Inspection on 11/10/06 for Sunningdale Lodge

This inspection was carried out on 11th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Sunningdale Lodge 29/10/09

Sunningdale Lodge 11/11/08

Sunningdale Lodge 07/11/07

Sunningdale Lodge 23/01/06

Sunningdale Lodge 26/07/05

Sunningdale Lodge 08/03/05

Sunningdale Lodge 30/07/04

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

CARE HOMES FOR OLDER PEOPLE Sunningdale Lodge Dene Road Hexham Northumberland NE46 1HW Lead Inspector Aileen Beatty Key Unannounced Inspection 09:30 11 October & 6th November 2006 th 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 DS0000040471.V290643.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. DS0000040471.V290643.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sunningdale Lodge Address Dene Road Hexham Northumberland NE46 1HW 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) 01434 603357 01434 608865 sunningdalelodge@schealthcare.co.uk Southern Cross Home Properties Limited Mrs Elin Winter Care Home 50 Category(ies) of Dementia - over 65 years of age (50) registration, with number of places DS0000040471.V290643.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named resident is known to be under 65 years of age. No further admissions of residents under 65 years are to take place without the prior agreement of the CSCI. 23rd January 2006 Date of last inspection Brief Description of the Service: Sunningdale Lodge is a 50-bedded care home, which provides care including nursing for elderly people with dementia. The home is located on the outskirts of Hexham, next to another residential care home, also owned by the Southern Cross Group. The home is purpose-built with accommodation is on three floors. The lower ground level provides catering and laundry facilities. There is a large attractively landscaped rear garden, with seating. Fees range from £383 to £400.78 (council) and £478 private. DS0000040471.V290643.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over two days, starting on xxxx and ending on 06/11/06. The inspection involved a tour of the premises, discussions with staff residents and visitors and a review of records. The inspector ate lunch with residents. The inspection found that the overall standard of care is satisfactory. What the service does well: What has improved since the last inspection? What they could do better: Many ladies wear socks with dresses or no tights or socks at all. This must be addressed to make sure dignity is preserved and they wear what they normally would prefer to. Staff must not stand up when feeding residents. Training is required in person centred care. DS0000040471.V290643.R01.S.doc Version 5.2 Page 6 Malodour in a minority of rooms must be addressed. There is a noticeable urine odour in the ground floor foyer. Social care plans and care plans to help staff care for people with dementia need to be further developed and more detailed. 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. DS0000040471.V290643.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 DS0000040471.V290643.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Intermediate care is not provided so standard 6 was not assessed. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents needs are assessed before they move into the home, to ensure the home is an appropriate place which provides the care that they need. EVIDENCE: Care records for the most recently admitted residents were read. They found that a full assessment was carried out before they moved into the home. A pre admission assessment is carried out by the home manager, and a comprehensive assessment is provided from social services. This information helps the home to decide that they are able to provide the correct level of care to the person. DS0000040471.V290643.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Service users health, personal and social needs are usually set out in an individual plan of care. Service user health needs are fully met. Medication policies and procedures are generally satisfactory. Service users are not always treated with respect. Their right to privacy is upheld. EVIDENCE: The care records of four residents were read. The standard of care records is generally good. The records checked found admission information, past history, physical assessments of nutritional needs, continence, falls and pressure sore risk, dependency levels, psychological and social needs. DS0000040471.V290643.R01.S.doc Version 5.2 Page 10 Information from these assessments is used to write care plans, which describe to staff how the resident must be cared for. Care plans relating to physical care are generally very good, assessments are carried out regularly and there is a clear link between assessments and care plans. Moving and handling care plans include the size of sling to be used, which is good. Where residents are assessed as being at high risk of developing a pressure sore (bed sore), a preventative plan is in place. One resident was sitting in the lounge with socks on which were very tight round the top as she has very oedematous (swollen) legs. Staff are aware she has oedema and changed the socks when it was pointed out to them. It was surprising that no one had noticed this beforehand, as there were a number of staff present at the time. The Residents individual GP visits when requested. The GP may also access other services on their behalf such as occupational therapist, dietician, dentist, and physiotherapist. The optician visits at least six monthly but will call in between if necessary. A chiropodist also visits when required. Some social care plans are good with detailed past history information about the person’s interests, previous jobs, family etc. One social care plan includes handwritten song lyrics provided by the family for staff to use as a prompt for singing with one resident. Not all social care plans are this detailed. Some need to be further developed to contain as much detail as possible. The home manager now attends a regular focus group, which looks at best practice in dementia care. A number of new developments resulting from these groups are planned, especially in relation to activity planning. There are a number of new staff in the home, and some require training to make sure they speak appropriately to residents. On both days of the inspection, some staff were found to treat residents like children at times. This included leading them around by the hand, and saying things like “good girl” and “clever boy” and “don’t do that”. While this may be well intended, training in person centred care would help staff to identify this as poor practice. Some staff were also observed to “tidy up” residents including putting shoes back on or rearranging clothing without speaking to them or explaining what they were going to do. Some staff are more experienced and there were numerous examples of staff responding appropriately to residents and reassuring and comforting them. Some staff demonstrate a good knowledge of individual residents preferences and were heard asking if they would like to listen to the radio and were aware which channel they would prefer. Medication procedures in the home have improved. There were no gaps found in medication records and the trolley and fridge were tidy with no supplies of medicine belonging to people who have left. The fridge temperatures are taken DS0000040471.V290643.R01.S.doc Version 5.2 Page 11 regularly. Some supplies were in the cupboard awaiting return to pharmacy. Not all staff are aware of the returns policy and all staff administering medicines must be made aware of the procedures for the disposal and return of medicines. Residents are generally clean and tidy in appearance. Badly marked clothing is changed, and staff provide residents with aprons at mealtimes to help prevent clothing becoming badly marked. Staff must remember not to just walk up to residents and place the apron over their head. This happened a number of times. Staff must be reminded to explain everything they are doing, as residents will not be familiar with the routine because of their short-term memory problems. The purpose of the aprons is to preserve dignity, but these must be offered and put on discreetly. An unusually high number of residents did not have tights on, and most ladies were wearing socks with dresses and skirts or no tights or socks at all. A high number of men were not wearing socks and many had no shoes or slippers on. Staff explained, “They take them off”. Staff must make sure that residents are encouraged to wear appropriate footwear for safety and comfort. Ladies must have their own supplies of tights if they would prefer this, and their personal preferences must be recorded in care plans. Staff were seen to preserve the dignity of residents in other ways such as helping with personal care in private, and knocking before entering rooms. DS0000040471.V290643.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The activities the home meets the social cultural religious and recreational needs of most residents. Service users maintain contact with family and friends if they wish. Service users are not always encouraged to exercise choice and control over their lives. Meals are wholesome and nutritious, but not served in a satisfactory way with all the required equipment. EVIDENCE: A new activities coordinator has been appointed since the last inspection. They are inexperienced but very enthusiastic and keen to develop in this role. Some good ideas for activities were described. There are photographs of various activities that have taken place displayed at the front entrance. These include sweet making afternoon, which was very successful. DS0000040471.V290643.R01.S.doc Version 5.2 Page 13 There were no organised activities taking place on either day of the inspection. There are visits to church 4 – 6 weekly, and a priest visits the home weekly. Entertainers are brought into the home on a regular basis. The home has access to a shared mini bus. The manager described plans to improve activity planning and social care planning, and this is one of the areas being looked at in the dementia forum. There should be a clear link between assessed social needs and the individual care plan, and activities planned to meet the needs of that individual. This is very clear in physical care plans but less clear in social and psychological care plans. This needs to be developed further. Some care plans examined contain a lot of information about past interests and life and others have very little. The manager said that this is an area being further developed. Visitors are able to visit the home at any reasonable time. They are offered refreshments and may visit in private. One resident attends a local luncheon club, and befrienders arranged by social services visit two residents twice a week. Residents are not always encouraged to make choices for themselves. Some staff ask people what they would like to do, where they would like to sit, eat, drink, etc. Other staff direct the residents and do not actively encourage them to make choices form themselves. This links to previous standard where some staff tend to be very parental in their caring style, to the degree of even telling the person off. This is an unacceptable style and must be addressed through staff training and supervision. It must be emphasised that this relates to a very small number of staff and is an indication of inexperience and not meant unkindly. It is important for people with dementia to be able to “engage” with their surroundings this includes visual stimulation and opportunities to pick up objects of interest. Research has shown that items need to be at quite close range for people to be aware of them. It is recommended that while considering planned activities, the home also thinks about what opportunities residents have to explore the environment on their own. Staff training should also include an awareness of this need. One resident was apparently “disengaged” for most of the two-hour period (staring into space or asleep), they then sat up at the dinner table and picked up and began to examine a placement, turning it over and looking at the front and back with interest. This was taken from him and put back in the right place by a member of staff. Again, this demonstrated a lack of awareness of the importance of that act. This example highlights that choice and control is often taken away by staff who may not even be aware they are doing it. In contrast, another resident was very much enjoying holding a soft toy, which they spoke to a stroked constantly. Staff also offered choices of meals and drinks to some people. The manager described ways that they are trying to make mealtimes more pleasant for residents. On the first day of the inspection, the inspector joined DS0000040471.V290643.R01.S.doc Version 5.2 Page 14 residents for lunch then visited other dining rooms. There was soft music playing but nothing else that noticeably enhanced the experience for people. Tables are not fully set, there were no napkins, placemats or condiments and a staff member was again standing up to feed residents which is very bad practice. A requirement was set at the last inspection that staff must receive training in how to help to feed people and that they must not stand up to do it. In one dining room, two visually impaired residents were having problems keeping the food on their plate, which was all over the table. When asked why plate guards are not used, staff replied that they have them available (they were on the trolley) but that they hadn’t put them on. Multicoloured plastic beakers are used for juice and are unsightly and childish. It is strongly recommended that these are changed for something more adult in style. The meal was tasty and well presented. The kitchen was inspected and found to be clean and well organised. Kitchen staff are aware of special diets and allergies. They also have up to date first aid, adult protection and health and safety training. A new hot trolley and fridge have been provided since the last inspection. DS0000040471.V290643.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Complaints are acted upon and taken seriously. Service users are protected from abuse. EVIDENCE: There is a satisfactory complaints procedure in place. There has been one complaint since the last inspection. The manager dealt this with appropriately. The complaints procedure is clearly displayed. There have been no adult protection issues since the last inspection. There is a policy in place but this was written before the home was taken over by Southern Cross and was last reviewed in 2004. It is recommended that this be reviewed to ensure that it is up to date and contains reference to the most recent legislation. This procedure was not read during the inspection so may be satisfactory. Seven staff are currently doing safeguarding adults training distance-learning course. DS0000040471.V290643.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users live in a safe and well-maintained environment. Most areas of the home are clean, pleasant and hygienic. EVIDENCE: The inspection involved a tour of the premises. Most areas of the home are safe and well maintained. Bedrooms are personalised and homely. Southern Cross have introduced front door style bedroom doors into homes for people with dementia. They are given the opportunity to choose the colour door that they would like. There is a knocker and false letterbox. This emphasises that this is their home and having chosen a colour they like, may help some residents be “drawn” to their own room. Photographs have been put on doors of the resident it belongs to. Some residents may not recognise themselves at DS0000040471.V290643.R01.S.doc Version 5.2 Page 17 the age they are now, or may be able to recognise a picture of a pet or family member more easily. It is recommended that the home think of ways in which the individual resident may be drawn towards their own room, as it appears very corporate company style at present and not very individualised. This doesn’t appear to fit with the philosophy behind using these doors. Upon entering the internal doors in the home there is a mild odour problem. On the first day of the inspection, staff tried to locate the problem and mopped the area hoping it would alleviate the smell. It did not make much difference, and on the second day the smell was still there. This must be addressed, and also the odour problem in a small number of bedrooms. Most of the home is odour free. Some storage is required for toiletries in some en suite rooms. Some en suite bathrooms are very bare. It is recommended staff help residents to choose some items to brighten these rooms. The bed of one resident who spends long periods of time in bed faces a bare wall and door. It is recommended that where possible, beds are placed to provide a view e.g. towards the window. If this is not possible, some visual stimulation should be provided. The majority of the home is in good decorative order. Some bedrooms are starting to look shabby and in need of redecoration. It must be confirmed that they are part of a rolling programme of redecoration. Linoleum that is lifting in the bathroom must be repaired or replaced. Most areas of the home are clean and tidy. Some bedrooms and en suites were found to be untidy and residents moving things around do not always cause this. Staff must ensure they tidy up. It was noted that there was a shortage of domestic cover on the first day of the inspection, which may account for the cleanliness of some areas being unsatisfactory. DS0000040471.V290643.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Service users needs are usually met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported by the homes recruitment policies and practices. Some staff are trained and competent to do their jobs. EVIDENCE: There were sufficient staff on duty during the inspection, although a member of kitchen staff was helping to cover sickness. Concerns have been expressed in the past that at times, there appears to be no one available to help. This has been raised by visitors before and also again during this inspection. It must be confirmed that staff breaks are taken separately to ensure as many people as possible remain on the floor. The manager explained that there were a lot of new staff on duty on the first day of the inspection in particular. Staff receive a detailed induction but it was DS0000040471.V290643.R01.S.doc Version 5.2 Page 19 very obvious that there were a number of staff who were inexperienced on duty at the same time. This was more evident on the first day of the inspection. This did appear to impact on the standards on the day, and the manager was surprised by some of the issues I had raised that would not normally be. While recognising that it may not always be possible to do so, new staff should be allocated to work alongside more experienced staff to act as role models. This may mean moving staff between floors. The files of the most recently appointed staff were checked and contain all of the required information included references and criminal records checks. One file is awaiting a photograph. Staff receive regular training. Over 50 have NVQ level 2 or above. Four staff are doing NVQ level 3. Training delivered in the last twelve months includes fire training, moving and handling, prevention of pressure sores care planning, nutrition, food hygiene, The Alzheimer’s Society “yesterday, today and tomorrow” training, eye care, health and safety, continence care, and palliative care (care of the dying). More recently staff have attended first aid and falls awareness training. Night staff fire training is not up to date and must be brought up to date as a matter of urgency. DS0000040471.V290643.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The manager is currently going through CSCI fit person process. The home is run in the best interests of service users. Service users financial interests are safeguarded. The health, safety and welfare of service users and staff are promoted and protected. DS0000040471.V290643.R01.S.doc Version 5.2 Page 21 EVIDENCE: There is currently no registered manager, and the acting manager is going through the fit person process with CSCI. This involves providing CSCI with an application, references, health checks and a fit person interview. The acting manager demonstrates enthusiasm and commitment to the role. The home is run in the best interests of service users generally. The improvement in some of the areas listed above including promotion of choice and dignity and an improvement in the communication of some staff will help to make sure this continues. Financial procedures have not changed since the last inspection. An audit of money was not carried out this time. Procedures are satisfactory. The health safety and welfare of staff and residents are promoted and protected. Staff receive regular safety training, and were seen using moving and handling equipment with care and expertise. Kitchen and domestic staff confirmed they receive COSHH training (to deal with hazardous substances such as cleaning products). Electrical equipment is tested regularly. There were no major safety issues identified during the inspection. Some valances in some bedrooms are quite long and may present a tripping hazard. The doors that lead from bedrooms onto external courtyard were locked and the alarm switched on. Gas engineer inspected the facilities in September 2005. Legionella water chlorination took place in April 2006. Emergency lighting was serviced in April 2006. On the second day of the inspection an external contractor was testing the fire alarms. DS0000040471.V290643.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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X 2 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 3 X 3 X 3 X X 3 DS0000040471.V290643.R01.S.doc Version 5.2 Page 23 Yes 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 OP7 Regulation 15 Requirement Social and psychological care plans must be improved and updated. Timescale for action 06/01/07 2. 3. OP7 OP9 15 13 (2) A detailed social history must be obtained wherever possible. Care plans must state preference 06/01/07 for tights or socks and relatives consulted if necessary. All staff who administer medicine 06/12/06 must be aware of the returns policy. Training and supervision must be 06/02/07 used to help staff communicate appropriately with residents. Residents must be given choices in all aspects of their lives. Training in how to assist residents with feeding should be provided. OUTSTANDING Tables must be fully set at meal times. Aids and adaptations must be made available to residents when they need them. DS0000040471.V290643.R01.S.doc Version 5.2 Page 24 4. OP10 OP27 18 1 (c) 5. OP15 19 06/12/06 6. 7. 8. OP18 OP19 OP19 13 (6) 23 2 (m) 23 2 (d) 9. 10. OP26 OP27 23 2 (d) 18 1 (c) Confirm the adult protection procedure is up to date. Provide storage in en suites where required. Confirm all bedrooms will be decorated as part of rolling programme of redecoration and confirm when this will take place. All areas of the home must be kept clean, tidy and odour free. Staff must receive up to date training in dementia care based on person centred principles. Night staff fire training must be brought up to date. 06/01/07 06/02/07 06/02/07 06/12/06 06/01/07 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. Refer to Standard OP12 OP19 OP19 Good Practice Recommendations Consider making items available for residents to explore in the environment as part of activity planning (self directed activity). Explore ways to encourage residents to locate their own bedroom (individualised pictures or photographs). Some en suite bathrooms be made more homely and warm in appearance. DS0000040471.V290643.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 DS0000040471.V290643.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. 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