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Inspection on 21/06/05 for The Old Rectory Care Home

Also see our care home review for The Old Rectory Care Home for more information

This inspection was carried out on 21st June 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

What the care home does well

Service users in general feel comfortable in this home and feel well looked after. They speak well of the staff and feel settled in the Home. They like their rooms and garden. Most feel they can control their routines going to bed when they like and all of them like the food. So in general the Home makes people happy. There is good contact with relatives and service users can see their families when they want to. The doctors and nurses and other community medical professionals are consulted appropriately and staff are monitoring the health of the service users well. The arrangements for looking after and giving out medicines are working well and staff do it properly. Training of staff is given a high priority and the Home has 52% of its staff with a national care qualification which is excellent. The home has good procedures for the recruitment of staff and this protects the service users. The health and safety of service users is taken seriously in the Home and measures are in place to ensure the Home is safe.

What has improved since the last inspection?

There has been an improvement in the provision of activities with a paid staff member now coming in once a week. Entertainers, church services and reminiscence sessions are all arranged on a regular basis. Efforts need to continue especially in relation to service users going outside and in individual activities but things are better. There has been a lot of improvement in the choice of meals now offered. There are always two choices on the menu for both dinner and tea and breakfast is flexible and service users like this. The choices are displayed in large print on a big blackboard outside the dining room where service users can see them and this is going down well. Service users are much happier about the food now offered.

What the care home could do better:

The manager needs to ensure that the balance is right between the needs of the service users he admits and the resources he has to cater for those needs. A review is recommended to ensure that staff have the time and expertise to cater for all the needs of existing service users. The literature given out to prospective service users needs to be more accurate including the complaints procedure. The care records need to be fuller and show what is happening to a service user on a daily basis. Service users need to be given more choice about whether they want to be private, for example sitting in their rooms in private or seeing the doctor in private. More care hours should be provided in order to cater for the dependency levels of the service users. More training on dementia should be provided.

CARE HOMES FOR OLDER PEOPLE The Old Rectory Care Home Norwich Road Acle Norwich NR13 3BX Lead Inspector Dot Binns Announced 21 June 2005 9.30am 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 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 Old Rectory Care Home I55 S61106 The Old Rectory V226944 210605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Old Rectory Care Home Address Norwich Road Acle Norwich NR13 3BX 01493 751322 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) pearlcare@yahoo.co.uk Pearlcare (Acle) Ltd John Mills-Darrington Care Home 34 Category(ies) of Old Age (34) registration, with number of places The Old Rectory Care Home I55 S61106 The Old Rectory V226944 210605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Up to thirty-four (34) Older People of either sex, not falling into any other category, may be accommodated. Date of last inspection 28 January 2005 Brief Description of the Service: The Old Rectory is a period residence located in the small rural market town of Acle, mid way between Norwich and Great Yarmouth and close to the Norfolk Broads. There are shops, a weekly market, pubs and a church all within walking distance and there are bus and train services to Acle. The property has been purposefully adapted and extended to provide residential accommodation for up to 34 older people. There are 3 double and 28 single rooms and many have direct access into a well planned garden. The double rooms and 24 of the single rooms have en suite facilities. The Old Rectory Care Home I55 S61106 The Old Rectory V226944 210605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine announced inspection taking approximately 7.5 hours. Discussions were held with both the manager and the provider about the progress of the home and whether the recommendations of the last inspection had been implemented. Five service users were chosen at random and seen in private to discuss their views of the Home. Three staff were also interviewed. Some the building was toured and individual rooms were seen when talking to the service users. Records and policies were also examined and the medication storage system was also inspected. A survey was sent out by the Commission to the Home for distribution to service users and their relatives. Five replies were received and those views have been taken into account. What the service does well: Service users in general feel comfortable in this home and feel well looked after. They speak well of the staff and feel settled in the Home. They like their rooms and garden. Most feel they can control their routines going to bed when they like and all of them like the food. So in general the Home makes people happy. There is good contact with relatives and service users can see their families when they want to. The doctors and nurses and other community medical professionals are consulted appropriately and staff are monitoring the health of the service users well. The arrangements for looking after and giving out medicines are working well and staff do it properly. Training of staff is given a high priority and the Home has 52 of its staff with a national care qualification which is excellent. The home has good procedures for the recruitment of staff and this protects the service users. The health and safety of service users is taken seriously in the Home and measures are in place to ensure the Home is safe. The Old Rectory Care Home I55 S61106 The Old Rectory V226944 210605 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Old Rectory Care Home I55 S61106 The Old Rectory V226944 210605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Old Rectory Care Home I55 S61106 The Old Rectory V226944 210605 Stage 4.doc Version 1.30 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 standard(s) 1,2,3 and 4 The information provided to service users is not comprehensive enough and should be reviewed. Appropriate information is gathered to assess the needs of each service user before coming into the Home. However it is not absolutely clear that the Home can meet those needs. The admission policy is not accurately reflecting the registration status of the Home and needs to be reviewed. EVIDENCE: The Home has no separate statement of purpose. The Service Users’ guide contains a summary of the statement of purpose but omits other details. The complaints procedure gives the name of a previous provider and is not up to date. Service users are however provided with terms and conditions statements and these were seen at the inspection. Overall information given to service users was not as useful as it should be. The Old Rectory Care Home I55 S61106 The Old Rectory V226944 210605 Stage 4.doc Version 1.30 Page 9 There was an assessment document on each file showing that staff had the information on admission to help the service users appropriately. The Home currently has a high number of service users who have short term memory problems or mild confusion. Many of these service users need a lot of assistance from staff. The information provided by the manager shows that all of the service users have high needs and in discussions with the staff, it was clear that they have to provide a lot of physical care to many of the service users. The Home is not registered to take those with dementia however and does not provide the facilities which a registered home for those with dementia should. Staffing levels and training would have to be considerably higher. Whilst it is understood and accepted that some service users will deteriorate in health during their stay and have increasing needs, the manager and provider need to look very carefully at their admission policy as they could be compromising their registration. If service users are still within their registration but have high needs, the Home may need to look at a higher staffing ratio in order to cater for those needs. A recommendation has been made to review this situation. The Old Rectory Care Home I55 S61106 The Old Rectory V226944 210605 Stage 4.doc Version 1.30 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 standard(s) 7,8,9 and 10, The care plans are in place but are not adequately maintained. They need to be better. Service users health care needs are met. Procedures and records for the administration of medication are satisfactory. The service users right to privacy is only partially upheld and should be linked in to the right to choose. Improvements need to be made on this. The Old Rectory Care Home I55 S61106 The Old Rectory V226944 210605 Stage 4.doc Version 1.30 Page 11 EVIDENCE: Each service user has a care plan based on the assessment information. The information covers aspects of health, personal and social care. However although this information is in place, there were very few entries made by staff on a day to day basis showing that the care was being appropriately given. The main entries were about medical contacts and reviews of care were often to state “no change”. A general record gave the most basic and repetitive information about staff tasks but this was not available in a confidential format and should not be used. Information about interests and quality of life issues seemed to be ignored. It was very difficult to see how you could verify how a service user was progressing from these notes. The system for staff recording the welfare and progress of service users must be overhauled and the manager emphasise the importance of the records. Medical contacts were appropriately recorded in the records and there was evidence of GP visits and district nurses calling as well as opticians, dentists and chiropodists being in action. Trips to hospitals were also recorded. Service users confirmed they had all the attention they needed on the medical side, one saying “they are very good on that”. The GP and district nurse were surveyed for their views and both were satisfied with the overall care within the Home. The medication records were scrutinised and found to be completed appropriately. Controlled drugs are correctly accounted for and stored. The manager confirmed that staff who administer medication have been trained. Service users in general reported that staff treated them well and they were assisted in private when given help. They confirmed they saw their visitors in their room and received their mail intact. They were given private time in the bath. There was a practice confirmed by the service users, of staff staying in the room when service users saw a doctor. It is acknowledged that some frail service users may need this but this should not be a uniform practice and needs to be stopped. The Home is not complying with its own aims and objectives about privacy if such a practice is standard. One very dependent service user did want to have more private time in their room but felt obliged to go along with staff when they put her in the lounge “I’m in the lounge nearly all day” she complained. Staff need to ask the question more about where service users want to sit and not assume that being in company is for everyone. The Old Rectory Care Home I55 S61106 The Old Rectory V226944 210605 Stage 4.doc Version 1.30 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 standard(s) 12,13 and 15 In general service users felt comfortable and happy in the Home. Some improvements can still be made but there is more emphasis now on social care. Service users are able to maintain contact with their families and enjoy their visits. Service users are receiving a balanced and appealing diet with choices about what they eat. EVIDENCE: Overall the service users were quite happy in the Home saying they ”made it your Home” and they had “always been so happy here” and “they were quite content”. Another said “I cant complain about this place at all” and “ staff are very good and pull my leg”. Four were very happy with their routines though one person thought she was woken up too early and helped to bed too early, “6.30 when I would prefer 9pm”. This was pointed out to the manager to ensure staff are asking service users rather than assuming. Bathing was mainly offered once a week though staff said they would fit in others if the service users wanted. Overall service users thought staff were good and kind. The Old Rectory Care Home I55 S61106 The Old Rectory V226944 210605 Stage 4.doc Version 1.30 Page 13 There was a view amongst the service users that some service users needed a lot of looking after and that could mean they had disturbed nights. This impacted on to other service users. This could relate to the fact that some service users are being admitted to the Home with high needs. (As mentioned in the section Choice of Home.) To ensure a good quality of life for everyone, there has to be a relationship between those being admitted and the resources including staffing in the Home. It is not clear whether this balance is right. The Home has made an effort to provide more activities since the last inspection. One person is now employed once a week to provide a variety of activities, for instance bingo was offered this week. Reminiscence is also provided fortnightly and entertainers come in regularly. A church service is held once a month. Staff also said they sometimes organised games with the service users and there is a lovely garden for them to enjoy. All of this was good news. Where there could be further improvement is in the development of the key worker system where staff have special responsibilities for three or four service users including looking at their social care. One record for instance showed that a service user enjoyed Gilbert and Sullivan but no assistance had been given to ensure he heard this music. Key workers could also take responsibility for taking their service users out for a walk or round the garden. These individual pursuits will enrich the quality of life for service users and staff should be supported to encourage them. Service users gave several examples of their family visiting and there were several visitors coming into the home on the day of the inspection. Service users said they could see their visitors in their rooms or in the lounges and sometimes they went out with their family to their home or to local events. There was no problem regarding family contact. There has also been a big improvement in the meals with the service users very aware of the fact that there is a choice of menu at all meals. Most described the food as very good and could give examples of what they were offered. Although sandwiches were still offered at teatime (and one service user felt they were still offered too much) there was much more variety on the menu at teatime and service users enjoyed the prawn salad and the cheese on toast. The menus in general showed a good balance and the day’s menu was displayed in large letters on a black board near the dining room. This is a big improvement on the last inspection and the cook should be congratulated for her efforts. Homemade cakes were also in evidence in the kitchen ready for tea. Most of the service users eat together in the dining room. The Old Rectory Care Home I55 S61106 The Old Rectory V226944 210605 Stage 4.doc Version 1.30 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 standard(s) 16 and 18 The complaints procedure is not clear in the service users guide though a correct one is displayed in the Home. The record of complaints could be more comprehensive. Adult protection procedures are in place. EVIDENCE: The complaints procedure was displayed in the Home but the procedure in the service users guide given out to all the service users, was out of date and needs to be amended. The address of the Commission was included. The Home does keep a record of complaints officially received and how they deal with them. They do not record concerns/complaints raised by service users which they should consider as this will make service users feel they have a voice and show what the Home did to remedy the situation. Policies for protecting service users from abuse were seen to be in place with a Speak Out policy, a gifts policy protecting service users from financial abuse and an adult protection policy. The new procedures from the Adult Protection Unit in Norfolk regarding how abuse is dealt were in the Home and the manager said that they had been discussed with staff. The Old Rectory Care Home I55 S61106 The Old Rectory V226944 210605 Stage 4.doc Version 1.30 Page 15 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 standard(s) 22 and26 The Home is well equipped with specialist equipment to enable service users to walk around the building. The home was clean and pleasant and there was no odour. EVIDENCE: The Home has specialist equipment to enable service users to walk easily about the building. A passenger lift was in operation and the corridors have handrails round them. Toilets and baths are adapted with rails and special seats and the call bell facility was tested and worker satisfactorily with staff responding promptly. The provider may want to consider the use of pressure mats for those service users who are prone to falling at night. An analysis of the accident book may show any particular difficulties. The Old Rectory Care Home I55 S61106 The Old Rectory V226944 210605 Stage 4.doc Version 1.30 Page 16 The Home was clean and tidy on the day of the inspection though domestic hours are lower than the standard of 1.8 hours per service user per week (about 16 hours short). There was criticism from three people about the cleanliness in the home and management may need to review these hours. On the day of the inspection however the home was clean and there was no unpleasant odour. The laundry contains two washing machines, both capable of a sluice wash and two tumble driers. The Old Rectory Care Home I55 S61106 The Old Rectory V226944 210605 Stage 4.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28 29 and 30 The care hours are slightly short and should be increased. Domestic hours are also low. Staff are well trained and the service users are in safe hands though staff are busy with a highly dependent client group. The recruitment procedure is satisfactory. Generally training is good in this home but more training on dementia is needed. EVIDENCE: The rota for the week of the inspection was provided and showed there to be 413 care hours provided for the week with the manager extra to that figure. (There were blanks spaces on the rota but the provider assured the inspector that these were always filled by agency staff.) From the information provided by the manager, 25 of the service users are reported to have dementia which means that they need a minimum of 13 care hours per week which comes to 325. The remaining service users require as a minimum 11 care hours per week and for 9 people (making 34 in all) this comes to 99 making a total of 424 care hours needed as a minimum. The Home is therefore a bit short of hours. It was clear from talking to staff that they felt very busy and these extra hours should be in place. If there were difficulties in obtaining agency staff, then the Home would be very short and this would give the Commission major concerns. The Old Rectory Care Home I55 S61106 The Old Rectory V226944 210605 Stage 4.doc Version 1.30 Page 18 The mix of staff was satisfactory with young and mature, qualified and learning. Staffing was distributed appropriately throughout the working day. Catering hours meet recommendations though the domestic hours are low at 45 hours when they should be 61. The information provided by the manager confirmed that 52 of staff are trained to NVQ2 which is a good ratio and meets the standard. Random staff recruitment files were examined and confirmed that the appropriate procedures are followed with references, criminal record checks and identity evidence obtained. Staff are issued with contracts and with the code of practice of the General Social Care Council. A training file is held on each staff and an overall plan shows the training staff have received. Induction notebooks are completed and other certificates on Moving and Handling and fire safety are also included. In view of the numbers of those in the Home with short term memory loss and mild dementia, much more training needs to be provided on this topic to ensure staff understand their needs. The Old Rectory Care Home I55 S61106 The Old Rectory V226944 210605 Stage 4.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,36 and 38 The manager is qualified and of good character and is able to discharge his duties with support from the provider. Staff are appropriately supervised with a chance to meet their manager regularly on a one to one basis. The health and safety of the service users and staff is taken seriously and promoted in the Home. EVIDENCE: The manager is experienced in the provision of care to older people and has an NVQ4 qualification in management. The manager is able to take responsibility for fulfilling his duties as a manager with the provider playing a supportive role. The lines of accountability seem clear. The Old Rectory Care Home I55 S61106 The Old Rectory V226944 210605 Stage 4.doc Version 1.30 Page 20 There was evidence in the staff files that one to one supervision was taking place on a regular basis. This meets the standard expected. The health and safety policies and procedures in the Home were in place and staff files showed that training is ongoing on such safety issues as Moving and Handling, food hygiene and on fire prevention. The fire records were also examined and tests and fire drills were up to date. Certificates were also seen for equipment in the Home such as the lift and bath hoists showing that these were properly maintained. Electrical testing is carried out. The accident record was appropriately completed and cross referenced with the care records. As far as it was possible to tell the safety of staff and service users is protected. The Old Rectory Care Home I55 S61106 The Old Rectory V226944 210605 Stage 4.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 1 3 3 2 x x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION x x x 3 x x x 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 3 x x x x 3 x 3 The Old Rectory Care Home I55 S61106 The Old Rectory V226944 210605 Stage 4.doc Version 1.30 Page 22 No Are there any outstanding requirements from the last inspection? 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 1 Regulation 4and 5 Requirement The registered person must compile a statement of purpose relating to the matters in Schedule 1. The registered person must ensure that the service users guide complies with regulation 5 and contains the information as listed in standard 1.2. The care records must be more fully documented to show how the staff are monitoring the service users and meeting their needs. The registered person must arrangements to ensure that the privacy of service users is respected. An up to date complaints procedure needs to be given out to all service users and included in the service users guide. Care hours should be increased to cater for the dependency levels of the service users. Timescale for action 30.9.05 2. 1 5 30.9.05 3. 7 14(2) and 17 30.9.05 4. 10 12(4) 31.7.05 5. 16 22 30.9.05 6. 27 18 31.8.05 The Old Rectory Care Home I55 S61106 The Old Rectory V226944 210605 Stage 4.doc Version 1.30 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 4 22 30 Good Practice Recommendations A review of the admission procedure is recommended to ensure that the service users admitted come within the registration category and can be properly catered for. It is recommended that an analysis of the accident record takes place on a regular basis with possible consideration given to the use of pressure mats to prevent falls. It is recommended that further training on dementia is provided to as many staff as possible. The Old Rectory Care Home I55 S61106 The Old Rectory V226944 210605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 3rd Floor, Cavell House St Crispins Road Norwich NR3 1YF 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 Old Rectory Care Home I55 S61106 The Old Rectory V226944 210605 Stage 4.doc Version 1.30 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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