Inspection on 13/01/09 for The Nunnery

This inspection was carried out on 13th January 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Nunnery 19/12/07

The Nunnery 15/05/07

The Nunnery 17/01/07

The Nunnery 20/04/06

The Nunnery 23/11/05

The Nunnery 13/04/05

The Nunnery 29/10/04

The Nunnery 23/05/04

Similar services:

Claremont House

Chesham House

Oak Ridge

Argyll House

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Nunnery 14 Denmark Street Diss Norfolk IP22 4LE     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Brenda Pears     Date: 1 3 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: The Nunnery 14 Denmark Street Diss Norfolk IP22 4LE 01379643201 01379642649 thenunnery@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Jane Wentford care home 23 Number of places (if applicable): Under 65 Over 65 0 22 mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 1 0 Mental disorder, excluding learning disability or dementia (MD), One person (1) male, who shall be named in the records. Old age, not falling with any other category (OP), twenty two (22) of either sex. Date of last inspection Brief description of the care home The Nunnery is situated close to one of the roads leading from the market town of Diss. Gardens to the rear slope steeply down the banks of the Mere, and there are panoramic views across the water to the town. The street frontage and main building is old, and there is a newer extension to the rear. A shaft lift provides access to the first floor. There is a lower ground floor (as a result of the sloping site), which is accessible via stairs or a stair lift. The home is registered to provide care for 23 people, and three of the rooms would be double. These rooms are currently being used for single occupancy as these residents do not wish to share. The current fees range from #340 to #520 per week. Care Homes for Older People Page 4 of 28 Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is a one star. This means the people who use this service experience adequate quality outcomes. This inspection considers information gathered about the service since the last key inspection in December 2007. In order to complete the inspection a site visit was conducted by an inspector and we spoke to four residents, the manager and to members of staff. During the site visit we completed a tour of the premises and also looked at records relating to people living and working in the home. Care Homes for Older People Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager does assess the needs of any new resident to make sure individuals can be supported before an agreement is undertaken. Evidence: A full assessment is undertaken before support is agreed and staff have confirmed that they feel there is adequate information to provide assistance. New residents in the home have confirmed that full information is provided by the manager before the admission into the home is carried out. Care Homes for Older People Page 9 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are in place but not all have been reviewed, these require regular review and updating to give appropriate information for staff to provide support. Staff must pay attention to the clothing being worn my residents to ensure they are as tidy and well dressed as they would wish to be. Evidence: We looked at three care plans and these confirmed that individual information is gathered and detailed but as these are printed documents, a lot of the information does not stand out very well. The files have coloured pages that have questions and boxes for a response. The response is then put into the box, but details have to be searched for as the printed form appears to merge together. Care plans have been reviewed but the manager stated, and files showed, that this practise is not currently being completed. Two files seen at this time had been reviewed but one other had not been reviewed regularly. Staff did express knowledge of the needs of residents during discussions at this time, but care plans do not show all Care Homes for Older People Page 10 of 28 Evidence: the care/support that is provided. For instance, one care plan shows that a prosthesis for one person is cleaned regularly and conditions observed. There was only one record of this being undertaken when the condition needed to be monitored. No subsequent record was found that indicated that this was now in a satisfactory condition. When discussing this with staff, they said this is carried out as stated in the care plan but is only recorded if anything adverse is found. This was discussed in depth with the manager at this time. One care plan did include information for staff on how to address one resident who is hard of hearing by talking slowly and clearly without shouting. Another stated that when dealing with catheter care staff are to make sure the resident is aware of the procedure you are about to perform. However, another stated that Plan of action agreed with resident but there was no information as to what this was. A file stated refer to district nurse directions but there was no copy of these in the care plan. When asked, staff said that these notes would be in that residents room, but the care plans do not contain all the details of the care required for each individual. The care plan format has detailed sections of information that show both doctors and district nurses provide support and other health care services are accessed when necessary. The district nurse was present at this inspection and stated that appropriate pressure relieving mattress toppers are provided to the home. When the manager was asked about specific mattresses to relieve the risk of pressure sores, she stated that the home is instructed by the nurses and advise is offered regarding the appropriate equipment to be used. The manager confirmed that if a specific mattress was required, this would be obtained for the resident concerned. The system for the storage and administration of medication are appropriate, a lockable trolley is in use and records were clear and up to date. Medication was orderly, clean and tidy in the storage area and names were easily see. The lighting in this area is very dull and does not support the dispensing of medication, the manager stated that this would be dealt with immediately. Previous staff meeting notes have confirmed that medication systems are monitored by the owner and any problems are discussed with staff. Discussions were undertaken regarding the change in legislation and the requirement for homes to have controlled drug cabinets in place. The manager stated she would refer to this and ensure the home complies in the timescales set down. The manager is also to ensure the small fridge being used for medication meets with requirements. This fridge is monitored regarding the temperature and is also kept locked. Care Homes for Older People Page 11 of 28 Evidence: Staff must pay attention to how they assist a person to dress daily, while there is choice, staff need to assist with decisions to make sure a person is appropriately dressed at all times. This has been mentioned in the previous report where a person looked very untidy and previous complaints received have been about how uncared for some residents appeared. At this inspection, a member of staff was assisting a person to walk to the lounge and the cardigan the person was wearing was very creased and looked as if this had been tumble dried in error. When this was pointed out to the manager, she agreed this was not acceptable, but this same person was taken to the lounge and was later seen in the same cardigan. Another lady said she felt cold and had on a blouse with a thin cardigan, when the manager was made aware of this, she did go and get a thicker cardigan for this person. Care Homes for Older People Page 12 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. While staff can discuss social events that are undertaken in the home and those that are planned, these are currently not recorded to evidence this. Evidence: Residents are able to have visitors at any time and two residents confirmed this during discussions at this inspection. There were no visitors at the time of this inspection to discuss this with. The manager explained that some new residents do have family and visitors that attend social functions and who also support the home. A new cook has recently been appointed and he explained that he would be getting to know the residents and discussing exactly what kind of meals they would like to have available. Food smelt and looked appetising at lunch time and residents said that they enjoy their food and have enough to eat. The manager explained that staff go around to each resident on a daily basis for meal choices and details such as how long people like their eggs boiled is recorded. Eggs are then taken out when the person chooses and cooked just how they like. The first question is always about their previous meal and if they enjoyed it or not. The lunch Care Homes for Older People Page 13 of 28 Evidence: on the day of this inspection was lamb chops or shepherds pie or mushroom risotto with steamed apples and custard or jelly or creme caramel. There is always cheese and biscuits available and the cook explained details of some special diets that are catered for. Residents are able to have drinks as they need and staff did offer refreshments during this inspection but there is no evidence that shows this is always the routine in the home. A previous request from visitors about being able to make their own drinks has been considered. The manager explained that this would then present problems with safety of residents should they use this facility. Visitors are currently able to have drinks from the kitchen as they wish. The staff constantly try to develop new activities and also undertake the organising of these events. The manager is currently developing a wish tree. This will be for each resident to write their wish and display on the tree and then these will be read and staff will try to make wishes come true. Other activities include quizzes, ten pin bowling, and mini olympics with home golf, darts and football. Family members and visitors attended and got involved with activities. There is also a resident of the week and a picture in the lounge showed this, accompanied by details of their favourite music, film, drink and other details. There are books available to residents and a folder containing financial and benefits information is also left for residents to view at their leisure. Information is also available regarding various medical conditions to inform residents if they have been recently diagnosed. There were no activities undertaken on the day of this inspection and care plans did not have any records to show who participates in what activity and for how long. Care Homes for Older People Page 14 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager does inform residents about access to alternative organisations for advocacy and a complaints policy is on display in the home. Evidence: The home has provided information regarding advocacy services and details of how to make contact if residents wish. Feedback from relatives has previously been mixed regarding the amount of contact they have from the home. There were no visitors at this inspection to discuss this with. The manager explained that some new residents do have family and visitors that attend social functions and do support the home. A complaints policy is on display and details of how to contact the Commission are also included and up to date. Staff confirmed that they have undertaken training on abuse and stated they feel they would be listened to if they brought any incidents to the attention of the manager. Residents appeared to be comfortable and confident when discussing matters with staff and the manager at this inspection. Care Homes for Older People Page 15 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. While the environment is being addressed and some improvement has been undertaken in some areas, the general environment in the home remains in poor condition. This is currently not providing a comfortable and homely environment for residents. Evidence: The kitchen area has had new wiring installed and new tiling throughout. The kitchen was seen to be bright, tidy and clean. A new cook has recently been appointed and he explained that he would be getting to know the residents and discussing exactly what kind of meals they would like to have available. Food smelt and looked appetising and three residents said that they enjoyed their food and have enough to eat. The environment has previously been assessed as poor due to the lack of regular maintenance and redecoration in the home. At the time of this inspection, the home had a strong odour in the entrance hall, in the main lounge area and in one bedroom. The manager was informed of this and she stated that she could not smell anything and that carpets were regularly deep cleaned and she would get the housekeepers to address the areas concerned. An electrical assessment has been undertaken and the manager provided a Care Homes for Older People Page 16 of 28 Evidence: comprehensive list of work that is due to be carried out. As each area of the home has the electrical work completed, redecoration will also be undertaken. The manager stated that a local carpet company is currently prioritising areas of the home and new carpet will be put into any room that is to become occupied. A new person was admitted to the home on the day of this inspection and this persons room has had new carpet. The manager stated that any room needing new windows have had these installed. Bathrooms have also been identified as needing new heating to improve the current bathrooms that have wall heaters and are very old in design. The electrics will be installed first and then refurbishment of each bathroom will follow. One bathroom has been upgraded and is now a wet room with a shower that has a chair to support people with varying needs. The lighting throughout the home and in the main entrance area is very low wattage and does not give off very good lighting, particularly for those people who are independent in the home. This also presents the home as being very dim and neglected, particularly in the front lobby area. Following discussions, the manager said that brighter bulbs would be installed. The furniture in the home is very worn as are some areas of carpet, this coupled with the lack of new, bright decoration, gives the home a very dull and faded image. The home does not present a welcoming and comfortable environment for residents or visitors. There is a large lounge and a smaller area known as The snug and staff were laughing and chatting with residents at this time. In the dining room, one table cloth was seen to be stained and had marks on it prior to a meal being served, this was pointed out to the manager. The home has a rear garden and overlooks a large lake to the rear. There is access to this water at the side of the garden and there is currently no guard for the safety of residents. The manager said this would be addressed as soon as possible. We spoke to the manager about a risk assessment being completed to identify risks and then procedures and actions taken to minimise all risk to residents in the home. Discussions were also undertaken with the manager regarding risk assessments for any external doors that lead from resident rooms. It was explained that current residents have been in the home for some years and there have been no problems. However, as previously stated, a risk assessment must be completed for the protection and welfare of residents. Care Homes for Older People Page 17 of 28 Care Homes for Older People Page 18 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels are currently sufficient to meet the needs of the number of residents in the home. Evidence: Rotas previously did not show the designated duties of staff on shift, however, rotas do now show who is senior on shift and also describes other job roles in the home. At the time of this inspection staffing consisted of three care staff, two people on work experience, one housekeeper as one other housekeeper had called in sick, one cook and the manager. There are two staff on duty during the night period and the home currently has an on call system that the manager and the deputy manager handle at all times. All laundry is completed by care staff on duty and this will obviously mean that staff are then taken away from their care duties at this time. Observations at this time showed staff undertaking their duties in a calm manner and during discussions, staff said that they work together to provide appropriate care at all times. The manager stated that criminal records are always obtained before any staff work alone in the home. The cook currently has an initial police check (POVA first check) and is awaiting his final criminal record check (CRB). Until this is received, he will be Care Homes for Older People Page 19 of 28 Evidence: working in the kitchen and will later get to know residents and their likes and dislikes regarding meals. Three staff files showed that appropriate information and checks are obtained prior to any new staff starting work. Although the manager said staff now take staggered breaks, staff actually took their lunch break together at this time. Staff explained that they attend to residents and listen out for any call bells. Staff were seen to be taking turns to check on residents during their lunch break. The staff room has a copy of policies and procedures that contain detailed information leaflets of various age related matters and illnesses. Policies and procedures have previously been reviewed and are now due to be updated again. Staff training carried out during the last year includes moving and handling, health and safety, refresher training regarding dispensing medication, protection of vulnerable adults and infection control. Care Homes for Older People Page 20 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. While there are records for the regular maintenance of many areas of the home, the general environment and safety of residents must be protected at all times through regular assessment, audit and through the vigilance of staff. Evidence: The home has a few fire exit signs on the ground floor, these identify fire doors but there are no signs to indicate the route to the fire doors in an emergency. The first floor did not have any fire signs and the manager must get in touch with the fire safety officer for advice and a full fire safety assessment. Accidents are recorded and details contain in a section of the report form to identify any action that is taken. One month had eight entries of falls for one resident and the action stated none. Discussions with the manager identified that this was the first month the person was in the home and the resident did not want to disturb staff by asking for assistance. This was discussed with the person and the incidents of falls has Care Homes for Older People Page 21 of 28 Evidence: now decreased, but the action taken was not documented or set out in records or on the care plan. Care Homes for Older People Page 22 of 28 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 7 15 The care plans must contain detailed information so that staff know how to meet individuals needs All medication must be clearly marked with the residents name. The areas for storage of medication must be kept clean 31/01/2008 2 9 13 (2) 10/01/2008 3 10 12.4(a) The residents must be 10/01/2008 assisted with dressing and personal care in a way which respects their privacy and dignity 4 19 23.2.(b) The Registered Manager 01/06/2008 must ensure that the Home is reasonable decorated and carpeted. This requirement is repeated 5 19 13 (4) A risk assessment must be 10/01/2008 carried out for the use of the electric bar heater in the small lounge/reception area. A suitable guard must be in place around this heater Care Homes for Older People Page 23 of 28 when in use. 6 20 23.2 (c)& (p) The Manager must ensure 10/01/2008 that the home is suitably heated and that heat in each bedroom can be controlled by the resident as and when they wish. This requirement is repeated The Registered Manager 10/01/2008 must ensure adequate heating is available and constant in the bathrooms. This requirement is repeated 7 25 23.2(p) 8 26 23 (2d) All areas of the Home must be kept clean and free from offensive smells 10/01/2008 9 27 17 (2) The rota must be an accurate 10/01/2008 record of the staff who are on duty at any one time 10 29 19.1(c)Sched The Manager must obtain the 10/01/2008 ule 2 information in Schedule Two of the Care Homes Regulations prior to employing new staff. This requirement is repeated 24 An annual quality assurance report must be sent to the Commission 20/06/2008 11 33 Care Homes for Older People Page 24 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 The service users health, personal and social care needs are set out in an individual plan of care. All care plans are to be reviewed and up dated on a monthly basis, or sooner if care needs change. (This has only been partly met from the previous inspection requirements) 27/02/2009 2 10 12 The arrangements for health 02/02/2009 and personal care ensure that service users privacy and dignity are respected at all times. Staff must support the dignity of residents with particular regard to the condition of clothing and to how the resident looks on a daily basis. 3 19 16 That the home is suitable, safe and well maintained in a comfortable and homely way. 26/06/2009 Care Homes for Older People Page 25 of 28 That the home continues to improve the environment in all areas until this standard is met. 4 19 12 The registered person shall make proper provision for the health and welfare of service users. That an environmental risk assessment is completed particularly with regard to external areas and access to water from the garden. 5 25 12 That the lighting meet the relevant health and safety requirements and the needs of individual service users. That the quality of lighting throughout the home supports the welfare and safety of residents. 6 26 16 The premises are kept clean, 26/02/2009 hygienic and free from offensive odours throughout. That cleaning programmes are in place to ensure the cleanliness of all areas and the home is kept free from odours at all times. 7 33 24 There is an annual development plan for the home based on the aims, objectives and statement of purpose of the home. Continued self monitoring is to be undertaken for all areas of the home and evidence of such monitoring 30/03/2009 13/02/2009 26/02/2009 Care Homes for Older People Page 26 of 28 to be available for inspection. 8 38 23 the registered manager 02/03/2009 ensures so far as is reasonably practical the health, safety and welfare of service users and staff. That a full fire safety check is undertaken to ensure fire signs meet with regulations and protect residents and staff. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 12 That full details are recorded of any activities undertaken by each resident to both inform care plans and also the development of any new activities. Care Homes for Older People Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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