CARE HOMES FOR OLDER PEOPLE
The Grange Nursing Home Keighley Road Colne Lancs BB8 0QG Lead Inspector
Marie Matthews Announced 27 June 2005 9.30 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. The Grange Nursing Home F57 F07 S22465 Grange V226274 27.6.05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service The Grange Nursing Home Address Keighley Road Colne Lancs BB8 0QG 01282 866054 01282 866054 the.grange@fshc.co.uk Alliance Care (Dales Homes) Ltd 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) Mrs Dianne Elizabeth Clarke Care Home 40 PD OP 2 38 Category(ies) of Physical disability registration, with number Old Age of places The Grange Nursing Home F57 F07 S22465 Grange V226274 27.6.05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The service must at all times, employ a suitably qualified manager who is registered with the Commission for Social Care Inspection. 2. The service must at all times, staff the home in accordance with the notice issued by the previous registration authority dated 21st January 2002. 3. Within the overall registered number of beds for older people (OP) 38 may be available for those service users requiring personal care and 38 may be available for those service users requiring nursing care. 4. Within the total number of 40 beds, 2 are available to named service users who fit into the category of younger adults with a disability (PD). These beds are available as long as these service users remain in the home. Date of last inspection 5.01.05 Brief Description of the Service: The Grange Care Home is a converted and extended Victorian house, which provides accommodation for up to forty people who require nursing or personal care. The current registration includes thirty-eight places for older people and two places for younger people with a physical disability. The home was converted from the original house and has had additional accommodation added. The home is situated in a quiet residential area on the outskirts of Colne close to shops and on a main road bus route. There is car parking in the grounds of the home. Lawned areas with mature trees surround the home and there are outside seating areas to the front of the building. The garden is well maintained and easily accessible to those residents who need to use a wheelchair. There are thirty single rooms and five shared rooms. Eighteen of the single rooms and three of the shared have en-suite toilets and hand wash basins. Two shared bedrooms have an en-suite bathroom. There is a passenger lift between floors. Communal areas in the home include three lounges and a dining room and there are seating areas in the reception hall. The Grange Care Home is part of the Four Seasons Health Care Group but registered to Alliance Care (Dales Homes) Ltd. The Grange Nursing Home F57 F07 S22465 Grange V226274 27.6.05 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The announced inspection was conducted at The Grange Care Home on 27th June 2005. The inspection involved looking at records, talking to management, three staff, twelve residents and three visitors, a tour of the home and generally looking at what was happening in the home. Information was also taken from comment cards filled in by two residents and one visitor. This inspection looked at things that should have been done since the last visit and a number of areas that affect resident’s lives. There were thirty-four people living in the home on the day of the visit. Residents and visitors were happy with the standards of care. What the service does well:
Detailed information was obtained about prospective residents before admission to the home to ensure their needs could be met. One new resident said the registered manager had visited him at home. Residents were provided with an attractive, comfortable, safe, well maintained and homely place to live in. Residents were happy with their rooms and some were personalised to add to the homely atmosphere. Residents said ‘my room is nice and bright’ and ‘it is always clean and tidy’. The gardens were safe, tidy and accessible. Residents and visitors made positive comments about the gardens and how they enjoyed sitting out in the warmer weather. A programme was seen indicating that repairs, replacement and renewals were ongoing. Staff treated people with respect and care was offered in such a way to maintain residents rights to privacy and dignity. One resident said she was ‘treated kindly’ and that staff made her feel ‘safe and looked after’. Staff and visitors said that staff worked very hard. One resident said they were ‘absolutely wonderful’ and another said ‘they get me anything I ask for’. There was a clear complaints system. Two visitors said they were aware of the complaints procedure and said concerns had been dealt with appropriately. People were confident their concerns would be listened to and taken seriously.
The Grange Nursing Home F57 F07 S22465 Grange V226274 27.6.05 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better:
The information given to new and prospective residents needed minor alteration to ensure that people had enough information to make an informed choice. Residents had still not been given a ‘contract’ and were therefore not fully aware of their rights of residence. The home did not have an activity co-ordinator in post. There was not a suitable and varied programme of activities to meet resident’s social needs, expectations and interests. Residents said there were no activities and ‘not much going on’. Another resident said ‘staff are lovely but they are too busy to entertain us’. As noted earlier the home was good at providing staff with a range of training to ensure they had the skills to meet the needs of residents in their care. However new staff had not consistently received the necessary basic training. The meals were good with a menu offering choice and variety although some residents still did not feel they were offered a choice. A number of residents said they ‘take what comes’. It was noted that a large number of residents needed assistance from staff with their meal and this resulted in other residents having to wait long periods of time before their second course arrive. Visitors said that food was still left to go cold at times.
The Grange Nursing Home F57 F07 S22465 Grange V226274 27.6.05 Stage 4.doc Version 1.30 Page 7 Staffing numbers were in accordance with the agreed minimum levels. However residents and visitors were concerned there were not enough staff on duty, particularly at meal times and in the afternoon and early evening when residents needed assistance with eating and going to bed. It was required that the staffing levels were reviewed to take into account the dependency levels of residents and layout of the building. The registered provider needed to ensure additional staff were on duty at peak times of activity to ensure all resident’s needs were met. Due to the current staffing numbers and routines of the home the residents were not consistently able to make choices and decisions about their life in the home. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Grange Nursing Home F57 F07 S22465 Grange V226274 27.6.05 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 The Grange Nursing Home F57 F07 S22465 Grange V226274 27.6.05 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, 2, 3 and 4. (standard 6 was not applicable) The home did not provide current or future residents and their representatives with enough information to enable them to make an informed choice about admission to the home. The home obtained detailed information about prospective residents to ensure the home was able to fully meet their needs. EVIDENCE: The statement of purpose and service user guide had been reviewed. The service user guide was available in resident’s rooms and was given to prospective residents or their relatives before admission. Some minor alteration needed to be done to make sure the service user guide included enough information. The contract for residents with the home was still under review by Four Seasons. The Grange Nursing Home F57 F07 S22465 Grange V226274 27.6.05 Stage 4.doc Version 1.30 Page 10 Three resident’s care plans were looked at and all had had their care needs assessed before admission to the home to determine whether their needs could be met. The assessments were detailed. The home had confirmed, in writing, that they were able to meet prospective resident’s needs. One new resident said the registered manager had visited him at his home. All residents had a care plan although one resident’s plan did not include all care needs as indicated in the assessment. (See standard 7). Training records showed that staff had received appropriate training to help them to meet the needs of the residents who lived at the home. The Grange Nursing Home F57 F07 S22465 Grange V226274 27.6.05 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 and 10. The standard of care planning had improved but still needed to include all information to ensure staff had a good understanding of how to meet the resident’s health needs. The systems for the management of medication had improved to ensure that resident’s medication needs were safely met. Staff treated people with respect and care was offered in such a way to maintain residents rights to privacy and dignity. EVIDENCE: Three residents care plans were looked at. Two of the residents had a well organised, detailed care plans developed from the assessment that included action to be taken by staff to ensure resident’s needs were met. One of the plans had not been generated from the care needs assessment and needed to include more detail. A range of risk assessments were included in the plans. One resident had not been risk assessed in relation to falling. One resident had been identified of being at risk of developing pressure sores although the care plan did not indicate interventions such as regular relief of pressure. One resident had needed bed rails, this had been risk assessed and discussed with relatives but there was no care plan available.
The Grange Nursing Home F57 F07 S22465 Grange V226274 27.6.05 Stage 4.doc Version 1.30 Page 12 There was evidence to support that resident’s had been involved in the development of their care plans, reviews had taken place monthly and the care plan reflected any changing needs. Three residents said they had been consulted about their care. One resident said ‘I talk to staff about my care’. Three visitors said they had been consulted about their relatives care as needed. Policies and procedures for medication had not been reviewed. Concerns raised at the last visit had been resolved. Records were clear and accurate and a system of auditing was in place to ensure safe practices. Residents confirmed their privacy was respected and that staff knocked on doors before entering their rooms. One resident said she was ‘treated kindly’ and that staff made her feel ‘safe and looked after’. Staff were seen talking to residents and visitors in a friendly but respectful manner. The Grange Nursing Home F57 F07 S22465 Grange V226274 27.6.05 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 and 15. The home did not provide a suitable and varied programme of activities to meet the social needs, expectations and interests of the residents. Residents were not consistently able to make choices and decisions about their life in the home but visitors were made to feel welcome. The meals were good with a menu offering choice and variety although some residents still did not feel they were offered a choice. EVIDENCE: Residents said they were offered a choice in relation to many aspects of their care. One resident said he could stay in his room and could usually get up and go to bed when he was ready. Other residents, who required assistance, said staff were often busy and they had too wait. The home was in the process of recruiting someone to organise activities. Residents said there were no activities and ‘not much going on’. One resident said he did his ‘own thing’ and was able, with assistance from staff, to visit friends outside of the home. One visitor was disappointed there were no trips out of the home and hadn’t been for some time. The two residents who completed the comment card both said the home did not provide suitable activities. Another resident said ‘staff are lovely but they are too busy to
The Grange Nursing Home F57 F07 S22465 Grange V226274 27.6.05 Stage 4.doc Version 1.30 Page 14 entertain us’. Residents and their visitors were able to sit in the attractive gardens. Visitors confirmed they were welcomed into the home, could visit at any reasonable time and see their relative in private. One visitor said ‘staff are friendly enough’. The menu had been reviewed since the last visit and was displayed in the entrance hall. The majority of residents said they enjoyed the food. Records showed that a choice of meal was now available but six residents said they were not given a choice and ‘take what comes’. Residents confirmed they were able to dine in their rooms. The meal served looked nutritious and appealing. It was observed, at lunchtime, that ten residents needed assistance from staff with their meal and this resulted in other residents having to wait long periods of time before their second course arrived. A visitor said that resident’s meals were still left to go cold as staff were unable to help everyone at once. A requirement under the Care Homes Regulations 2001is made to ensure extra staff were available at peak times.( se Requirements below) The Grange Nursing Home F57 F07 S22465 Grange V226274 27.6.05 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 and 18. The home had a clear complaints system and residents and visitors were confident their concerns would be taken seriously. Staff awareness of how to respond to suspicion of abuse was good. EVIDENCE: From looking at records and talking to people it was clear that residents and visitors knew who to talk to if they were unhappy with their care. Two visitors said they were aware of the complaints procedure and if they had raised concerns these had been dealt with appropriately. Clear records had been kept. Policies and procedures were in place to guide staff with regard to suspicion or evidence of abuse. Staff said they were aware of what action to take. Training records showed that some staff had attended Protection of Vulnerable Adults training. The Grange Nursing Home F57 F07 S22465 Grange V226274 27.6.05 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, 24 and 26. The standard of the environment, both inside and outside, was good and provided residents with an attractive, comfortable, safe, well maintained and homely place to live in. EVIDENCE: There was an ongoing programme of repairs, renewal and refurbishment and evidence of this was seen around the home. Replacement of carpets and furniture, identified during a tour of the home, was included in the plan. Issues raised at the last inspection had been responded to. Residents were happy with their rooms and some were personalised to add to the homely atmosphere. Comments included ‘my room is nice and bright’, ‘its always clean and tidy’, ‘I can see out into the lovely gardens’. The extensive grounds were safe, tidy and accessible. Residents and visitors made positive comments about the gardens and were able to enjoy sitting out in the warmer weather.
The Grange Nursing Home F57 F07 S22465 Grange V226274 27.6.05 Stage 4.doc Version 1.30 Page 17 The home did not have a sluicing disinfector. At the time of the inspection the home was unable to meet this standard. Residents and visitors commented that the home was always clean and tidy. The Grange Nursing Home F57 F07 S22465 Grange V226274 27.6.05 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 and 30. The staffing numbers were not sufficient at peak times of activity to meet the needs of the residents and the layout of the home. The standard of recruitment practices had improved and protected the people living in the home. The home was good at providing staff with a range of training to ensure they had the skills to meet the needs of residents in their care. However new staff had not consistently received appropriate induction and foundation training Residents were confident that staff worked very hard to ensure their needs were met. EVIDENCE: Staffing numbers were in accordance with the agreed minimum levels. The rota was clear and showed that staff had worked extra hours to cover any staff shortages. However two visitors spoken to were concerned there were not enough staff on duty, particularly at meal times and in the afternoon and early evening when residents needed assistance with eating and going to bed. (See mealtimes standard 15). Six residents expressed their concerns about staffing numbers with the inspector. It was observed, at lunchtime, that ten residents needed assistance from staff with their meal and this resulted in other residents having to wait long periods of time before their second course arrived. Also after lunch the two care staff left on duty were helping those residents who wished to rest on their beds and residents said they had to wait as staff ‘were busy’. It was required that the staffing levels and dependency
The Grange Nursing Home F57 F07 S22465 Grange V226274 27.6.05 Stage 4.doc Version 1.30 Page 19 levels of residents were reviewed to ensure additional staff were on duty at peak times of activity to ensure all resident’s needs were met. Staff and visitors said that staff worked very hard. One resident said they were ‘absolutely wonderful’ and another said ‘they get me anything I ask for’. Three staff recruitment files were looked at that showed that a thorough recruitment procedure had been operated that ensured the protection of people living at the home. Staff passport photographs, as a means of identification, were not clear and the registered manager said this was under review. The registered manager said that a third of all care staff had an NVQ qualification and further training was being planned. There was a training and development plan and all staff had individual training plans. Individual plans showed appropriate training had been given to ensure staff were able to care for the people who lived at the home. Basic inductions for new staff had been done. One care staff had not completed the induction training to National Training Organisation specifications another care staff had but had not progressed to either foundation or NVQ training. The Grange Nursing Home F57 F07 S22465 Grange V226274 27.6.05 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, 32, 33, 35, 36, 37 and 38. The systems for consultation with residents, visitors and staff were good with evidence that views are sought and acted on. The registered manager had systems in place to ensure the health, safety and welfare of people in the home was promoted and protected. Staff had received formal supervision sessions to ensure they were supported and able to meet resident’s needs. EVIDENCE: The Grange Nursing Home F57 F07 S22465 Grange V226274 27.6.05 Stage 4.doc Version 1.30 Page 21 Mrs. Diane Clarke is the registered manager of The Grange Care Home. Mrs Clarke, a qualified nurse, has many years experience caring for elderly clients and extensive management experience. She is due to complete the Registered Managers Award training. Staff, residents and visitors made positive comments about the registered manager. They said she was ‘approachable’ and ‘helpful’. Records had been kept of regular staff meetings. Staff were confident they would be listened to. From discussion and looking at records it was clear that staff were appropriately supported and supervised. Meetings had been held for residents and their visitors to discuss issues that affect resident’s choices and routines. One visitor said they had attended a ‘open evening’ and had been able to ‘speak openly’. Another visitor commented he would be kept informed of any important matters affecting his relative. Residents and relatives were invited to complete a survey about the home every year. The results of the survey were on the notice board. Clear financial records were maintained by the home. Any money stored by the home for residents was kept in a ‘service user account’. Information about this was included in the service user guide. Records were clear, well organised and subject to regular audits. The registered manager promoted and protected the health, safety and welfare of people in the home. The Grange Nursing Home F57 F07 S22465 Grange V226274 27.6.05 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 2 1 2 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2
COMPLAINTS AND PROTECTION 3 x x x x 3 x 2 STAFFING Standard No Score 27 1 28 2 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 x 3 2 3 3 x 3 3 3 3 The Grange Nursing Home F57 F07 S22465 Grange V226274 27.6.05 Stage 4.doc Version 1.30 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 1 Regulation 5 Requirement The registered person must review the service user guide and make any additions required to fully meet the regulation. Timescale of 10/9/04 not met. The registered person must ensure a contract/ statement of terms and conditions of residence is given to residents. Timescale of 16/4/04 not met. The registered person must ensure the resident care plans are generated from the assessment and set out in detail the action to be taken by care staff to ensure all needs are met. The registered person must ensure once a risk is identified appropriate interventions to reduce the risk are documented in the care plan. The registered person must ensure policies and procedures, addressing medicines management, are reviewed in line with the Royal Pharmaceutical Society guidelines. Timescale of 28/2/05 not met. The registered person must ensure residents are given
F57 F07 S22465 Grange V226274 27.6.05 Stage 4.doc Timescale for action By 29/8/05 2. 2 5 By 29/8/05 3. 7 15 By 29/8/05 4. 8 13 By 29/8/05 5. 9 13 By 29/8/05 6. 12 16 By 29/8/05
Page 24 The Grange Nursing Home Version 1.30 7. 27 18 8. 30 12 opportunities for stimulation through activities in and outside the home which suit their needs, preferences and capacities. The registered person must ensure that staffing numbers are appropriate to the assessed needs of the residents and the size and layout of the building and that additional staff are on duty at peak times of activity. The registered person must ensure staff receive induction (within 6 weeks) and foundation (within 6 months) training to NTO specification. By 10/8/05 By 10/8/05 9. 10. 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 7 12 15 Good Practice Recommendations The registered person should ensure falls risk assessments are completed for all residents. The registered person should ensure there is an activities co-ordinator in post. The registered person should review that the practice of serving all residents at the same time to ensure that meals were not left standing too long in front of residents who need support with eating. The registered person should ensure residents are aware of an alternative choice of meal. The registered person should review the provision of sluicing facilities in the home in order to meet the requirements of this standard as regards nursing homes. The registered person should include a clear means of identification (photograph) on staff recruitment files. The registered person should ensure that 50 care staff are qualified to NVQ level 2 in care (or equivalent). 4. 5. 6. 7. 8. 15 26 27 28 31 The Grange Nursing Home F57 F07 S22465 Grange V226274 27.6.05 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Unit 4, Petre Road Clayton-le-Moors Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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