Inspection on 22/05/06 for The Old Parsonage

This inspection was carried out on 22nd May 2006.

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

The inspector 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 Old Parsonage 28/01/09

The Old Parsonage 13/02/08

The Old Parsonage 20/02/07

The Old Parsonage 31/01/06

The Old Parsonage 15/07/05

The Old Parsonage 27/01/05

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOMES FOR OLDER PEOPLE Old Parsonage (The) The Street Broughton Gifford Melksham Wiltshire SN12 8PR Lead Inspector Karen Mandle Key Unannounced Inspection 22nd May 2006 09.30 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 Old Parsonage (The) DS0000061474.V295922.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. Old Parsonage (The) DS0000061474.V295922.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Old Parsonage (The) Address The Street Broughton Gifford Melksham Wiltshire SN12 8PR 01225 782167 01225 783245 christine.rch@googlemail.com 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) Roseville Care Homes (Melksham) Limited Mrs Christine Ann Jones Care Home 20 Category(ies) of Dementia - over 65 years of age (20), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (20) Old Parsonage (The) DS0000061474.V295922.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The staffing levels set out in the Notice of Decision dated 23 December 2004 must be met at all times Date of last inspection Brief Description of the Service: The Old Parsonage is a 19th century listed building that has been converted for use as a care home and is situated on the edge of Broughton Gifford village in the north west of the Wiltshire countryside. The home is registered to provide nursing and care for 20 people with dementia and/or mental disorder who are aged 65 or over. On the day of the inspection, there were 20 persons resident in the home. Accommodation is provided on 2 floors of the home and consists of 14 single rooms and 3 double rooms. There is an accessible paved courtyard area to the rear of the building. Parking space is available. The home was purchased by Roseville Care Homes Ltd on 24th December 2004. The responsible individual is Mrs Edith Parkin. The registered manager is Mrs Christine Jones, who is a registered mental health nurse; she leads a team of nursing, care and ancillary staff. Broughton Gifford is about 10 minutes away from Melksham to the north and Bradford on Avon to the south. Both towns have railway stations. The M4 is about 30 minutes drive away. Old Parsonage (The) DS0000061474.V295922.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit for this key inspection commenced 22nd May 2006 when the inspectors Karen Mandle and Sally Walker toured the building, observed staff interacting with service users and attending to their care needs. The inspectors visited with many of the service users and 5 service users were case tracked through the inspection process. The service users due to needs were unable to participate with service users surveys, however two service users were able to verbally express their opinions which were positive about the home and the care they received. Relative/visitors comment cards were sent following the visit. Only one was returned on the 12th June 2006. The comments received were positive about the overall care provided at The Old Parsonage. During the inspection, care records were reviewed, as were medication procedures and records, accident reports, and employment records. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experience of people using the service. What the service does well: What has improved since the last inspection? Old Parsonage (The) DS0000061474.V295922.R01.S.doc Version 5.2 Page 6 Seven of the twelve requirements made at the previous inspection had been met. The medicines administration records were complete. The Commission has been informed of a completion of a bathroom. All wound dressings and catherisations are now carried out by using aseptic procedures. Employment references are now in English. The hoist and lifting scales are now regularly serviced. 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. Old Parsonage (The) DS0000061474.V295922.R01.S.doc Version 5.2 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 Old Parsonage (The) DS0000061474.V295922.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 All service users are fully assessed prior to admission ensuring that the home is able to meet their individual care needs. Quality in this outcome area is judged to be good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager Christine Jones RMN conducts a full assessment of all prospective service users prior to admission ensuring that the home is able to meet all aspects of nursing and social care. The assessment is documented and used towards implementing a care plan at the time of admission to the home. Many of the service users have complex mental health care needs, which are detailed in the assessment. Old Parsonage (The) DS0000061474.V295922.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Each service is provided with a care plan providing information to reflect all nursing needs and care needs, apart from falls risk assessment. Health care needs are dealt with appropriately. The medication procedure is safe apart from the storage of disposable medication. The current staffing level cannot ensure that service users are fully supported and supervised to maintain their dignity at all times. Quality in this outcome area is judged to be adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All service users have a care plan in place to direct nursing and care staff in how to meet the complex needs of the service user group. The inspectors reviewed six care plans following visits with all service users. The care plans provided information about mental health care needs and physical care needs. The manager was in the process of introducing a care chart document to further support the higher dependency care needs of frail service users. Photographs of the service users were not seen on the care plans, which are considered as a good means of identification for care staff as many service users have limited communication. All care plans should contain a falls risk Old Parsonage (The) DS0000061474.V295922.R01.S.doc Version 5.2 Page 10 assessment especially for those service users who clearly are at high risk of falling. Not all the care plans had been reviewed monthly. However the manager continues to improve the care plan format. Evidence was available that when the health care needs of the service user changed that prompt contact was made to the GP. Each service user is registered with a local GP. Evidence was also available of other health care professionals involvement with changing health care needs of the service users. Appropriate pressure reliving mattresses were in place following a pressure area risk assessment being completed. However when the service users were out of bed, pressure-relieving cushions were not being used in the armchairs placing a risk of pressure breakdown occurring during this time. The medication procedure was assessed as safe and all medication administration sheets were up to date. The unused medications waiting to be disposed of were not stored correctly. The qualified nurses are responsible for the administration of medication. Nursing and personal care was observed being provided behind closed doors either in the service users bedroom or bathroom. The care staff were observed and heard talking with service users in a respectful manner. However during the morning whilst all care staff were still very busy providing care upstairs in the home, a service user did remove all their clothes whilst sat in the communal lounge with six other service users who were not being supervised by a member of staff. At the time of this incident-taking place two carers were providing full support to a service user having a general bath, whilst the other carer and manager were providing care to another very frail service user. The current staffing levels cannot ensure that service users are fully supported and supervised to maintain their dignity at all times. Old Parsonage (The) DS0000061474.V295922.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, and 15 The activities programme and social care needs of the service users cannot be fulfilled with the current staffing levels in place. Service users are fully supported by the home to maintain links with family and friends. Service users are able to maintain a limited control over their lives in line with their care needs. Service users were complimentary of the food provided and nutritional needs closely monitored. Quality in this outcome area is judged to be adequate. This judgement has been made using the available evidence including a visit to this service. EVIDENCE: An activities programme is in place and each service user has a social care plan supporting the social aspect of care. However due to the staffing level at the time of the inspection, activities were not taking place as all three care staff on duty were involved with providing personal care. Seven service users were observed spending the morning in one of the communal areas mainly unsupervised by staff, again due to the staffing level provided. However many of the service users attended the dining room for lunch where good interaction was seen between the staff and service users. Service users were calm and obviously enjoying this period. Old Parsonage (The) DS0000061474.V295922.R01.S.doc Version 5.2 Page 12 Service users are supported by the home to retain links with family and friends. Visits can take place to the home at any reasonable time. Service users may receive visitors in a communal room or in the privacy of their own room. Due to the complex mental health needs of the service user group, retaining control and choice over their own lives could be considered a high risk to service users. However it was evident with speaking with those service users who were able to communicate that service users are able to make choices within the home, as to how they spend their day. A service user clearly stated that she enjoyed being in her room most of the day and she always had what she liked for breakfast. Another mobile service user was observed freely walking about the home with no restrictions apart from the outside doors to the home. At the commencement of the inspection several service users were observed finishing a cooked breakfast, which they reported as a good. The lunchtime meal, which is the main meal of the day, appeared well presented and appetising. Again those service users who were able to express an opinion were complimentary of the food provided. All service users appeared to enjoy the main meal in the dining room. Service users at risk of not taking enough fluid were closely monitored and encouraged to drink adequate amounts of fluids. Old Parsonage (The) DS0000061474.V295922.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 17 A complaints procedure is in place. The registered manager and staff are trained in abuse awareness. The registered manager is fully informed of the local vulnerable adults procedure. Quality in this outcome area is judged to be good. This judgment has been made using available evidence including a visit to this service. EVIDENCE: A complaints procedure is in place and the registered manager maintains a record of any informal concerns raised from service users, families or representative. The CSCI have not recently received any complaints regarding the service provided at The Old Parsonage. The registered manager is fully informed of the local vulnerable adults procedure and how to implement the procedure if any allegation of abuse was raised or seen. The staff had received training in abuse awareness. Old Parsonage (The) DS0000061474.V295922.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 22 and 26 The home provides a comfortable, homely environment for service users to live in. The home is not providing adequate bathing facilities. The manual handling procedures and lack of equipment do not meet the needs of the service users. The home was clean to a good standard and infection control measures in place. Quality in this outcome area is judged to be poor due to manual handling issues. This judgment has been made using available evidence including a visit to this service. EVIDENCE: The home has recently been refurbished throughout to a good standard, with new flooring down which is practical yet homely in the corridors and communal areas. Both communal rooms and the dining room have been redecorated and homely furnishings provided in these rooms. The home now provides a good standard of accommodation for service users to live in. Old Parsonage (The) DS0000061474.V295922.R01.S.doc Version 5.2 Page 15 The main assisted bathroom on the ground floor has now been refurbished to a good standard. However one of the bathrooms on the 1st floor was not in use due to the door being off. Therefore the home cannot comply with Standard 21.4. The communal toilets did not have indicator signs on the doors which may assist service users with dementia to access the toilets with an aim to promote or maintain continence. All the doors leading off the corridors appeared the same. All service users have a manual handling assessment in place providing evidence of their manual handling needs. However the home has not met the requirements relating to manual handling practice made from the previous inspection. Incorrect manual handling practices where observed during the inspection, which may be due to the lack of manual handling equipment provided. Only one mobile lifting hoist in provided, which has to be transported between the two floors and only one lifting sling. This amount of equipment provided cannot meet the needs of the service users, therefore placing the service users at risk and the staff. Pressure relieving mattresses are provided for those service users assessed at risk of pressure damage, however the same service users were not provided with pressure relieving cushions whilst out of bed sitting in arm chairs placing them at risk of pressure damage during these periods. Wheelchairs were observed being used with out footplates. The home was clean to a good standard throughout. The laundry was organised and clean, which is a credit to the care staff that performed all laundry duties throughout the day, as a laundry person is not employed. This again has an impact on the staffing level, which does not meet the needs of the service users especially with added duties placed on the care staff. Infection control practices were in place apart from a night catheter bag left exposed. Clinical waste was dealt with appropriately. Old Parsonage (The) DS0000061474.V295922.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 The current staffing levels do not meet the complex care needs of the service user group and cannot ensure the safety and supervision of service users. Employment procedures are satisfactory with all required police checks made prior to employment. Mandatory training is provided but other elements of specialist training are limited. Quality in this outcome area is judged to be poor due to staffing levels. This judgment has been made using available evidence including a visit to this service. EVIDENCE: As previously stated and evidenced in this report the current staffing levels and added duties of the care staff do not meet the care or social needs of the service user group who all have complex mental health nursing needs and physical needs. The staffing provided from 8am to 2pm is 1 qualified nurse (usually the manager Christine Jones) and 3 carers. Whilst this staffing level is in line with the Staffing Notice and Condition of Registration for the home, due to the increased needs of the service user group and lack of administration staff to support the manager who is responsible for all administration duties, this current staffing level is low and cannot meet the care needs of the service user group. To fully support the service users an increase in carers each morning is needed and another qualified nurse two to three days a week during the 8am to 2pm shift will need to be strongly consider by the directors of the home. However the manager and the care staff were observed working very hard during the inspection to meet the needs of the service users within the constraints of the staffing levels. Old Parsonage (The) DS0000061474.V295922.R01.S.doc Version 5.2 Page 17 The inspectors reviewed six employment records all of which contained two references, employment contract, and appropriate police checks. The records did not all contain photographs of the employees as proof of identification. The manager is responsible for all issues relating to employment of staff. The staff had been provided with mandatory training, however training in line with service users care needs such as dementia training had not been provided. Old Parsonage (The) DS0000061474.V295922.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 The home is well managed by the registered manager. The manager and care team work hard to run the home in the best interest of the service users. The staff had not been provided with regular supervision. Health and safety issues are addressed apart from poor manual handling practices. Quality in this outcome area is judged to be adequate. This judgement has been made using the available evidence including a visit to this service. EVIDENCE: The registered manager Christine Jones RMN is an experienced manager who fully understands her role as manager and takes full responsibility of the home. Christine knows the full care needs of the service users at the home and supports the care staff to ensure that care needs are met. Christine shows good leadership skills and manages the home well. It was evident through observation during the inspection that the manager and that care staff work hard to provide a flexible approach to caring for the Old Parsonage (The) DS0000061474.V295922.R01.S.doc Version 5.2 Page 19 service users putting the interests of service users first. Breakfast time and getting up is flexible to the individual service users’ needs and service users are able to choose how they spend their day. The manager is responsible for the majority of service users personal spending money. Financial procedures are in place to safeguard the service users with all receipts kept and a full record of money received and spent maintained. However one area of the financial system was not safe which was fully discussed with the manager during the assessment. A system to ensure that regular supervision for all staff is not in place. This is again is due to the lack of trained nurses on duty who could provide time for the manager to implement the systems for supervision. This remains outstanding from the previous inspection. The home is generally well maintained and provides a safe environment for service users to live in. All accidents are recorded and the manager carries out a monthly audit of the accident record. The manual handling procedures and lack of equipment are not safe as addressed under Standard 22. However equipment that is in place is now regularly serviced. A store cupboard under the back stairs was found to be unlocked which contained cleaning chemicals. A mobile service user was seen using the stair-well and therefore could be placed at risk if the chemicals were not safely stored. Old Parsonage (The) DS0000061474.V295922.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 2 2 X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 2 1 X 2 Old Parsonage (The) DS0000061474.V295922.R01.S.doc Version 5.2 Page 21 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. 2. Standard OP7 OP8 Regulation 15 12 (10(a) Requirement Timescale for action 22/07/06 3. 4. 5. OP7 OP21 OP26 13(4) 12(1)(a) 13(3) 13(3) All service user care plans will be reviewed monthly. Service users assessed at risk of 01/07/06 pressure damage will be provided with appropriate pressure relieving equipment at all times. All service users will have a falls 22/07/06 risk assessment in place. The second bathroom on the first 01/07/06 floor must be fit for purpose. All urinary catheter bags will be stored correctly reducing the risk of infection. An additional qualified nurse must be on duty during the 8am to 2pm shift, two or three days a week to ensure the registered manager can provide supervision, review care plans, and perform any other tasks expected of her. One additional carer must be on duty during all the hours when service users are cared for in the lounges, to ensure that they are fully supervised at all times. DS0000061474.V295922.R01.S.doc 01/07/06 6. OP27 18(1)(a) 03/07/06 8. OP27 18(1)(a) 03/07/06 Old Parsonage (The) Version 5.2 Page 22 This requirement remains outstanding and will be addressed through enforcement procedures. 9. OP27 18(1)a(3) ab The manager must not be 03/07/06 performing administrative or managerial tasks when she is the only registered nurse on duty. This practice continues due to lack of administration staff provided by the Directors of the home. However this will be addressed under requirement Number 6. 10. 11. OP29 OP36 18 schedule 2 18(2) All employment files will contain 01/07/06 a recent photograph as proof of identity. The persons registered must 22/07/06 ensure that a system for supervision has been put in place for all staff. (Work has commenced to address this requirement but it has not been addressed in full.) This remains outstanding due to staffing requirements. 12. 13. 13. OP38 OP38 OP38 13 (4) 13(4)(a) 13(5) All wheelchairs will only be used when footplates are in place. All cleaning chemicals will be stored safely ensuring service users safety. Care reviews must be arranged for all service users who have been assessed as having complex manual handling care needs, to ensure professional advice on their specific needs and relevant equipment is available. This requirement remains outstanding and will be Old Parsonage (The) DS0000061474.V295922.R01.S.doc Version 5.2 Page 23 01/07/06 22/05/06 03/07/06 addressed through enforcement procedures. 14. OP38 13(4) 18(2) A system for continuous 03/07/06 supervision of staff must be put in place to ensure that all staff are supported in ensuring that correct and safe manual handling takes place when service users are being transferred or moved. This remains outstanding and will be addressed through enforcement procedures. 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 OP22 Good Practice Recommendations More lifting slings should be provided to assist residents with manual handling needs. (This is an un-met recommendation from the previous inspection.) Bathrooms and WCs should be easily identifiable by door labelling or other means. Service users’ room doors should have door knobs or push-plates. 2. 11. OP21 OP23 Old Parsonage (The) DS0000061474.V295922.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Old Parsonage (The) DS0000061474.V295922.R01.S.doc Version 5.2 Page 25 - 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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