Inspection on 25/11/05 for The Oaks Nursing Centre

This inspection was carried out on 25th November 2005.

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

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

Other inspections for this house

The Oaks Nursing Centre 08/08/06

The Oaks Nursing Centre 31/05/05

The Oaks Nursing Centre 22/12/04

The Oaks Nursing Centre 06/07/04

The Oaks Nursing Centre 24/02/04

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

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

CARE HOMES FOR OLDER PEOPLE The Oaks Nursing Centre 904 Sidcup Rd New Eltham London SE9 3PN Lead Inspector Ms Pauline Lambe Unannounced Inspection 25th November 2005 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 Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 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 Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Oaks Nursing Centre Address 904 Sidcup Rd New Eltham London SE9 3PN 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) 020 8857 9980 020 8851 0261 the.oaks@craegmoor.co.uk Speciality Care (Rest Homes) Limited Miss Lynn Carol Jones Care Home 113 Category(ies) of Dementia - over 65 years of age (113), Mental registration, with number disorder, excluding learning disability or of places dementia (5), Mental Disorder, excluding learning disability or dementia - over 65 years of age (113) The Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 5 places for people with mental health problems 40-59 years excluding learning disability or dementia A further 3 places in the above category for named service users as agreed in the letter from the NCSC dated 10/12/03 The Registered Person must provide additional supernumary management time on each Unit as detailed below:Knowle Unit 10 hours per week Burstead Unit 10 hours per week Oxleas Unit 10 hours per week Joydens Unit 15 hours per week Lessness Unit 15 hours per week Belvedere Unit 18 hours per week Category DE(E) agreement was in place to allow admission of service users from 60 years of age prior to the implementation of the Care Standards Act 2000. The Commission for Social Care Inspection endorses this agreement. maximum number of service users at any one time must not exceed 113 31st May 2005 4. 5. Date of last inspection Brief Description of the Service: The Oaks Care Centre is owned by Speciality Care (EMI) plc and is part of Craegmoor Healthcare. The home is registered to provide nursing care for 108 older people with dementia and 5 younger adults with a mental health disorder. The home is located on the busy A20 dual carriageway between Eltham and Sidcup. The home is within walking distance of public transport or local shops. The building is divided into six self-contained units. The largest unit accommodates twenty-five residents and the smallest thirteen. Each unit is accessed through a combination lock. The units have a number of bedrooms, bathrooms, toilets and open plan lounge / dining area with kitchenette. Accommodation is provided on two floors. The home has 71 single and 21 shared rooms and all bedrooms have en suite toilet and washbasins. The Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors from the Commission completed this unannounced inspection over 7 hours. The service was last inspected on 31st May 2005. The inspection focused on the residents and service provided in Knole and Oxleas Units. The deputy manager was in charge of the home. The inspection included talking to residents, staff, relatives and management. A number of relatives were contacted by phone after the inspection to obtain their views of the service. Records required by regulation such as care plans, medication, accident, safety and maintenance and employee files were inspected and the inspectors toured the premises. Relative feedback was generally positive and comments are included in the main body of the report. What the service does well: What has improved since the last inspection? What they could do better: Management must adhere to staffing levels at all times and ensure one to one care is provided when needed. Medicine records must be signed at the time of administration, staff must have access to the homely remedy policy and list agreed with the G.P and topical medicines must be used for a named resident. Social care plans must be prepared for residents The armchairs in Oxleas Unit must be kept clean or replaced, the work surface in the kitchenette on Knole Unit must be kept clean or replaced and the bathroom on Oxleas Unit must be kept clean. The Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 Page 6 Bedrooms must be kept at a comfortable temperature for residents. Adequate bedding must be provided to residents to ensure they are warm and comfortable when in bed. The management of resident money must be urgently reviewed and a system put in place to ensure residents and their representatives can see what money the resident has at any given time. 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 Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 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 Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 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): 1, 3, 4 and 5. Standard 6 does not apply to the home. There was evidence on the file seen that residents were assessed prior to admission. EVIDENCE: No changes had been made to the statement of purpose and service user guide since they were last viewed. Pre-admission assessments were seen on the care plans viewed and included a behaviour assessment scale of later life. Information on residents was also obtained from care managers, hospital and psychiatrist reports prior to admission. From observation and evidence provided staff were meeting the residents needs. One resident was receiving palliative care and the fact the resident did not speak English was addressed in the care plan. One resident on Oxleas Unit did not always have the one to one staff allocated as was identified in their care plan. This was the case on the morning of the inspection. The Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 Page 9 Residents, relatives and care managers were welcome to visit the home prior to the admission of a new resident. Requirement 1. The Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Care plans were quite well prepared. More attention was needed to medicine management. EVIDENCE: Four care plans were viewed. These included comprehensive assessments and care plans were prepared to show how most needs were to be met. Some care plans on Knole Unit were not specific as to how to manage challenging behaviour. Resident files contained information on health care needs. A resident on Oxleas Unit who had lost weight was being monitored appropriately. On Knole Unit residents who had lost weight were having their food intake monitored. Residents were registered with a G.P and supported to access other NHS services and hospital appointments. Assessments had been done to identify residents at risk of developing pressure sores and equipment was provided to prevent or treat these. Wound care records were well maintained. There was also evidence to show advice had been obtained from the tissue viability nurse appropriately. The Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 Page 11 Medicines on Knole Unit were well managed. Audits were regularly undertaken by the staff nurse or care manager. A check on medicines in stock showed inaccuracies in one homely remedy and for one resident’s medicines. On Oxleas Unit a number of inaccuracies were noted. These included some for homely and resident medicines. For example in some cases the remaining stock did not tally with the amounts dispensed and administered. Neither Unit had a copy of the homely remedies agreed with the G.P. The record for ‘as needed’ medicines was not always completed. A jar of ointment was seen in a bedroom, which was prescribed for another resident. The manager said she was looking into getting medicines provided in blister packs with pre-printed medication charts. This idea should be progressed as it may prevent the errors noted. Residents were unable to comment on how their privacy was respected. Staff were observed providing care in private in bedrooms and bathrooms. Relatives seen said staff treated residents with respect. A number of residents on Knole Unit present were seen to be in a state of ‘well-being’ for example they were talkative, smiling and responsive. Two residents were being aggressive with each other and staff managed the situation well. Relatives present and contacted after the inspection said they were satisfied with the care provided. Comments made included ‘staff are very caring to the residents’, ‘residents are always clean and tidy’ and ‘ residents could not be better cared for’. Requirements 2 and 3. The Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14 and 15. Social care plans and recording resident involvement in these could be better. Most of the residents could have only limited input over their own lives. Meals provided were satisfactory. EVIDENCE: Two full time activity organisers were employed. An activity programme was prepared but this was flexible delivered based on resident acceptance. Social care plans must be better and reflect the resident’s choice and preferences. The social activity diary viewed for a number of residents on Knole and Oxleas Unit indicated the residents had little participation in activities. Relative seen on Knole Unit said activities were provided but often residents were not interested in taking part. They said residents enjoyed music sessions and parties. Some of the relatives contacted after the inspection said their resident was happy in the home. Most of the residents could have only limited input over their own lives, which made it difficult to assess standard 14 in the unit inspected. On other units in the home residents could be more active in this area. Lunch was observed in Knole and Oxleas Units. The meal was served calmly and staff were attentive and helpful. A high number of residents required The Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 Page 13 assistance to have their meal. To assist with feeding the manager had the activity and domestic staff trained to help feed residents. Residents were given very large meal portions and many did not manage to eat all the meal. Menus were displayed and included pictures. A choice of meal was provided but most residents were offered one choice. One resident on Oxleas Unit asked for a different meal and this was provided. Foods were pureed separately to make them look appetising. Relatives present said the meals were always good and that the menu was followed. Relative contacted after the inspection agreed with these comments. Requirement 4 and recommendations 1 and 2. The Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 Page 14 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): Procedures were in place to ensure complaints and allegations or suspicions of abuse were appropriately investigated. Systems were in place to record incidents/accidents that could adversely affect the health or welfare of the residents. EVIDENCE: A system was in place to record complaints. Those seen showed complaints had been managed appropriately and feedback given to the complainant. Two letters of appreciation were seen. Relatives contacted after the inspection said they knew whom to see if the had a concern and some said that issues raised were dealt with quickly. Residents on Knole and Oxleas Unit would have difficulty making a complaint. Relatives seen said they knew how to deal with a complaint and indicated they knew the manager and care managed well enough to raise concerns with them. Policies and procedures were in place to manage allegations or suspicions of abuse. Staff displayed their awareness of adult protection and how to deal with such an incident. Since the last inspection a number of concerns were referred to social services by the home or other agencies, in relation to resident care. The protection of vulnerable adults team were involved in a number of these but none of the issues were substantiated based on the evidence provided in care records. The Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 Page 15 One of these issues remained outstanding at the time of this inspection and was being followed up by social services, the PCT and the Commission. The Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 22, 24 and 26. The refurbishment programme commenced in January 2004 was still in progress. The work done so far has improved the environment but efforts must be made to complete the programme. Some environment standards required improvement and have been identified below. EVIDENCE: The lounges in Knole and Oxleas Units were adequately furnished and decorated. On Knole Unit there was a white board displaying the day, date, weather and activities. On Oxleas Unit some of the lounge armchairs needed recovering or replacing. The carpet outside the nurse station on this unit was worn and damaged and could pose a trip hazard to residents and others. On Knole Unit the work surface in the kitchenette was badly stained. The bathroom on Knole Unit had been nicely refurbished and a new assisted bath provided. Staff said residents enjoyed using the new bath. The floor and bath in the Oxleas bathroom were stained and the room had an unpleasant odour. The Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 Page 17 Bedrooms were clean and tidy. Some bedrooms viewed lacked the personal touch. More effort should be made to encourage relatives to personalise these or staff to do so based on the resident’s social history and interest. This applied particularly to bedrooms on Oxleas Unit. On Knole Unit bedroom light switches are outside the room. In other units in the home switches were moved to the inside of the bedroom and this should happen on Knole Unit. On both units bedrooms were quite cold as the windows were left open. Staff must ensure they close bedroom windows before taking residents to their rooms for the night. Also in both units beds had only one blanket. Some extra blankets were seen in the linen store however as the residents in the home suffer from dementia staff must ensure they are warm enough when in bed. Some relatives contacted after the inspection commented on this and also felt the bedding was inadequate. The relatives said they were satisfied with the environment and that it was generally clean and tidy. Suitable equipment was provided to assist residents to maintain their independence. Staff had access to protective clothing and hand washing facilities where waste was handled. Requirements 5, 6, and recommendation 3. The Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. From the rotas seen staffing levels were adhered to. Concerns were noted in providing staff to one to one residents who needed this. Staff had access to training relevant to their roles. EVIDENCE: Each unit had a designated staff team consisting of a part time care manager, qualified nurses, care assistants and domestics. Rotas seen for a four week period showed that staffing levels were adhered to. However in view on the number and needs of the residents on Belvedere Unit the registered Provider should consider having two nurses on duty particularly for the morning shift. On Oxleas Unit one resident was assessed as needing one to one care. Staff said and records showed that the additional member of staff was not always provided. This was the case on the morning of the inspection. Although the home is separated into units with a designated staff team the rotas showed that staff are moved from unit to unit to cover shifts. This practice could pose a problem to continuity of care for residents. Some of the relatives contacted after the inspection said they noticed that staff in the units changed regularly. What they said was the nurses were not changed but the care assistants were changed regularly. The Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 Page 19 Three staff files were viewed and found to comply with regulation. Staff said they were provided with training relevant to their roles and felt this had improved the quality of care they provided. Since the last inspection training such as moving & handling, infection control, fire safety and adult protection was provided. NVQ training programmes were in hand for care staff. Recommendations 4 and 5. The Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 35, 36 and 38. The home manager was registered with the Commission. Staff received formal supervision. Records seen showed attention was given to providing a safe environment. Concerns were identified in the management of resident’s personal finances. EVIDENCE: The manager was registered with the Commission and continued to present as committed and energetic in fulfilling her role. Staff spoke positively about the management input and support. Relative meetings were held and minutes kept. The minutes were not viewed on this occasion. Since autumn 2004, residents’ finances had been mainly managed from head office. It was said, that when head office took over this responsibility, they mislaid the receipts for residents’ expenditure, which they had collected from The Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 Page 21 the home. Since that time staff in the home had been unable to provide residents and relatives with accurate records of what monies individual residents had in the common resident’s account. The administrator kept records for all resident expenditure but despite her best efforts was unable to provide accurate information to residents and relatives as most financial transactions were managed at head office. The records of individual monies held in the common residents’ account, kept in the home and those kept at head office, did not always match. This is a very unsatisfactory and worrying situation and must be resolved without delay. All residents had access to personal allowances and the home acted as appointee for two residents. A process to ensure staff received formal supervision was in place. The supervision process had settled into a routine and staff spoke positively about the benefits of supervision. Some staff said supervision did not happen very frequently with some not receiving any since May 2004. A selection of safety records checked included the moving and handling equipment, the lift, the landlords gas safety certificate, providers public liability insurance, the PIR system and fire safety records. Up to date certificates were not seen for the hoists and assisted baths or the fire alarm service. At the time of writing this report the Commission had received written confirmation that the hoists and baths were serviced on 15/11/05 and the fire alarm on 15/12/05. The other records viewed were satisfactory. The fire alarm was checked weekly and fire drills held monthly. A fire drill was held on 11/7/05 for the night staff and a record kept of those present. Requirement 8 and recommendation 6. The Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 17 18 2 X 2 3 X 2 X 2 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 2 2 X 3 3 X 3 The Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP4 Regulation 18 Requirement The Registered Person must ensure staffing levels are adequate to meet the needs and special needs of residents admitted. Residents assessed as needing one to one care must have this provided at all times. The Registered Person must ensure care plans reflect how care needs are to be met. This includes how to manage a residents challenging behaviour. The Registered Person must ensure staff keep accurate medicine records. Medicines must be signed for at the time of administration. Accurate records must be kept of homely remedies. Staff must have access to the homely remedy list agreed with the G.P. Topical medicines must be for individual use and never shared between residents. The Registered Person must ensure social and activity care plans are prepared for residents. DS0000006767.V259390.R01.S.doc Timescale for action 30/12/05 2 OP7 15 30/12/05 3 OP9 13 30/12/05 4 OP12 16 30/12/05 The Oaks Nursing Centre Version 5.0 Page 24 5 OP19 23 6 OP21 23 7 OP24 23 8 OP35 17 Schedule 4 (Timescale of 29/07/05 was not met.) Residents involvement in activities must be recorded to support care plan implementation. The Registered Person must ensure the home is well maintained. Armchairs on Oxleas unit must be recovered or replaced as needed. The carpet by the nurse station on Oxleas Unit must be repaired. The work surface on the kitchenette unit on Knole unit must be replaced. The Registered Person must ensure bathrooms are kept free of offensive odours and the stains recovered from the bath and floor in Oxleas bathroom. The Registered Person must ensure bedrooms are maintained at a comfortable temperature for residents and that adequate bedding is provided. The Registered Person must ensure a record is kept for all money deposited, received, returned to the resident and how the money was used. The records must be accurate, up to date and available to the resident, their relative or representative on request. 20/02/06 20/01/06 20/01/06 27/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 Page 25 1 2 3 OP12 OP15 OP24 4 5 6 OP27 OP27 OP36 The Registered Person should consider increasing the activity hours provided to ensure the needs of the residents are appropriately met. The Registered Person should serve meals to residents in portions suited to their needs. The Registered Person should continue to move light switches from the outside to the inside of bedrooms. This should be done for residents on Knole Unit. Also more efforts should be made to encourage relatives to personalise bedrooms. If this is not possible then maybe staff could do this for the residents based on the person’s social history, interests and hobbies. The Registered Person should try to keep regular staff on the units to ensure continuity of care for residents. The Registered Person should consider having two nurses on duty on Belvedere Unit for the morning shift in view of the number and needs of the residents there. The Registered Person should ensure staff receive supervision every six weeks as stated in this standard. The Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Oaks Nursing Centre DS0000006767.V259390.R01.S.doc Version 5.0 Page 27 - 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. 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