Inspection on 25/07/06 for Stonesby Lodge

This inspection was carried out on 25th July 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Stonesby Lodge 03/08/09

Stonesby Lodge 14/08/08

Stonesby Lodge 19/09/07

Stonesby Lodge 04/01/06

Stonesby Lodge 14/04/05

Stonesby Lodge 09/09/04

Stonesby Lodge 06/05/04

Similar services:

Trevayler Residential Care Home

Thornham Grove

Thistle Hill Hall

Conifer Lodge

Westwood Lodge

Egerton Lodge Care Home

Alfred Minto House Care Home

St Matthews Unit

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

CARE HOME ADULTS 18-65 Stonesby Lodge 109 Stonesby Avenue Leicester Leicestershire LE2 6TY Lead Inspector Ruth Wood Unannounced Inspection 25th July 2006 12:30 Stonesby Lodge DS0000006370.V304391.R01.S.doc Version 5.2 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 Stonesby Lodge DS0000006370.V304391.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 Adults 18-65. 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. Stonesby Lodge DS0000006370.V304391.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stonesby Lodge Address 109 Stonesby Avenue Leicester Leicestershire LE2 6TY 0116 2830128/2701744 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) gbonom@dmu.ac.uk Mr R Bonomaully Mrs S Bates Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (12) of places Stonesby Lodge DS0000006370.V304391.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No additional conditions of registration. Date of last inspection 4th January 2006 Brief Description of the Service: Stonesby Lodge provides a service for 12 people with mental health needs. The home, opened in 1989, is an extended detached house located on the edge of the Saffron Lodge estate. It has a large lounge-diner and a smaller lounge where staff and service users may smoke. The majority of residents rooms (7 single and 1 double) are located on the ground floor. There is one single and one double room located on the first floor. All rooms have wash hand basins and double rooms have appropriate screening. There are two bathrooms, one shower room and two additional toilets. The home has two internal courtyards, accessible to residents, which have recently been made more attractive with plants, paving and patio furniture. The home is situated on a main road, close to shops, churches, day services, the library and other amenities. There are regular bus services to Leicester and Wigston. Current fees at the home range between £287 and £310. Stonesby Lodge DS0000006370.V304391.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on a weekday starting at 12.30pm and lasting five and half hours. Discussion was held with the majority of the residents, including two of the three whose care needs were focused on in detail. These three residents’ assessments and care plans were examined and their care was also discussed with the registered manager and staff members. Other documentation such as staff records, fire records, menu and medication records were examined and a full tour of the home was made. The amount of preparation possible before making this visit was limited, as the Registered Provider Mr Bonomaully had not returned the pre-inspection questionnaire. Preparation was therefore confined to a review of the previous inspection reports and correspondence received from Mr Bonomaully since the last inspection. What the service does well: What has improved since the last inspection? One senior staff member has taken responsibility for planning and recording menus and ensuring that there is always a choice available for residents at lunch and tea. One resident commented, “If you get two good ones on Stonesby Lodge DS0000006370.V304391.R01.S.doc Version 5.2 Page 6 together it’s really difficult to choose”. Some improvements have been made to the home’s physical environment; the kitchen walls have been painted and new storage cupboards have been installed on the upstairs landing. 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. Stonesby Lodge DS0000006370.V304391.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Stonesby Lodge DS0000006370.V304391.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,4 Quality in this outcome area is good. Residents are given plenty of opportunity to get to know the home before moving in and their needs are competently assessed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three residents’ case files were examined; these all contained an assessment of need completed by the manager in consultation with the resident. Files also contained assessments and /or care plans from professionals such as social workers or community psychiatric nurses. Discussion with the manager, two staff members and two of the residents indicated that two of the assessments were generally an accurate reflection of residents’ actual needs. One resident was currently undergoing re-assessment as their needs had changed considerably in recent weeks. Arrangements for new residents entering the home were discussed with the manager. Since the last inspection in January, one resident came to live at the home for a short period and a new resident came to live at the home in March. Residents can visit for a few hours, a day or overnight to see if they feel comfortable in the home. This process also enables staff to ascertain if they are able to meet the resident’s needs. Stonesby Lodge DS0000006370.V304391.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. Residents’ needs are reflected in their plans and they can make choices as to how to spend their time. Some improvement is needed in how risk is managed and documented. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three residents’ care plans were examined. The detail of information contained within plans varied; information about one resident who had recently moved into the home was less detailed than that of another resident who has lived in the home a number of years and has more complex needs. One resident’s care plan was being updated due to changing needs in recent weeks. Staff displayed a good understanding of residents’ needs and discussion with two of the residents indicated that plans were generally an accurate reflection. Daily records for all residents were detailed and written in appropriate language; these form the basis of the handover which takes place at the end of each shift. Many of the residents are able to travel independently, and frequently leave the home for periods during the day. An existing resident had helped a new resident get to know the local bus routes when they first moved in. This Stonesby Lodge DS0000006370.V304391.R01.S.doc Version 5.2 Page 10 resident said that they appreciated being able to “come and go as I like” but said that they always told staff where they were going and what time they would be back. One resident who previously did not leave the home has now started to stay out for long periods. As this resident has some additional health needs there could be a risk to their safety. The manager outlined her assessment of the risk and the response that would be made if they did not return by a certain time. This information was not documented in the resident’s care plan and the two staff members on duty both gave a different interpretation of the response to the resident’s absence. It is therefore important that risks of this nature be clearly assessed and documented, together with any action to be taken by staff. All residents are able to manage their own finances and staff do not have any input in this. Certain restrictions on alcohol and cigarette consumption are in place for some residents but the reasons for these are clearly documented in care plans and these documents include residents’ signatures, indicating that they have agreed to these restrictions. Stonesby Lodge DS0000006370.V304391.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. Residents are able to access appropriate community, leisure and vocational activities and are well supported in maintaining their personal relationships. Residents receive good food, which they enjoy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents are engaged in a variety of daytime activities; some formal such as attendance at specialist day care/ drop in centres and college courses others less formal such as visiting the library, local museums or going shopping. Some residents enjoy playing board and card games either with staff or each other and two residents regularly go out for a walk together. One residents’ family was visiting during the inspection and said that they were always made to feel welcome in the home. One resident said that they visited their daughter regularly and that she also came to the home to visit and joined her for such celebrations as Christmas dinner. Another resident said that they visited their mother regularly. Stonesby Lodge DS0000006370.V304391.R01.S.doc Version 5.2 Page 12 The majority of residents were very enthusiastic about the food. A senior staff member has recently taken responsibility for preparing menus and all residents are offered a choice of two alternatives for lunch and tea (when the main meal of the day is served.) One resident commented “If you get two good ones on together it’s really difficult to choose” On the day of the inspection tea was either grill steaks or meat pie with broccoli, broad beans and potatoes followed by home made apple strudel or yoghurt. One resident commented that their favourite was the homemade shepherd’s pie. Menu records showed that a good selection of ‘traditional English’ homemade food was served which included plenty of fresh vegetables, homemade puddings and cakes. This would seem to suit the age and culture of the residents currently living in the home. Stonesby Lodge DS0000006370.V304391.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. Residents receive appropriate levels of personal support, their healthcare needs are well met and medication is stored and administered appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information about residents’ personal support needs is outlined in care plans and discussion with residents and the manager indicated that this information was accurate. Residents require varying levels of assistance, including support with such areas as nail and hair care, again depending on their level of independence in this area. Residents enjoy good access to a full range of health care professionals including chiropodists, opticians and dentists. The majority also have regular contact with their consultant psychiatrist at a local outreach clinic. One resident said that they had been for a hospital check up for their diabetes with the manager that morning. They also stated that staff checked their blood sugar levels twice per day and gave them support in sticking with their diet and managing their diabetes. The manager confirmed that she had accompanied the resident to this appointment and said that she liked to ensure residents had support for such appointments, usually attending herself to ensure consistency. Stonesby Lodge DS0000006370.V304391.R01.S.doc Version 5.2 Page 14 Medication is stored appropriately and securely and there was no evidence of excessive storage. Records of medication received were examined together with the medication administration record, which was fully completed. Staff are currently experiencing some difficulty in managing one resident’s medication. The resident is observed to take their medication but retains some of the tablets in their mouth until not observed when they place them in their pocket. All tablets found are being kept in a separate medicine bottle but it is difficult to clearly identify them as they are often partially dissolved. All instances of this are recorded, in full, in the residents’ daily notes. It is recommended that the registered manager contact the pharmacist to enquire how this should be recorded on the medication administration record. The manager has arranged a full care review for this resident next month. Some residents are prescribed medication to be taken ‘as required’. This is administered on the assessment of the staff member and/or resident as to whether they need this medication. The registered manager was able to outline the circumstances when residents should take their medication but these protocols are not clearly documented. Documentation must be put in place to ensure consistency in administration of this medication. All residents’ medication is reviewed by their consultant psychiatrist every 3 to 6 months or their general practitioner every 12 months. The district nurse monitors residents’ blood medication levels on a regular basis. Stonesby Lodge DS0000006370.V304391.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. Residents’ views are listened to and practice within the home generally protects them from abuse, however some improvement is required in staff recruitment practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents were observed to have a very open relationship with the manager and staff and the majority said that if they were unhappy with anything in the home they would tell either the manager or “the boss” – meaning the provider Mr Bonomaully. One resident however said that if they weren’t happy they would leave the home. A copy of the complaints procedure is displayed on the residents’ notice board in the lounge. All residents were also aware of who the inspector was and the reason for their visit. There are policies in the home on how to deal with challenging behaviour and staff said that they felt well supported by the manager in this aspect of their work. The five staff that have undertaken their National Vocational Qualifications have studied such issues as abuse as part of this. The Registered Manager seemed a little unclear as to the current guidance relating to Criminal Records Bureau (CRB) checks and had recently appointed a member of staff prior to identifying whether this person appeared on the protection of vulnerable adults register (POVA). This staff member is currently on sickness leave and is not due to return to the home until late August. The manager stated that she had applied for a POVA and an enhanced criminal records bureau check. She was reminded that no staff member should start work at the home until these checks had been completed to ensure that the person concerned had not been identified as posing a risk to vulnerable adults. Stonesby Lodge DS0000006370.V304391.R01.S.doc Version 5.2 Page 16 It is recommended that the manager obtain and read the Department of Health ‘s current guidance in this area. Stonesby Lodge DS0000006370.V304391.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is adequate. The home is clean and there are no obvious risks to health and safety but several areas are in poor repair and decoration. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A full tour of the home was made with the registered manager, which included all residents’ bedrooms. Several repairs were identified, including broken tiles in one resident’s bedroom, an expelair fan not working in the laundry, several rotten window frames and some rooms that urgently required re-decoration and their worn/stained carpets to be replaced. The home has never fully met all national minimum environmental standards, although standards have improved by a process of the inspector identifying specific shortfalls, making requirements and the provider eventually meeting these. It was clear from discussion with the manager that there is still no system by which repairs and the need for re-decoration is identified, reported to the provider and then logged when completed. The registered provider and manager must put in place a system for ensuring that the physical environment of the building is improved and that the improvement is maintained. The home has a cleaner who visits the home on a daily basis (except Sundays); the home was clean, tidy and fresh smelling. Stonesby Lodge DS0000006370.V304391.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 Quality in this outcome area is good. Residents are well supported by sufficient numbers of staff who could benefit from additional training in some areas. Recruitment practices are generally good but guidance on pre-employment checks must be followed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff were observed to have an open and friendly relationship with residents and residents spoke positively about the support they received from staff members. Two members of staff are on duty during the day and there is one waking night staff member. Many staff members, including the registered manager, live locally and are able to come in to the home at short notice should they be required. Staff demonstrated a good understanding of residents’ individual needs and five out of the eight staff members have obtained a level two National Vocational Qualification in care. Staff members appeared to have less knowledge concerning general aspects of mental health care or recent developments in this area. Since the previous inspection (in January) no staff members have attended training in any area and there does not seem to be a culture of developing and/or improving practice by regularly accessing training. Only one new staff member has been appointed since staff records were last examined. The records for this staff member included a completed application form, an interview assessment form and two written references. A check on Stonesby Lodge DS0000006370.V304391.R01.S.doc Version 5.2 Page 19 the Protection of Vulnerable Adults register and a Criminal Records Bureau check were not completed prior to the staff member starting work. These have now been applied for and the staff member is currently on extended sickness leave and therefore not working in the home at this time. (Please see Standard 23 for further details) Stonesby Lodge DS0000006370.V304391.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. The health and safety of residents is promoted but a systematic quality monitoring system should be developed to ensure standards in all areas are continually monitored and improved. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager has still not started her Registered Manager’s Award (RMA) but is hoping to do so in September. She has several years’ experience of working with adults with mental health needs and staff said that they felt well supported by her in their work. One resident also commented, “Sue runs things well here.” There is no system of quality assurance in the home and no formal method of consulting with residents, their families and other interested parties (such as doctors and social workers). This must be developed to ensure that standards within the home are monitored and the quality of service maintained and improved. Stonesby Lodge DS0000006370.V304391.R01.S.doc Version 5.2 Page 21 The fire officer visited the home on 23rd May 2006 and the manager stated that he assessed the home as ‘low risk’ and made no recommendations for improvements. No documentary evidence was available of his visit, although it was recorded in the home’s visitor’s book. Documentary evidence that the fire system and extinguishers had been serviced in December 2005, was forwarded to the Commission after the last inspection together with evidence that all portable electrical appliances had been tested. Fire records showed that emergency lighting and fire systems are tested on a regular basis and that the last fire drill was held on 31st May 2006 when all staff and residents evacuated the building. Three staff members hold certificates in first aid but not all staff responsible for preparing food hold certificates in food hygiene; training should be made available for these staff members as a priority. Stonesby Lodge DS0000006370.V304391.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 Adults 18-65 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 X 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 1 X X 2 X Stonesby Lodge DS0000006370.V304391.R01.S.doc Version 5.2 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 YA20 Regulation 13 Requirement Information about when certain residents should take ‘as required’ medication must be clearly documented to ensure consistency in administration. The registered manager and provider must ensure that no staff member starts work in the home unless their name has been checked against the Vulnerable Adults Register and they have obtained an enhanced Criminal Records Bureau check. The registered manager and provider must implement a system to ensure that repairs are identified and undertaken promptly to ensure residents’ safety and comfort. Timescale for action 04/08/06 2 YA23 19 25/07/06 3 YA24 23 14/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Stonesby Lodge DS0000006370.V304391.R01.S.doc Version 5.2 Page 24 1 2 3 4 5 YA9 YA23 YA24 YA24 YA24 6 YA35 7 YA39 8 YA42 The risk assessment for the identified resident must be clearly documented together with any action to be taken by staff in response to their continued absence. The registered manager should obtain and read the Department of Health’s current guidance relating to the Protection of Vulnerable Adults. The various repairs identified by the manager during the tour of the home must be undertaken to ensure the comfort and safety of residents. The rooms identified by the manager during the tour of the home should be redecorated and those carpets identified as needing replacement should be replaced. A system should be implemented to monitor when areas of the building need redecoration and when items of furniture, curtains or floor coverings need replacing. It is suggested that residents be actively involved in this process. Staff members should have access to training which develops their understanding of mental health to ensure that they continue to meet all present and future residents’ needs effectively. A method of measuring and ensuring quality in the home must be implemented to ensure that standards are maintained and improved. This system should include regular and ongoing consultation with residents, their relatives and other interested parties such as social workers and doctors. All staff members who prepare food must receive training in food hygiene to ensure that the health and safety of residents is protected. Stonesby Lodge DS0000006370.V304391.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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 Stonesby Lodge DS0000006370.V304391.R01.S.doc Version 5.2 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. 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. 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