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Inspection on 04/07/05 for Stamford Nursing Centre

Also see our care home review for Stamford Nursing Centre for more information

This inspection was carried out on 4th July 2005.

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

The home was clean and well furnished. All bedrooms had ensuite facilities.The gardens were attractive and seating was provided.The statutory records such as resident`s case records, staff records and maintenance records were up to date and information was kept in an orderly manner. Staff interviewed were noted to be well mannered, alert and knowledgeable regarding their roles and responsibilities. Staff caring for those with dementia had completed the relevant mental health training. Arrangements were in place to ensure that the healthcare needs of residents are attended to. Monitoring charts for pressure area care had been introduced. The home had purchased hip protectors for residents who were at risk of falls. The home had a low incidence of fractures. Residents who were interviewed stated that they were satisfied with the quality of meals provided. The home had a comprehensive programme of social activities and the activities organiser had records of activities provided for residents. Frequent outings were organised for residents. One of the activities organisers had completed training organised by the Alzheimer`s disease society. Staff reported that the manager was supportive and expressed confidence in her.

What has improved since the last inspection?

Care plans were comprehensive and contained information to ensure that the needs of residents can be met. This include the care plans of those with dementia. The home had air conditioning in treatment rooms where medication was stored.

What the care home could do better:

The arrangements for the administration of medication are in need of improvements. Deficiencies were noted in the recording and ordering of medication by the CSCI pharmacy advisor and requirements have been made for these to be rectified.The registered person must also ensure that nursing staff update their training in the care of residents with diabetes. Some improvements in the area of health and safety are also required. The registered person must ensure that the brush and pan are either stored away from the food preparation area or in a closed cupboard and call bell cords are within the reach of someone who may have fallen to the ground.

CARE HOMES FOR OLDER PEOPLE STAMFORD NURSING CENTRE 21 Watermill Lane Edmonton London N18 1SU Lead Inspector Daniel Lim Announced 4 & 5 July 2005 @ 09.30 am 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 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. STAMFORD NURSING CENTRE G59 S27823 Stamford Nursing Centre V230722 04.07.05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Stamford Nursing Centre Address 21 Watermill Lane, Edmonton. London N18 1SU Telephone number Fax number Email 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 8807 4111 020 8807 9479 William Daly for ANS Homes Ltd Christina Walsh N Care Home with Nursing 90 beds Category(ies) of PD Physical Disabilities (14 beds) registration, with number OP Old Age (43 beds) of places DE Dementia (33 beds) STAMFORD NURSING CENTRE G59 S27823 Stamford Nursing Centre V230722 04.07.05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home will provide accommodation for up to 90 service users of either gender. 2. 43 of the 90 service users will be over 65 years of age and require nursing care. 3. To provide nursing care to 14 service users aged between 21 and 65 years of either gender. Care for these service users is to be provided in a `Young Adult Physically Disabled Unit` situated on the first floor of the home. The unit must have a team of staff specifically dedicated to it and this must be indicated on staff files and duty rosters. 4. Care for these service users is to be provided in a `Young Adult Physically Disabled Unit` situated on the first floor of the home. The unit must have a team of staff specifically dedicated to it and this must be indicated on staff files and duty rosters. Specifically to provide for 33 service users of either gender aged over 50 years of age. The unit being sited on the second floor of the existing building. The unit must have a team of staff specifically dedicated to it and this must be indicated on staff files and duty rostas. 5. Two named individuals whose dates of birth are 20/04/1949 and 09/01/1944 and who are therefore under 65 years of age, at the time of issue of this certificate, are to permitted to remain in this home. They may occupy two of the 43 beds in the elderly nursing unit. Date of last inspection 8 December 2004 Brief Description of the Service: Stamford Nursing Centre is a care home registered to provides nursing care for older adults and a specified number of younger adults with physical disabilities. The home is owned by ANS Homes Limited. The organisation owns and run other similar care homes across the UK. The home aims to provide a high quality of nursing care to adults convalescing after surgery or illness, older people who require nursing care, adults aged over fifty with physical disabilities and those requiring palliative care. The home is a large modern purpose built three storey building. The kitchen, laundry, reception and administrative offices are all located on the ground floor. The bedrooms are located on all three floors and all of them have ensuite facilities. Floors are connected by stairways and a passenger lift. Each floor has a lounge and separate dining room. There are two additional smaller lounges. Smokers use one of these lounges. Fourteen younger adults are accommodated in a separate wing on the first floor. The home is located close to the North Middlesex Hospital and along the North Circular Road. It is within walking distance of shops, restaurants and transport facilities located the High Street in Edmonton. STAMFORD NURSING CENTRE G59 S27823 Stamford Nursing Centre V230722 04.07.05 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on 4 & 5 July 2005 and took a total of 10 hours to complete. The inspector found that most of the National Minimum Standards had been met and the overall quality of care provided was of a high standard. During this inspection, the inspector was accompanied by the manager of the home (Mrs Christina Walsh). The inspector was able to interview seven residents. The feedback received from them was positive. Completed questionnaires were also received from thirty-two residents, two relatives and a social services staff. These indicated that residents were well cared for. Statutory records including six residents’ case records, the maintenance records and financial records of the home were examined. The premises including the bedrooms, laundry, kitchen, gardens and communal areas were inspected. Staff on duty were interviewed on a range of topics associated with their work and staff records (including supervision and training records) were examined. In addition, the minutes of staff meetings and residents / relatives meeting were also examined. What the service does well: The home was clean and well furnished. All bedrooms had ensuite facilities.The gardens were attractive and seating was provided. STAMFORD NURSING CENTRE G59 S27823 Stamford Nursing Centre V230722 04.07.05 Stage 4.doc Version 1.30 Page 6 The statutory records such as resident’s case records, staff records and maintenance records were up to date and information was kept in an orderly manner. Staff interviewed were noted to be well mannered, alert and knowledgeable regarding their roles and responsibilities. Staff caring for those with dementia had completed the relevant mental health training. Arrangements were in place to ensure that the healthcare needs of residents are attended to. Monitoring charts for pressure area care had been introduced. The home had purchased hip protectors for residents who were at risk of falls. The home had a low incidence of fractures. Residents who were interviewed stated that they were satisfied with the quality of meals provided. The home had a comprehensive programme of social activities and the activities organiser had records of activities provided for residents. Frequent outings were organised for residents. One of the activities organisers had completed training organised by the Alzheimer’s disease society. Staff reported that the manager was supportive and expressed confidence in her. What has improved since the last inspection? What they could do better: The arrangements for the administration of medication are in need of improvements. Deficiencies were noted in the recording and ordering of medication by the CSCI pharmacy advisor and requirements have been made for these to be rectified. STAMFORD NURSING CENTRE G59 S27823 Stamford Nursing Centre V230722 04.07.05 Stage 4.doc Version 1.30 Page 7 The registered person must also ensure that nursing staff update their training in the care of residents with diabetes. Some improvements in the area of health and safety are also required. The registered person must ensure that the brush and pan are either stored away from the food preparation area or in a closed cupboard and call bell cords are within the reach of someone who may have fallen to the ground. 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. STAMFORD NURSING CENTRE G59 S27823 Stamford Nursing Centre V230722 04.07.05 Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection STAMFORD NURSING CENTRE G59 S27823 Stamford Nursing Centre V230722 04.07.05 Stage 4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3, 4, 6 The manager and her staff had a good understanding of the needs of residents and were able to ensure that their needs are met. EVIDENCE: Seven residents who were interviewed indicated that that their care needs had been met at the home and they were satisfied with the care and services provided. Comments made included, “excellent service”, “nice staff” and “well cared for by staff”. Completed questionnaires received from residents and relatives indicated that the respondents were satisfied with the care provided at the home and the needs of residents had been met. This was also confirmed in the minutes of care reviews examined by the inspector. A sample of six residents’ case records which were examined contained comprehensive plans of care and details of how residents needs had been met. The inspector observed that residents in the home were clean, appropriately dressed and appeared well cared for. STAMFORD NURSING CENTRE G59 S27823 Stamford Nursing Centre V230722 04.07.05 Stage 4.doc Version 1.30 Page 10 STAMFORD NURSING CENTRE G59 S27823 Stamford Nursing Centre V230722 04.07.05 Stage 4.doc Version 1.30 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10 Residents had been treated with respect and arrangements were in place to ensure that the healthcare, personal, cultural and social needs of residents are attended to. Some improvements are however, needed in the administration of medication. EVIDENCE: Feedback from the seven residents interviewed, indicated that their healthcare needs had been met. Comments made included, “can see the doctor when I want to” and “my healthcare needs attended to”. The sample of six case records examined were up to date and plans of care had been reviewed monthly. These had been signed by residents or their representatives. Records of medical and healthcare treatment were documented. Staff interviewed were knowledgeable regarding the care to be provided to residents. STAMFORD NURSING CENTRE G59 S27823 Stamford Nursing Centre V230722 04.07.05 Stage 4.doc Version 1.30 Page 12 The CSCI pharmaceutical advisor who inspected the arrangements for the handling and administration of medication made the following comments: 1. The medication policy was comprehensive. 2. The records for the receipt, administration and disposal of medication were satisfactory. The medication profiles were generally up to date. 3. The dose of insulin for one resident had been entered on the administration chart by staff but this had not been signed by the GP. 4. On the ground floor a resident’s medication container was not available but she had been given lactulose at the morning medicines round. This indicated that she had been given it from another resident’s bottle. 5. Some twenty items of medication had not been received from the pharmacy. This resulted in residents concerned not being given their morning medication. Staff said they had contacted the pharmacist who stated that they had been dispatched on the morning of 4th July. However, they had not been received by 1.15pm. Staff stated that this had not happened to this extent previously. The medication was received later that afternoon. 6. Senior nursing staff had received training in specialised clinical procedures and there were policies to cover these specialised areas. 7. The temperatures of the clinical rooms were monitored and air conditioning was provided. The temperatures were below 25oC. The temperatures of the fridges were maintained between 2-8oC. 8. PEG feeds were stored in a separate storeroom and also in residents’ bedrooms. The temperature of the storeroom was monitored and had at times exceeded 25oC. 9. The storage and recording of Controlled Drugs was examined. It was noted that the stock recorded for liquid preparations was not checked but was arrived at by deducting the quantity of medication given. As a result, in some cases there may be a little more than indicated in the Controlled Drug Register. Requirements have been made in this report for the identified deficiencies to be rectified. STAMFORD NURSING CENTRE G59 S27823 Stamford Nursing Centre V230722 04.07.05 Stage 4.doc Version 1.30 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 The daily life and routines of residents were well organised and they were able to exercise choice and control over their lives. The feedback received from residents indicated that they were happy with the activities provided and the meals served. EVIDENCE: The inspector met one of the home’s activities’ organisers and saw the home’s programme of weekly social and therapeutic activities. The programme was varied and comprehensive. Residents who were interviewed indicated that they were satisfied with the activities provided and considered them appropriate. The case records examined contained social care plans and details of activities that residents had engaged in. The inspector was also able to view plants and flowers which were grown by residents. These were attractive. A volunteer from a local church was STAMFORD NURSING CENTRE G59 S27823 Stamford Nursing Centre V230722 04.07.05 Stage 4.doc Version 1.30 Page 14 conducting a music session during the morning and the inspector noted that residents were enjoying the session. Residents who were interviewed stated that they had been visited by their families and friends. There was also documented evidence of consultation meetings with residents. The manager was able to provide examples of how residents could exercise choice and control in their lives (such as choice of meals, daily routine and items to have in bedrooms). Evidence that residents had been provided with choice of meals was noted in the home’s menu. The bedrooms inspected had been personalised by residents with their personal items such as photos and souvenirs. The kitchen and arrangements for the provision of meals were examined. With one exception, these were satisfactory. The inspector noted that the brush and pan were kept in the kitchen. For hygiene reasons these must be stored away from the food preparation area or in a closed cupboard. STAMFORD NURSING CENTRE G59 S27823 Stamford Nursing Centre V230722 04.07.05 Stage 4.doc Version 1.30 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17, 18 There was evidence that the rights of residents are protected and complaints are taken seriously. This protects residents from abuse and ensures that any complaints they have are listened to and acted upon. EVIDENCE: The complaints record was examined. There was documented evidence that complaints recorded had been promptly responded to. Staff who were interviewed were found to be knowledgeable regarding adult protection procedures. The staff records examined indicated that staff had been provided with training in adult protection. Seven residents who were interviewed stated that they had been well treated. Comments made about staff included, “nice staff”, “helpful”, “kind” and “caring” . STAMFORD NURSING CENTRE G59 S27823 Stamford Nursing Centre V230722 04.07.05 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,23,24,25,26 The home was clean and maintained to a high standard, therefore providing a pleasant environment to live in. EVIDENCE: The premises were inspected and found to be clean and well furnished. The maintenance person who was interviewed stated that repairs had been promptly carried out and there were no major maintenance problems. The treatment rooms where medication was stored had been provided with air conditioning. The hot water in bedrooms was tested and found to be within the required safe temperature range of no higher than 43 C. The gardens were attractive and seating had been provided. STAMFORD NURSING CENTRE G59 S27823 Stamford Nursing Centre V230722 04.07.05 Stage 4.doc Version 1.30 Page 17 The communal areas were well furnished and appeared cosy. Fresh flowers were provided on tables in the dining rooms. The required maintenance records and safety certificates were seen by the inspector. These included safety inspection certificates for the lifts, hoists, assisted baths, gas installations and records of portable appliances testing (the electrical installations are not due to be tested until October 2005 as the home is newly built). The laundry was inspected and staff interviewed were aware of the need to wash soiled and infected laundry at a temperature of at least 68C for at least 10 minutes. Linen and clothes which had been washed were examined. These were found to be clean and neatly folded. STAMFORD NURSING CENTRE G59 S27823 Stamford Nursing Centre V230722 04.07.05 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29, 30 The recruitment process in place ensures that residents’ needs are met by an appropriate group of staff. Further updates for staff in the care of residents with diabetes is needed. EVIDENCE: Staff who were on duty were interviewed on a range of topics associated with their work. They were noted to be knowledgeable regarding their roles and responsibilities. Residents who were interviewed stated that staff were professional in their approach and respectful towards them. One relative stated that the staffing levels were inadequate (particularly at weekends). This was discussed with the manager and her staff. The staff rota and staffing arrangements were examined in detail. In addition, accident records and the complaints book were examined. At this inspection the inspector did not find any evidence to indicate that the staffing levels were inadequate. The training records examined, indicated that staff had been provided with most of the essential training required. Staff caring for residents with dementia had received training in dementia and mental health. However, some nursing STAMFORD NURSING CENTRE G59 S27823 Stamford Nursing Centre V230722 04.07.05 Stage 4.doc Version 1.30 Page 19 staff had not received training updates on the care of residents’ with diabetes. This is required to ensure that staff are updated in this area. STAMFORD NURSING CENTRE G59 S27823 Stamford Nursing Centre V230722 04.07.05 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 35, 36, 38 Systems were in place to ensure that the rights and interests of residents are safeguarded. With one exception, health and safety arrangements were satisfactory. EVIDENCE: When interviewed on a range of topics associated with the care of residents and staff management, the manager was found to be knowledgeable. Residents and staff interviewed expressed confidence in their managers and stated that they were fair and approachable. A formal system of quality assurance and monitoring had been implemented. STAMFORD NURSING CENTRE G59 S27823 Stamford Nursing Centre V230722 04.07.05 Stage 4.doc Version 1.30 Page 21 The financial records of three residents whose money were kept by the home were examined. They were well maintained and receipts had been obtained for transactions made. The fire logbook examined indicated that fire drills and weekly checks of the fire alarm had been carried out. Fire training had been arranged for staff. When questioned, staff were knowledgeable regarding the fire procedures. There was evidence in the minutes of meetings examined to indicate that residents and their representatives had been consulted regarding the management of the home. Residents who were interviewed said that suggestions made by them had been responded to. The inspector noted that some call bell cords in residents’ bathrooms had been knotted and were out of reach of someone who may have fallen. This was discussed with the manager. For safety reasons, call bell cords must be within the reach of someone who may have fallen to the ground. STAMFORD NURSING CENTRE G59 S27823 Stamford Nursing Centre V230722 04.07.05 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 4 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 3 4 3 x 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 x 3 x 3 3 x 2 STAMFORD NURSING CENTRE G59 S27823 Stamford Nursing Centre V230722 04.07.05 Stage 4.doc Version 1.30 Page 23 no 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 9 Regulation 13(2) Requirement The registered person must ensure that medication such as lactulose is only administered to the resident concerned from the residents own labelled container. The registered person must ensure that there are clear, signed instructions by the GP for any medication that is labelled ‘to be administered as directed by the GP’. The registered person must ensure that the temperature in the room where the PEG feeds are stored is kept below 25 C. The registered person must ensure that medication is obtained in time so that they can be checked and administered promptly to residents requiring them. The registered person must ensure that the brush and pan are either stored away from the food preparation area or in a closed cupboard. The registered person must Timescale for action 13/8/05 2. 9 13(2) 13/8/05 3. 9 13(2) 13/8/05 4. 9 13(2) 13/8/05 5. 15 16(2)(g) 13/8/05 6. 30 18(1) 3/10/05 Page 24 STAMFORD NURSING CENTRE G59 S27823 Stamford Nursing Centre V230722 04.07.05 Stage 4.doc Version 1.30 7. 38 12(1)(a) ensure that nursing staff update their training in the care of residents with diabetes. The registered person must ensure that call bell cords are within the reach of someone who may have fallen to the ground. 13/8/05 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 Good Practice Recommendations STAMFORD NURSING CENTRE G59 S27823 Stamford Nursing Centre V230722 04.07.05 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Solar House, 1st Floor, 282 Chase Road, Southgate, London, N14 6HA 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 STAMFORD NURSING CENTRE G59 S27823 Stamford Nursing Centre V230722 04.07.05 Stage 4.doc Version 1.30 Page 26 - 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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