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Inspection on 09/10/07 for St Teresa`s Home for the Elderly

Also see our care home review for St Teresa`s Home for the Elderly for more information

This inspection was carried out on 9th October 2007.

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.

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

What the care home does well

St Teresa`s provides a comfortable, safe and clean environment which is maintained to a good standard. Care plans are in place which include peoples needs and how they should be met. The manager and registered person work well together and the staff team demonstrated a good knowledge and understanding of the needs of people using the service. People using the service made comments including `the staff are caring, cheerful and helpful`, `the midday meal is excellent`, `it`s a happy and peaceful place`, Relatives of people using the service made comments including `I feel fortunate to have found St Teresa`s`, `we feel fully satisfied that our relative is well looked after` and `my relative received support above and beyond that required to attend a funeral`.

What has improved since the last inspection?

The records of wounds is more detailed, with a clear care plan in place for each wound and includes regular photographs and reviews of the size and progress. The manager reported that they have improved the assessments to make them more detailed. People who use the service are weighed monthly and the records are used to monitor if an individual needs a nutritional assessment through a dietician.

What the care home could do better:

Some people felt that the evening meal could be more than soup and a sandwich and would like to see egg, beans or cheese on toast for a change. This was discussed with the manager who said this would be raised with people using the service and could be tried. A few people using the service and their relatives said that there could be more to do. One person felt that call bells should be answered quicker. This was discussed with the manager who reported that they are often responded to quickly but not turned off in the office, so people can still hear a bell.

CARE HOMES FOR OLDER PEOPLE St Teresa`s Home for the Elderly 12 Lansdowne Road Wimbledon London SW20 8AN Lead Inspector Emma Dove Key Unannounced Inspection 1:20 9th and 15th October 2007 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 Teresa`s Home for the Elderly DS0000019128.V349157.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 Teresa`s Home for the Elderly DS0000019128.V349157.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Teresa`s Home for the Elderly Address 12 Lansdowne Road Wimbledon London SW20 8AN Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8879 7366 020 8879 1070 Patriciaheller@btinternet.com The Congregation of the Sisters of St Ann Mrs Loyola Maria Goodsell Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places St Teresa`s Home for the Elderly DS0000019128.V349157.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st October 2006 Brief Description of the Service: St Teresa’s Home for the Elderly provides nursing and residential care for up to 28 people. Twenty-five people are currently living there. Accommodation is provided over three floors that are served by a passenger lift and stair lifts. The ground floor has a lounge, separate dining room, activities room, an assisted bathroom and some bedrooms. One the first floor is a second lounge, more assisted bathrooms and toilets with more bedrooms and the top floor has remaining bedrooms with an assisted bathroom and a separate toilet. The home is run by the Congregation of the Sisters of St Anne and is located in a residential area of Wimbledon. The current range of weekly fees are from £455 for residential care, up to £764 for nursing care. A full list of current fees is available from St Teresa’s. Information about the CSCI and a copy of the most recent inspection report are available. St Teresa`s Home for the Elderly DS0000019128.V349157.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over five hours on the 9th October and three hours on the 15th October 2007 by one regulation inspector. The inspection included speaking with people who use the service, staff, the manager and the registered person as well as looking around communal areas and four bedrooms. Questionnaires were sent to people who use the service, relatives and health professionals. We have received twelve completed questionnaires, comments from these are included in the relevant section of this report. An Annual Quality Assurance Assessment was returned in good time to be included in this report. We have also received appropriate notifications. What the service does well: What has improved since the last inspection? The records of wounds is more detailed, with a clear care plan in place for each wound and includes regular photographs and reviews of the size and progress. The manager reported that they have improved the assessments to make them more detailed. People who use the service are weighed monthly and the records are used to monitor if an individual needs a nutritional assessment through a dietician. St Teresa`s Home for the Elderly DS0000019128.V349157.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. St Teresa`s Home for the Elderly DS0000019128.V349157.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 Teresa`s Home for the Elderly DS0000019128.V349157.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 5 People who use the service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service understands the importance of having sufficient information when choosing a care home. It has developed clear information to help people understand what services are provided. Admissions are not made until a full assessment has been made. EVIDENCE: A Statement of Purpose and Service users Guide are in place and include information about the services provided, the fees and any extra charges, how to make a complaint, the meals provided and information about bereavement. Five relatives and six people using the service said that they received enough information to help them make the decision to move in. One person said that their relative had found the home and that it’s ‘alright’. St Teresa`s Home for the Elderly DS0000019128.V349157.R01.S.doc Version 5.2 Page 9 Three people said that they had a contract of residence, one person wasn’t sure if they had a contract and two people said that their relatives are dealing with that detail. Assessments are completed by the manager or deputy, which will determine whether the home is suitable for an individual. The manager reported that they have a one month trial period to help with the assessment process and to give people the option to move out if the home is not suitable. St Teresa`s Home for the Elderly DS0000019128.V349157.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, 10 and 11 People who use the service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Personal healthcare needs including specialist nursing and dietary requirements are clearly recorded in each person’s care plan. Personal care is responsive to individuals needs and preferences. An efficient medication policy is in place which staff understand and follow. Medication records are generally up to date. The service is highly efficient when caring for people who are terminally ill or dying. EVIDENCE: Care plans are in place which have been developed from the assessment of need and are reviewed every month. Care plans note the areas the individual needs support, with some detail of how support should be given. Care plans also note the areas the individual can manage themselves, to ensure people maintain some independence. Some areas of the care plan, where an individual needed a specific chair, cushion or support were seen to be followed during the visit. One person confirmed that they had been involved in St Teresa`s Home for the Elderly DS0000019128.V349157.R01.S.doc Version 5.2 Page 11 developing their care plan. Care plans seen, had been signed by the person using the service. The wording used in one care plan was the opinion of staff. Attention must be paid to ensure peoples needs are written in a manner that is factually correct. A detailed verbal handover takes place every day when each person using the service is discussed. Any concerns or issues with individuals are reported on to medical professionals, relatives or other appropriate person from these handovers. Three relatives said that the home ‘always’ and one relative said the home ‘usually’ meets the different needs of people. One person added ‘people get the most wonderful care’. Three people who use the service said that they ‘always’ and two people ‘usually’ receive the care and support they need. Five relatives said that they are always kept up to date with important information about their relative. The manager reported that staff pay attention to detail when helping people with personal care tasks, ensuring people are well presented, the way they wish to look. People looked well cared for with a number of people wearing brooches and scarves, although one person needs new shoes. People are registered with a GP and see other health professionals including the dentist, optician and chiropodist in the home or local community when required. Records include the date people saw a health professional and any actions needed. Care plans were seen to have been updated after a person had seen the GP. Four health professionals said that the home ‘always’ seeks appropriate medical advice and follows it and that people’s health care needs are full met. Three people who use the service said that they ‘always’ and two people said that they ‘usually’ get the medical help they need. Records of wounds were seen to be clear and detailed, noting the size of the wound, the dressings being used, frequency of changing the dressings and a photograph. Reviews of wounds included changes, progress and photographs. Clear policies and procedures are in place for the receipt, administration and disposal of medication. Medication is securely stored and correctly labelled. Medication Administration Record Sheets were up to date and signed with the exception of medication for two people. Medication was seen to be given following the procedures. The manager and deputy have completed detailed medication training and they will be passing some of the information to all staff through in-house training sessions. A list of the signature of staff who administer medication could be added to the medication file. St Teresa`s Home for the Elderly DS0000019128.V349157.R01.S.doc Version 5.2 Page 12 Care plans contain details of peoples wishes regarding terminal illness and death. This is an area that is managed very well for people using the service and their families. A number of letters seen at the service confirmed that relatives had been satisfied with the care their relative received and the support they had received at the time of their relatives death. The service has links with a local hospice. The manager reported that they will be formalising the way they record in this area in the near future. St Teresa`s Home for the Elderly DS0000019128.V349157.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People who use the service have access to a few regular planned activities and are able to maintain links with the local community. People who use the service have the opportunity to develop and maintain family relationships. Visitors are welcome. The menu is varied and takes into account peoples health and religious needs. Mealtimes are well-managed social occasions. EVIDENCE: The manager reported that a volunteer comes to the home two afternoons a week to provide activities. Three people who use the service said that they enjoyed these afternoons, when they often did a quiz. In addition to this, a massage therapist visits every week. Someone comes to the home on a regular basis to play the piano and another person comes at a different time to play the flute. In addition, mass is held six days a week. Staff reported that they spend time with individuals. The manager reported that they want to increase the amount of time staff spend with people who stay in their rooms. Five people said that they ‘always’ and one person said that there are ‘usually’ St Teresa`s Home for the Elderly DS0000019128.V349157.R01.S.doc Version 5.2 Page 14 activities in the home that they can take part in. Two people said that they can join in with activities if they wish. Three relatives said that the home ‘always’ supports people to live the life they choose. One additional comment noted that ‘more activities are needed’. Birthdays were seen to be celebrated with a cake, glass of wine or a cup of tea. Two people said that they were very happy with the way their Birthday was celebrated and particularly enjoyed the glass of wine and cake. Visitors were seen to be made welcome, offered drinks and updated with information about their relative. Four relatives said that the home ‘always’ helps their relative keep in touch. One relative said that they visit regularly. A varied menu is provided with a choice of main meal at midday, including a vegetarian alternative. People choose their dessert from a sweet trolley after the midday meal. Three people said that they ‘always’ and ‘usually’ like the meals provided. Peoples comments about the food included ‘the food is always very good’, ‘lunch was good’ and ‘I enjoy the fish’. St Teresa`s Home for the Elderly DS0000019128.V349157.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure which is clearly written and accessible to people who use the service and their relatives and representatives. People are aware of how to make a complaint. Staff complete training in the protection of vulnerable adults. EVIDENCE: The complaints procedures is included in the Statement of Purpose and Service Users Guide. Ten questionnaires indicated that people are aware of how to make a complaint and that any issues have been dealt with appropriately. One person noted that they were not sure if they knew the complaints procedures, but this was not an issue. The manager reported that they have not received any complaints since the last inspection. We have not received any complaints. Appropriate policies are in place for the protection of vulnerable adults. Some staff have completed training and others are due to complete this training in the near future. St Teresa`s Home for the Elderly DS0000019128.V349157.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24 and 26 People who use the service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The home provides a physical environment that meets the specific needs of the people who live there. The well-maintained environment provides specialist aids and equipment to meet the needs of the people who use the service. There is a selection of communal areas, giving people the choice of where to meet with visitors. Most bedrooms are single, some bedrooms are shared. Some bedrooms have ensuite facilities and all bedrooms are personalised to the individuals taste. EVIDENCE: St Teresa’s has been developed over the years to meet the needs of the people using the service. There are two lounges, a dining room, a chapel, some bedrooms, a bathroom and toilet, laundry room and kitchen on the ground floor. Another lounge is on the first floor with more bedrooms, bathrooms and St Teresa`s Home for the Elderly DS0000019128.V349157.R01.S.doc Version 5.2 Page 17 toilets. Remaining bedrooms are on the second floor with a bathroom and toilet. Staff have a separate rest and changing area. Administrative staff have an office near the main entrance and the managers office is near the dining room, both are easily accessible by people who use the service and visitors. The environment is maintained to a good standard with an ongoing programme of redecoration and replacing furniture and furnishings when required. Bedrooms are furnished with a bed, wardrobe and chest of drawers. Some bedrooms have an ensuite toilet. Bedrooms were seen to have been personalised to peoples taste and some people have brought in items of furniture, pictures, ornaments and other personal belongings. People made positive comments about their rooms and how important it is for them to have their belongings around them. One person said that they had recently moved to a ‘better’ room and they were pleased. People who use the service have access to a garden with seating area when the weather is good. Individuals made positive comments about being able to use the garden and having a nice view over the garden from the lounges and some of the bedrooms. The environment could be improved for people who have dementia. Five people said that the home is ‘always’ with one person saying ‘usually’ fresh and clean. All areas of the home were seen to be clean and fresh. St Teresa`s Home for the Elderly DS0000019128.V349157.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service receive adequate quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People who use the service have confidence in the staff that care for them. Staff levels were seen to be sufficient to meet peoples needs. The service has a recruitment procedure, although some of the checks required were not completed for new staff. Staff have access to in-house training and the service makes good use of the local authorities training programme. EVIDENCE: The staff rota identified two nurses and four care assistants on duty during the morning with two nurses and three care assistants in the afternoon and one nurse and two care assistants at night. The manager and deputy are sometimes available in addition to these hours. Domestic, catering, maintenance and administrative staff are available in addition to these hours. The staffing levels were seen to be sufficient to meet peoples needs. People using the service, staff and visitors felt that there are enough staff at the home. Six people feel that the staff ‘always’ and two people said staff ‘usually’ have the right skills and experience. Six people said that staff listen and act on what they say. Two people said that staff are ‘always’ and four people said staff are ‘usually’ available when they are needed. Two people said that staff St Teresa`s Home for the Elderly DS0000019128.V349157.R01.S.doc Version 5.2 Page 19 sometimes take time to come when they are called. One person said that the night staff are not always as helpful. People who spend most of their time in their bedrooms said that they sometimes feel isolated. This was discussed with the manager and is an area the service hopes to improve over the next year, by enabling staff to spend more time with individuals. Staff files contained a copy of the application form, proof of the individuals identity and a copy of their contract of employment. Two written references were in place, although they were not always from the member of staffs last place of work. Two staff files contained confirmation that a clear enhanced Criminal Records Bureau (CRB) check had been completed. Two staff files did not contain evidence that a CRB check had been completed. For new staff, a POVA first and a CRB check must be completed before the person starts work. The manager reported that these checks have been requested but they were in the process of changing the agency who complete them, and had been unable to send forms due to the recent postal strikes. The manager confirmed that copies of previous CRB checks had been received from these staff as part of the checking system. Staff have access to in-house training and the local authorities training programme to help them develop and improve their skills. Records indicated that staff have completed training in infection control, first aid, record keeping, fire safety, managing incontinence, care of people with dementia and the protection of vulnerable adults. St Teresa`s Home for the Elderly DS0000019128.V349157.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People who use the service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The manager has the required skills and experience to run the home and demonstrated a commitment to improving the services provided with the involvement of people who use the service, their relatives and staff. Systems are in place to monitor the quality of service provided. Health and safety checks are completed at the required intervals. EVIDENCE: The manager has been in post for over two years and has previous experience as deputy manager. The manager has completed training to NVQ Level 4. Regular meetings are held with people who use the service to find out their opinion on the service. St Teresa`s Home for the Elderly DS0000019128.V349157.R01.S.doc Version 5.2 Page 21 An annual quality assurance questionnaire is sent to people using the service and is a part of the admissions pack. The results from the questionnaires is used to improve services provided. The most recent questionnaires included lots of positive comments about the home, the staff, the food and the services provided. The manager reported that they are looking into holding more frequent management and staff meetings, to improve communication and planning within the service. The home holds money for some people. The records are clear and detailed. Three balances were checked, up to date and correct. The balance for one persons money was not up to date, due to administrative staffs holiday. This was updated on our second visit. People using the service sign when they receive money from the home. It may be useful to get relatives to sign when they give money to administrative staff. Appropriate health and safety policies, procedures and practices are in place. Checks are carried out at the required intervals and records are well maintained and up to date. The electrical check had been completed although the certificate had not been received at the home, the manager reported that the electrical supply was due to be checked again so that a valid certificate was in place. The fire alarm is tested weekly with a daily check of the premises, particularly fire escape routes. St Teresa`s Home for the Elderly DS0000019128.V349157.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 St Teresa`s Home for the Elderly DS0000019128.V349157.R01.S.doc Version 5.2 Page 23 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 OP29 Regulation 18 (1) Timescale for action A POVA first and CRB check must 23/11/07 be completed before new staff start work, to protect people using the service from harm. Requirement 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. Refer to Standard OP19 OP30 OP27 OP35 Good Practice Recommendations Consideration should be given to making the environment better for people who have dementia. The provision of training in person centred care training should be considered. The staffing levels and staff deployment within the home should be kept under review. Consideration should be given to asking relatives to sign records when they leave money for the person using the service. St Teresa`s Home for the Elderly DS0000019128.V349157.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Teresa`s Home for the Elderly DS0000019128.V349157.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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