DS0000004410.V279653.R01.S.doc 31/03/06 15/03/06 8 OP24 16 31/03/06 31/03/06 St Mary`s Nursing Home Version 5.1 Page 24 requirement must be forwarded to the Commission. Carried from the inspection in September 2005. 12 OP26 16 13 The registered person and manager must ensure that the hand wash facilities in the laundry are clean and usable at all times. Carried from the inspection in September 2005. 13 OP29 S. 1 7 9 19 The registered person and manager must ensure that the staff records are up to date and contain all information as specified in Section 1 of the Care Home Regulation 2001. Carried from the inspection in September 2005. 14 OP33 24 The registered person and manager must ensure that there is a suitable quality assurance and monitoring system in place and the results of surveys are available for inspection with plans for improvement. Carried from the inspection in September 2005. 15 OP38 13 16 The registered person and 30/04/06 manager must ensure that all unused toilets and bathrooms used as storage are decommission, or that the taps and flushing systems are available to be flushed every seven days in accordance with the management of Legionelleas. 30/04/06 31/03/06 15/03/06 St Mary`s Nursing Home DS0000004410.V279653.R01.S.doc Version 5.1 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 Refer to Standard OP13 Good Practice Recommendations The registered manager should consider ways to increase the home’s contact with the community. St Mary`s Nursing Home DS0000004410.V279653.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Mary`s Nursing Home DS0000004410.V279653.R01.S.doc Version 5.1 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!