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Inspection on 24/04/06 for The Grove Residential Home

Also see our care home review for The Grove Residential Home for more information

This inspection was carried out on 24th April 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

What the care home does well

This home provides a comfortable, clean and homely environment for residents. The staff group know the residents well as most have been working in the home for a number of years. Residents spoken to said they liked living in the home and that the staff responded to their needs promptly and they felt their current needs were being met. Specific comments were "The staff are very good, very kind". Residents also said that they would feel comfortable to raise any concerns if they had any with the staff. Meals are varied, well balanced and nicely presented offering choice and variety. The registered provider is actively involved in the home and residents said that she visits frequently and always has time to chat with them.

What has improved since the last inspection?

Since the previous inspection two additional visits have been made to monitor action taken to address the number of outstanding requirements. These have now been met. Progress has been made in relation to care plans, these now clearly indicate residents needs and what action staff should take to meet the needs.

What the care home could do better:

Residents should be informed when their plan of care is to be reviewed and given the choice as to whether they wish to be involved. An up to date copy of `Safeguarding Adults` should be obtained from the Local Authority and scheduled training in adult protection should also include the reporting process. Training should also be made available in relation to nutrition. Attention must be made to the exterior woodwork of the property and the current heating problems in unoccupied rooms. A registered manager must be recruited and an application for the registration must be received by the Commission. The registered provider must notify the Commission of any significant events which affect the well-being of residents

CARE HOMES FOR OLDER PEOPLE The Grove Residential Home West Ashby Horncastle Lincolnshire LN9 5PR Lead Inspector Elisabeth Pinder Key Unannounced Inspection 09:30 24th April 2006 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 The Grove Residential Home DS0000057752.V288009.R01.S.doc Version 5.1 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. The Grove Residential Home DS0000057752.V288009.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Grove Residential Home Address West Ashby Horncastle Lincolnshire LN9 5PR 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) 01507 522507 Highgrove Care Ltd Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places The Grove Residential Home DS0000057752.V288009.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th September 2005 Brief Description of the Service: The Grove cares for older people in a non-smoking environment in a large detached property situated in the village of West Ashby, which is two miles from the market town of Horncastle. The home used to be a country house and is set in its own mature grounds and walled gardens with car parking facilities to the front and rear. The house is a listed building and therefore any changes to the facade must involve a planning process. The home has three floors and there is a passenger lift to the bedrooms on the first floor and a stair lift to the second floor. The rooms on the second floor have been created from attic accommodation and all four have traditional sloping ceilings. On the first floor there are four stairs to negotiate to access three of the single bedrooms. Thirteen of the bedrooms are single, two of them have an ensuite toilet. There are two toilets on the ground floor, two bathrooms with toilets and one single toilet on the first floor and a shower room on the second floor. The current fee range is £330 – 370 per week. Additional charges are made for hairdressing, chiropody and newspapers. The Grove Residential Home DS0000057752.V288009.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit was made to the home to form part of a key inspection. It started at 09:30 and lasted 6 hours. Information already held on file was used to plan the visit. This consisted of regulation 26 reports, two additional visit reports and a meeting held with the providers in February 2006 when the future management of the home was discussed. This site visit focused on key inspection standards and checking whether requirements from previous inspections had been met. A partial tour of the home and a sample of records were inspected. The main method used for this was “case tracking” a sample of three residents with a range of needs via their records, discussion with them and two staff on duty during the visit. Although no relatives were seen during the visit a representative dealing with the financial issues of a resident was spoken to. The acting manager, who spent time discussing many issues that arise in the running of a care home, facilitated this inspection. What the service does well: What has improved since the last inspection? The Grove Residential Home DS0000057752.V288009.R01.S.doc Version 5.1 Page 6 Since the previous inspection two additional visits have been made to monitor action taken to address the number of outstanding requirements. These have now been met. Progress has been made in relation to care plans, these now clearly indicate residents needs and what action staff should take to meet the needs. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Grove Residential Home DS0000057752.V288009.R01.S.doc Version 5.1 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 The Grove Residential Home DS0000057752.V288009.R01.S.doc Version 5.1 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, Standard 6 is not applicable in this home Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Information about the service is available and procedures are in place to ensure residents are only admitted into this home after a full needs assessment has been carried out. EVIDENCE: There has been one admission since the previous visit and records were available to show that the needs of this resident were properly assessed and planned for. Residents ‘case tracked’ did not have pre-admission assessments as they had been living in the home for a number of years. A Statement of Purpose and Service User Guide has been written and given to all residents. It is also available to visitors in the reception area of the home. Contracts/statement of terms and conditions are held on residents’ individual files. The Grove Residential Home DS0000057752.V288009.R01.S.doc Version 5.1 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 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Care plans contain sufficient information to ensure residents’ health and care needs are met and demonstrate the involvement of residents or their relatives. Medication is administered and stored using safe procedures. Residents’ privacy and dignity is respected. EVIDENCE: The care records of three residents were checked and all contained care plans which identified the residents’ needs and how to meet them. Care plans are available for staff to refer to and those seen had been signed by residents or their relatives showing their involvement. The files also contained individual risk assessments in relation, for example, to manual handling needs and falls. There was also information on residents’ files to demonstrate that staff review care plans on a monthly basis, however, there was no evidence that residents are involved in these reviews and staff said they are only involved if there are changes to their needs. It is recommended that residents are informed when The Grove Residential Home DS0000057752.V288009.R01.S.doc Version 5.1 Page 10 their plan of care is to be reviewed and given the choice as to whether they wish to be involved. Records also demonstrated that health care is promoted. For example records are kept of any G.P, district nurse and chiropodist visits. However, the acting manager said that she is currently experiencing difficulty in finding a dentist who is willing to visit residents in the home. Staff spoken to said that they are kept informed about residents needs and that they work as “key workers,” having specific responsibilities for 3 or 4 residents, such as ensuring they have sufficient toiletries/confectionery. Staff also had a good knowledge of the care needs of residents and how to meet them. Residents comments were generally positive about the care provided, specific comments were ‘staff are very good, very kind’. A good rapport was noted between staff and residents. Staff gave clear examples of how they try and ensure that residents’ privacy and dignity is respected in the home such as knocking on bedroom doors and closing bathroom/toilet doors. A telephone call had been made to CSCI prior to the visit regarding a resident who self-medicates but is not taking all her medication. Appropriate action is being taken to address this issue, the residents risk assessment is being reviewed and updated involving the GP, family and resident. Medication is stored safely and systems for administering medicines has now changed. Staff dispense medication from individual ‘blister’ packs. Training records show that all staff involved in handling medication have undertaken training. Most of the medication is delivered to the home but staff still collect from one surgery. A homely remedies policies is currently being drawn up with help from the community pharmacist. The Grove Residential Home DS0000057752.V288009.R01.S.doc Version 5.1 Page 11 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 good. This judgement has been made using available evidence including a visit to the service. Residents interests are generally accommodated and this has improved since the last inspection. Meals provided are good and take into account individual preferences and special dietary needs. Visitors are made welcome at this home and residents have choices as to how they lead their lives. EVIDENCE: Activities are currently organised by the acting manager who said she has tried various activities and generally finds many residents do not want to join in. One resident spoken to said ‘we do not have any activities’, however, when this was pursued it was established that this resident often goes out when activities are taking place. One resident was observed reading and she said she had got the book out of the home’s library and felt that there was a good selection to choose from. Another resident said how she loves to play dominoes in the evenings with a few other residents and another resident said she was looking forward to going out for a walk when the weather improves. The Grove Residential Home DS0000057752.V288009.R01.S.doc Version 5.1 Page 12 Records in the home showed that monthly communion services are held in the home and singers had been in over the Easter period. A staff member said that the ‘Boy Scouts’ had planted some bulbs in the garden. Information received through regulation 26 reports evidenced that an Autumn fair had taken place and two residents had been to Skegness for fish and chips in November. The minutes of a residents meeting held in September detailed discussions held with residents about their social needs and the programme of activities including how money raised from fund raising events was to be spent. A recording system has been started, but this needs reviewing to ensure that activities undertaken are recorded on individual files and is kept up to date. Residents gave examples of having choices as to how they live their lives in the home. One resident said she chose when to have a bath and what time she goes to bed. Another resident said she frequently goes out to her daughters. One visitor was spoken to and stated that although he doesn’t visit frequently he has always been made to feel welcome. Comments about the food were generally positive. Residents said that there is a choice of main meals and plenty of variety. Menus seen verified this. The cook asks each resident what they would like to eat on a daily basis and records are maintained. However, the acting manager said that a recent visit from the home’s Environmental Health Officer identified that a more healthier diet should be offered, including cooking with brown flour and adding pasta to the menu. Menus are therefore to be reviewed, the cook is asked to ensure these are written with residents to ensure their preferences are taken into account. Training records evidenced that all staff have undertaken a Basic Food Hygiene course and information was given about the recent CSCI publication ‘In-focus, highlight of the day’, which focuses on improving meals for older people. It is also recommended that the cook undertakes training in relation to nutrition. The Grove Residential Home DS0000057752.V288009.R01.S.doc Version 5.1 Page 13 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 & 18 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. The home takes the issue of addressing complaints very seriously and residents are confident that their concerns will be listened to and acted upon. However, robust procedures are not in place to protect residents from abuse. EVIDENCE: A copy of the home’s complaints procedure is incorporated in the Service User Guide which has been given to all residents and is available in the reception area of the home. Residents said that they feel comfortable to raise any concerns and would speak to one of the staff. The acting manager stated that no complaints have been made to her or the provider since the last inspection. No complaints have been received by the CSCI since the last inspection. The home’s adult abuse procedure needs to be up dated to clarify that no investigation should be carried out prior to social service involvement. A copy of the Local Authority Safeguarding Adults’ procedure should be obtained. The acting manager said that training in abuse is scheduled for May and it is recommended that training includes the reporting process. The Grove Residential Home DS0000057752.V288009.R01.S.doc Version 5.1 Page 14 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, 25 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents living in this home live in a clean, homely environment and are enabled to personalise their rooms. There are, however, some issues that require further action to ensure that as far as possible any potential health and safety risks to residents are reduced. EVIDENCE: The home was clean and well decorated. All furnishings are of a domestic nature and residents said they like the home and are happy with their bedrooms and felt that they are kept clean. One resident’s bedroom was seen, and this was individually decorated and furnished. Staff said they felt they worked in a safe environment. Whilst there was not a full tour of the premises on this occasion, those areas of the home seen which included the lounge, conservatory, dining area and one bedroom were clean, tidy and comfortably furnished. No unpleasant odours were noted. However, the exterior woodwork is in need of repair and redecoration. One visitor The Grove Residential Home DS0000057752.V288009.R01.S.doc Version 5.1 Page 15 spoken to said he felt the exterior of the home ‘looks shabby’ and one resident also made comments about this. Information received from the provider identified that quotes were being obtained to repair a small leak to the roof. This has now been repaired. Currently heating problems are being experienced with some radiators in unoccupied bedrooms not working. However, the acting manager said the plumber is due to service the boiler and plans to drain the system to try and rectify this problem. Residents must not be accommodated in these rooms until this has been fully actioned. The Environmental Health Officer visited the home on 08/03/06 and the report highlighted two main issues: a) A Food Safety Management System needs to be set up and implemented by the end of April 2006. b) The Kitchen should be refurbished by the end of July 2006 The food safety management system has been implemented including a hazard analysis and quotes are to be obtained regarding the kitchen refurbishment. The Grove Residential Home DS0000057752.V288009.R01.S.doc Version 5.1 Page 16 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 using available evidence including a visit to the service. The deployment and number of staff on duty is sufficient to meet the needs of the residents. Staff are recruited using robust procedures. Training has improved since the last inspection but must continue to be a priority. EVIDENCE: There are currently 14 residents living in this home and staff rotas and discussion with staff and residents indicated that there is sufficient staff to meet their current needs. Rotas demonstrated that there is always a minimum of 2 carers on duty during the day and 1 wakeful carer at night and 1 sleep-in. Risk assessments have been undertaken in respect of residents care needs throughout the night and the provider considers that the current level of staff is meeting the needs at this time. Residents spoken to confirmed this. In addition there is a cook and two domestic staff employed. No new staff have been employed since the last visit. Residents said that staff were caring and very kind. Those spoken to said they felt their needs were currently being met. Staff said that they have time to talk with residents and that there was sufficient time to meet residents’ social needs. This was observed during the visit. The Grove Residential Home DS0000057752.V288009.R01.S.doc Version 5.1 Page 17 Progress has been made in staff training opportunities and staff have recently undertaken courses in health and safety, manual handling, first-aid, fire and medication. However, staff must undertake adult protection training. Whilst the home has satisfactory policies on equal opportunities it is recommended that training in diversity issues is carried out. Information available shows that 30 of care staff currently have a National Vocational Qualification (NVQ) and four staff are undertaking this training. Plans are in place for one other staff member to be trained as an assessor. Staff spoken to confirmed that they have been given a copy of GSCC (General Social care Council) code of practice. The Grove Residential Home DS0000057752.V288009.R01.S.doc Version 5.1 Page 18 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, 37 & 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. There must be clear leadership giving staff guidance and direction to ensure residents needs are met. The quality monitoring system of the service must be improved to enable residents, relatives and staff to comment on ways in which the service can be developed. EVIDENCE: Since the registered manager left the home suddenly in June 2005 the home has been run by acting managers. For approximately three months this role was shared between two senior carers one of whom decided to remain as senior carer. The second member of staff has continued in this position with the support from the provider. It was agreed at a meeting in February 2006 that the acting manager would submit an application to CSCI for registration. To date this has not been received. During the visit the role of a registered The Grove Residential Home DS0000057752.V288009.R01.S.doc Version 5.1 Page 19 manager was discussed and the current acting manager said that she does not feel ready for this. She is currently undertaking NVQ level three and feels management training is essential before she considers this position. Records and discussion confirmed that the acting manager works in a supernumerary capacity to the carers between the hours of 9 – 3 in the home and then on call from her home. Staff spoken to said they receive regular supervision and feel supported by the acting manager. Residents said they knew who was in charge, although one resident expressed concern over the changes. Records showed that a sudden illness resulting in a resident being taken into hospital had not been notified to the Commission. When this was discussed with the acting manager she was unsure of what necessitated notification. During the visit the inspector was also informed that an amount of money had gone missing from the kitchen and again this had not been reported to the Commission. The provider must ensure an effective quality monitoring system is undertaken and the results of any surveys should be published for information. Although a quality and monitoring system has been developed aiming to obtain residents and relatives’ comments about the service, only six questionnaires were returned. The provider is asked to explore different ways of seeking stakeholders views to enable a full audit and review of the quality of care provided to be carried out. Further attention needs to be given to ensuring that potential health and safety risks are documented and include any action taken to minimise risks. For example, the fire risk assessment needed updating and risk assessments must be written regarding rooms where the radiators are not working. Records to demonstrate the maintenance of the environment such as service certificates were available. The acting manager said that the home does not keep any monies on behalf of residents. This is carried out by their family or representative. The Grove Residential Home DS0000057752.V288009.R01.S.doc Version 5.1 Page 20 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X 2 3 The Grove Residential Home DS0000057752.V288009.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP18 Regulation 13[6] Requirement The registered provider must make arrangements to prevent residents from being at risk of harm and abuse. Up to date procedures must be available for all staff to ensure any allegations of an adult abuse are reported using the appropriate referral procedures of the Local Authority. Training scheduled for May should include the reporting process. The registered provider must undertake risk assessments in relation to the heating supply of the home and ensure appropriate actions are taken to minimise risks identified. The registered provider must recruit a manager and an application for the registration of the manager must be received by the Commission. The home must undertake an effective quality monitoring system based on seeking the views of residents and visitors with the results of any surveys DS0000057752.V288009.R01.S.doc Timescale for action 30/06/06 2. OP25 23[2][p] 31/05/06 3. OP31 8 30/06/06 4. OP33 24[1, 2, & 3] 30/06/06 The Grove Residential Home Version 5.1 Page 22 5. OP37 17 published for their information. The registered provider must notify the Commission of any significant events which affect the well-being of residents. 31/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. 7. Refer to Standard OP7 OP12 OP15 OP19 OP19 OP30 OP28 Good Practice Recommendations Residents should be informed when their plan of care is to be reviewed and given the choice as to whether they wish to be involved. Records should be maintained and kept up to date of all activities provided and this should also be recorded in residents individual files. It is recommended that the cook undertakes training in relation to nutrition. The registered provider should liaise with his fire officer to ensure the home’s fire risk assessment complies with legislation. The exterior woodwork should be repaired or replaced and redecorated. The registered person should ensure that staff receive training in relation to equality and diversity issues. The home should have a minimum ratio of 50 trained staff members to NVQ level two excluding a registered manager The Grove Residential Home DS0000057752.V288009.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 The Grove Residential Home DS0000057752.V288009.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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