Inspection on 21/05/08 for The Lawns, Brixton

This inspection was carried out on 21st May 2008.

CSCI found this care home to be providing an Adequate service.

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.

Other inspections for this house

The Lawns, Brixton 29/05/09

The Lawns, Brixton 21/03/07

The Lawns, Brixton 15/02/06

The Lawns, Brixton 04/08/05

The Lawns, Brixton 28/02/05

The Lawns, Brixton 09/09/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/11/2008.

CARE HOMES FOR OLDER PEOPLE The Lawns, Brixton Brixton Plymouth Devon PL8 2AX Lead Inspector Susan Samways Unannounced Inspection 21st May 2008 10:00 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 Lawns, Brixton DS0000003611.V365085.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. The Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Lawns, Brixton Address Brixton Plymouth Devon PL8 2AX Telephone number Fax number Email address 01752 880465 01752 880465 The Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 4 The Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 5 Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Wells House Limited, Manager post vacant Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (8), Physical disability over 65 years of age (18) of places The Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 6 SERVICE INFORMATION Conditions of registration: 1. The Home is registered as a Care Home with Nursing for a maximum of 22 Service Users in the categories of PD(E) 18, OP 8, TI(E) 4 Date of last inspection 21st March 2007 Brief Description of the Service: The Lawns care home is situated in the village of Brixton, in the South Hams area of Devon. The home is a detached country house, set in its own grounds. Accommodation is provided on two floors with a mezzanine floor between. The home provides 16 single and 3 double bedrooms. Communal facilities comprise: - a lounge, conservatory and dining room. Most parts of the home are wheelchair accessible. There is a shaft lift to all floors and a stair lift on the main staircase. The home is registered to accept a maximum of 22 persons, aged over 65 years of either gender whom suffer from physical frailty, illness or disability. The home provides a comfortable friendly atmosphere, service users are encouraged to furnish their rooms as they choose, and each room is individual in its character. The last CSCI inspection report is displayed in the entrance foyer at all times for people to read. The fees range from £380 - £575 Depending on the degree to which nursing care is required. The contracts examined clearly breakdown the fees charged and what is included in the fee. Contracts are issued to every Service User whether they are publicly or privately funded. The Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 7 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 stars. This means the people who use this service experience adequate quality outcomes. This was an unannounced inspection which was carried out over two days. Two inspectors were present on the first day and a total of 17 hours were taken to complete the inspection. There is currently no registered manager but the operations manager, who covers both The Lawns and another nursing home, stated that she is taking that responsibility until the new care manager is registered with the Commission for Social Care Inspection. Time was spent in discussion with both the operations manager and the care manager regarding the care provided. A sample of care plans, staff files and other documents were examined. During the inspection several of the people living in the home were spoken to as were some staff and visitors. Prior to the inspection the operations manager had completed the Annual Quality Assurance Assessment which provided information about how the national minimum standards had been met, what had improved since the last inspection and future plans for The Lawns. What the service does well: Those living in the home who were spoken to said that the staff are kind and caring. Staff were observed to treat people with respect, to respond to them appropriately and to have a good rapport with them. Relatives said that they were happy with the care, that they were kept informed, their concerns are listened to and acted upon and any questions they might have answered readily. Friends and relatives can visit at any reasonable time and those spoken to said they are always made welcome. Everyone asked said that the food was good and the meals seen during the inspection looked and smelled appetising. The Lawns provides people with a pleasant and comfortable environment in which to live. The home is well equipped to provide the care required. The Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 8 What has improved since the last inspection? 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 summary of this inspection report can be made available in other formats on request. The Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 9 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 Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The assessment process used does not include the person’s social, emotional or psychological needs and therefore the home cannot ensure that all their needs can be met. The Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 11 EVIDENCE: The files for three people living in the home were examined. Assessments found included pressure sore prevention, manual handling, falls and nutrition. Each of these had been reviewed monthly. A new assessment form has recently be introduced for use prior to someone being admitted to the home. It covers all aspects of the person’s physical care and well being but does not cover their social, emotional or psychological needs. This needs to be addressed in order to establish that the needs of the whole person can be met. One example of this new form having been used was seen which showed that more space for notes is required to adequately record the assessor’s findings. The operations manager stated that the home’s Statement of Purpose has been updated and at the time of the inspection was at the printers. She also said that anyone considering moving to The Lawns is welcome to visit the home for a day or part of a day, tour the building and meet staff and other people living there and stay for a drink or a meal. If the home can meet their needs and they wish to take up residence they are offered a one month trial period. The Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although it was clear during the inspection that the staff on duty understood the care needs of the people they were caring for; care plans did not have sufficient information to guide staff how to provide care. This may mean that people are reliant on regular staff who understand them being available in order to have their care needs fully met. People are being put at risk of not receiving the care they need. The medication procedures and practices could place those living in the home at risk. Staff treat residents with respect and are caring and supportive but end of life care needs to be improved. The Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 13 EVIDENCE: The care plans for three people living in the home and one for a former resident were examined. These were found to include risk assessments for falls, pressure sore prevention, manual handling and nutrition. Evidence was also seen that regular reviews had been carried out. However, the reviews did not always clearly record the changes in care provision the person needed. This could mean that staff do not have sufficient information to provide continuity of care and the person relies on staff that know them well understanding their changed care needs. Examples of this were wound care for different areas of the body being recorded on the same sheet, no use of body maps to clearly identify the sites of sores, bruising or other marks, changes in mobility due to dressings or increasing frailty. The care plans seen did not include reference to social and emotional support. The way in which individuals were seen to spend their time, e.g. on their own with no radio or other stimulation, was not reflected in the care plan. This may mean that staff do not know what interests the person, what their preferences are, what is important to them or what emotional support they may require. Daily records were found to be kept in two ways, the notes made by the nursing staff with the care plans and a separate file with records made by the care staff. This system means that there is the potential for important information to be missed by staff. The daily records should be one document with everyone taking responsibility for including information of note. A locum GP who visited the home during the inspection said staff follow her instructions and provide good care. Staff observed caring for people seemed to have a genuine rapport with them. Those living in the home spoken to during the inspection said that the staff are kind and helpful. Visitors said that they were happy with the care provided and that they were kept informed of any changes in their relative’s condition. They also said that they felt able to ask questions and that these were readily answered. The medication records were inspected in detail. Some of the records of controlled drugs were not accurate and were amended in the presence of one of the inspectors. The records for all other medication also contained inaccuracies with some medication not signed for. The medication for each person is hand written on to a chart and then coded. The procedure for this must be strictly followed to ensure that errors are not made. Out of date creams, nutritional supplements, dressings and other materials were found stored in the treatment room. Some were nearly three years past The Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 14 the expiry date. This is clearly unsafe as they could be used if the expiry date is not checked. These items need to be disposed of as soon as possible. Medication for disposal was also found stored in a cupboard as the disposal drum was full and a new one had not yet arrived. The disposal of medication needs to be reviewed to prevent the storage for excessive periods of time of medicines no longer required. Not all chemicals used were clearly labelled or securely stored. For example a spray bottle of blue liquid found in a bathroom was in easy reach and had no label on it. End of life care plans are not being used. This may mean that staff have not had the opportunity to find out what is important to the person i.e. are they religious, what support do they want from staff and relatives. The care manager advised that they would be introducing the Liverpool care pathway for people at the end of life and would be working in conjunction with the Macmillan nurse team to implement this. The care manager advised that training had been booked for this. The Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 15 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. 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 using available evidence including a visit to this service. The home endeavours to provide a range of activities but preferred lifestyle and interests need to be included as part of the assessment process in order to ensure that these are appropriate. The meals provided are of a good standard but the food preferences of those living in the home need to be ascertained and the menu for the day made readily available to ensure that everyone’s needs are met. EVIDENCE: Both the operations manager and the care manager stated that people living in the home are encouraged to participate in the activities organised which include carpet bowls, quizzes, bingo, exercises and watching sport on television. Some entertainment is provided from external sources and the library supplies large print books. The operations manager said that people The Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 16 are encouraged to continue with their interests and hobbies but these were not found to be recorded in their assessments or care plans. Religious services are held every other month which some people spoken to said they appreciated. The operations manager stated and visitors spoken to confirmed that efforts are made to ensure that contact with family and friends is maintained. Visitors are welcome at any reasonable time and private telephone lines to bedrooms can be installed. Visitors said that they are always made welcome, that they are kept informed of their relatives condition and that any questions they might have are readily answered. People living in the home and visitors praised the standard of the meals. Lunch was seen on both days of the inspection and the meals looked and smelled appetising. However, one person was heard to exclaim at the size of the portions saying it was far too much. This can be very off putting for someone with a poor appetite. Other people spoken to said that they never knew what was for lunch until it was put in front of them. One person said that lunch was always a surprise, another said that they were always given potatoes which they didn’t like and never ate. Meals are very important and time needs to be spent ascertaining everyone’s food preferences. These should be recorded in the care plans and a list kept in the kitchen for the cook’s reference. The menu for the day needs to be readily available to everyone so that alternatives can be requested in good time when required. The Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a clear complaints procedure which is readily available. Staff training regarding the protection of vulnerable adults needs to be provided/updated as soon as possible in order to safeguard those living in the home. EVIDENCE: The home has a clear complaints procedure a copy of which was seen displayed in the reception area. This is also included in the Statement of Purpose. One visitor spoken to said that they had raised a concern with the home which had been addressed promptly. They said they had confidence that if there was a more serious issue it would be dealt with appropriately. The operations manager said that the home had received no complaints in the past twelve months. The Commission for Social Care Inspection had received one concern about The Lawns in that time but this was not substantiated. The home has policies and procedures in place regarding the protection of vulnerable adults. However, the staff have had little or no training regarding recognising abuse and what action to take. This needs to be addressed as soon as possible. The Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 18 Those living in the home or their relatives manage their financial affairs. However, most people have some money for the purchase of small items and for the payment of bills such as the hairdressers which is looked after by the home and topped up by the relatives. Each person’s money is held seperately and securely with only the operations manager and the care manager having access to it. Records of all transactions are made but currently receipts are not kept. This should be reviewed. The Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,22,24,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Lawns provides the people living there with a safe and comfortable environment in which to live. EVIDENCE: The Lawns provides people with a pleasant, comfortable environment in which to live. It is well maintained and decorated and the operations manager stated that there is a rolling programme of refurbishment. The visitors spoken to all said that one of the reasons The Lawns had been chosen as a suitable home for their relatives was that there were no unpleasant odours. The Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 20 Those living in the home had been encouraged to bring with them personal items such as furniture (especially favourite chairs), ornaments and photographs and these were evident during a tour of the home and visits to bedrooms. Each room also has a lockable safe. The home is well equipped with specialist items such as pressure relieving mattresses and cushions, hoists and height adjustable beds. Bathrooms also have facilities to make assistance with bathing or showering as easy as possible. Efforts have been made to ensure that the environment is as safe as possible. The dining room has non slip flooring, water temperatures are controlled, there are hand washing facilities in every bedroom and elsewhere in the home and a shaft lift and stairlift provide safe access to the first floor. In addition the care manager stated that all radiators are now covered and all fire regulations are complied with. Infection control policies and procedures are in place. The Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Failure to obtain the necessary checks required prior to a new member of staff commencing employment places those living in the home at risk. EVIDENCE: The Lawns provides nursing care and therefore has a registered nurse on duty 24 hours per day. They are supported by a team of carers 60 of which have NVQ Level 2 in care or above. Staff rosters seen showed that there were adequate staff on duty each day. In addition there are catering, cleaning and maintenance staff. The files for five staff were examined. These were both nursing and care staff, recently appointed and longer serving. Each file had a completed application form, two references and a record of the police checks made. Where required work permits were seen to be in place. Nurses’ PIN numbers, confirming their The Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 22 registration, were found recorded on their files but not in a consistent way which makes them difficult to check. However, in each case the check of the protection of vulnerable adults list, which must be made before anyone commences employment in the home, had been made after they had started working. In one case there was no evidence that the check had been made at all, in others it was obtained as much as six weeks after they had commenced working in the home. This is not acceptable as it places those living in the home at risk. Some staff said that they were happy with the level of training that they receive others were not so satisfied. Training records are kept individually on each member of staff’s file. This makes it difficult to have an overview of training requirements. A chart detailing training received and refresher training due for the whole team would make it easy to identify who should be attending which sessions. Many of the people living in the home have problems with short term memory loss or dementia. No record of staff receiving training in managing these conditions was found. The Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The lack of a registered manager needs to be addressed as soon as possible but outcomes for those living in the home have remained fairly stable. Safe working practices should be improved with further staff training. The views of those living in the home are sought and acted upon. The Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 24 EVIDENCE: There has been no registered manager at The Lawns for well over twelve months. A new care manager has been appointed but has yet to submit an application for registration to the Commission for Social Care Inspection. This needs to be done as soon as possible. In the mean time the operations manager has been taking that responsibility. The views of those living in the home and their relatives are regularly sought. The results are collated and shared with them. One visitor said that a comment they had made on the questionnaire had been acted upon and therefore they felt it had been worthwhile taking the time to complete the form.. There are plans to extend the quality assurance system to other aspects of the running of the home. As previously recorded in this report, the financial affairs of those living in the home are managed by themselves or their relatives. Only money for sundries is held by the home with access to it limited to the operations manager and the care manager. Generally the home employs safe working practices with staff required to attend manual handling training annually and fire safety training available twice a year. However, not all staff have had infection control training and an unlabelled bottle of blue liquid was found within easy reach in one of the bathrooms. These issues need to be addressed. Environmental safety measures have been put in place e.g. water temperature controls, window restrictors, and equipment is serviced at the required intervals. Policies and procedures for safe working practices are in place. The Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 25 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 1 x 2 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 3 3 x 3 x 3 3 3 STAFFING Standard No Score 27 3 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 x x 2 The Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 26 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 OP3 Regulation 14 Requirement The assessment process must include all aspects of the person’s life including their social, emotional and pschological needs to ensure that the home can adequately care for them. The care plan must include sufficient information in order to guide the staff in the provision of all aspects of the person’s care. This must be up to date reflecting any changes in the person’s condition. Medication policies and procedures must be reviewed and adhered to in order to ensure that medication is administered safely and medicines no longer required are disposed of promptly. All staff must have up to date training regarding the protection of vulnerable adults in order to safeguard those living in the home. The registered person must ensure that no staff commence employment before the POVA DS0000003611.V365085.R01.S.doc Timescale for action 31/07/08 2 OP7 15 31/07/08 3 OP9 13 31/07/08 4 OP18 13 31/08/08 5 OP29 19, schedule 2 30/06/08 The Lawns, Brixton Version 5.2 Page 27 6 OP30 OP38 18 check has been completed with a satisfactory response. This is to ensure that no one deemed unsuitable to work with vulnerable people is employed. All staff must receive appropriate 30/09/08 training for the work they are doing, in particular infection control and dementia care. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP8 Good Practice Recommendations Care records should be reviewed with regard to daily records, wound care, the use of body maps and mobility in order for staff to clearly no what care and support they should be giving and for any changes to be noted. End of life care should be reviewed to ensure that wherever possible the person’s wishes are ascertained and carried out. A person’s preferred lifestyle and interests need to be included as part of the assessment process in order to ensure that daily routines and actvities provided are appropriate. The food preferences of those living in the home need to be ascertained and the menu for the day made readily available to ensure that everyone’s needs are met. 2 3 OP11 OP12 4 OP15 The Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Lawns, Brixton DS0000003611.V365085.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!