Inspection on 10/01/06 for The Old Vicarage Nursing Home

This inspection was carried out on 10th January 2006.

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 Old Vicarage Nursing Home 20/08/07

The Old Vicarage Nursing Home 26/07/06

The Old Vicarage Nursing Home 21/08/05

The Old Vicarage Nursing Home 12/01/05

The Old Vicarage Nursing Home 08/07/04

The Old Vicarage Nursing Home 16/03/04

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

CARE HOMES FOR OLDER PEOPLE The Old Vicarage Nursing Home, 160 High Street Chasetown Nr Walsall WS7 8XG Lead Inspector Pam Grace Unannounced Inspection 12:45 10 January 2006 th 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 Old Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 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 Old Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Old Vicarage Nursing Home, Address 160 High Street Chasetown Nr Walsall WS7 8XG 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) 01543 685588 01543 683306 Morecare Limited Mrs Deborah Withington Care Home 27 Category(ies) of Dementia - over 65 years of age (27) registration, with number of places The Old Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. DE Dementia over the age of 60 years for 27 persons Date of last inspection 21st August 2005 Brief Description of the Service: With its Victorian façade, thoroughly renovated and entirely private, The Old Vicarage Care home provides specialist nursing care for those service users suffering from the effects of dementia over the age of 60 years (27).The home is located on a main road in Chasetown with easy access for visitors, not far from a few shops. The main town is only two miles away. There is a medium sized garden with a sun patio and seating area. This is accessed via a ramp and suitable for wheelchairs. There are sufficient car parking facilities. The Old Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This statutory unannounced inspection was carried out over 5 hours by one inspector. A tour of the home was undertaken and discussions were held with service users, and staff. The home’s care manager is currently on maternity leave, and agreed prior arrangements had been made for the care manager at the sister home, to oversee the running of The Old Vicarage. There has also been an RMN appointed to assist the overseeing registered care manager in the running of the home. Relevant records and documentation were examined, including a selection of care plans, which were randomly chosen. The registered manager for the sister home assisted the inspector throughout the inspection. At the end of the inspection, feedback was given to the manager, outlining the overall findings of the inspection, and the requirements made. Service users spoken with were very positive about the care they were receiving. There were also service users who were unable to communicate, the inspector noted that they appeared well cared for, and were happy in their surroundings. Conditions in the home were determined by direct observation, and sampling other services provided, such as medication, and aspects of health and safety measures. The staff and service users were thanked for their co-operation and open willingness to contribute to the inspection process. Some of the previous requirements and recommendations had not been met these were carried forward. Six requirements and 5 recommendations were made as a result of this unannounced inspection. The Old Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Care plans must contain up to date risk assessments, and be signed by the service user or their representative. Wound treatment records must contain information regarding the actual treatment of the wound, including the cleansing of the wound, and type of dressing to be used. Equipment that is identified through a risk assessment process e.g. cot sides, must then be put into place and used. Cot sides, where fitted, must have appropriate padded bumpers in place. Staff must work hours commensurate to Health and Safety recommended standards, to comply with employment legislation and to ensure the safety of service users. NVQ training targets must be met. Care staff must receive supervision 6 times yearly as per the National Minimum Standard. Accident forms must offer a full report and record of the event. The Old Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 Page 7 Dining tables should have placemats, condiments, and some wall decorations e.g. flowers to brighten the room. Bathrooms should have water thermometers. That a review of bed linen supplies, towels and flannels, is undertaken, and that these are replaced, or renewed as appropriate. 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 Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 Page 8 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 Old Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 Page 9 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): Standards 2,3,4 Service users and or their representatives are assured that the home would be able to meet their assessed needs. EVIDENCE: There were 25 service users living at the home at the time of the inspection. Discussion with service users and staff, evidenced that service users needs are being met, and that pre admission assessments were undertaken. This was also evident in care plans sampled, and daily records. There was also evidence of specialist advice and treatment contained within care plans seen. Regular reviews were evidenced in care plans seen, however some of these were not up to date, and care plans were not signed. The home’s administrator confirmed that all service users have received a written contract/statement of terms and conditions. The manager confirmed that service users are informed in writing that their assessed needs will be met by the home. The Old Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 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): Standards 7,8,9,10 Care plans seen, did not contain up to date risk assessments, and were not signed by the service user or their representative. Wound treatment records did not clarify the actual treatment of the wound, and type of dressing used. Appropriate arrangements are in place for identifying and meeting the health and personal care needs of service users in the home. However, cot sides must be used in conjunction with risk assessments, and appropriate padded bumpers must be utilised. Service users are protected by the home’s policies and procedures for dealing with medicines. Staff demonstrated a personal empathy with residents through a respectful, yet friendly discourse. The Old Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 Page 11 EVIDENCE: The Inspector examined five service user care plans at random. Care and health records examined showed that appropriate arrangements are in place for identifying and meeting the health and personal care needs of service users in the home. There was evidence of consultations from medical specialists and other professional support services. These included recorded visits from the General Practitioner. Care plans examined were comprehensive, and included a profile of the service user’s social, physical and psychological status, however, these care plans had not been signed by the service user or their relative. Risk assessments contained within care plans seen were not all up to date, and one had not been put into action, this was in relation to cot sides for a service user. The Inspector noted that during a tour of the building, one service user had a chair placed next to the bed, instead of cot sides, and some cot sides did not have appropriate padded bumpers. This was brought to the immediate attention of the manager. The Inspector noted that each service user has a key worker who is responsible for maintaining an in-depth awareness of those service users. The Home operates a Standex system of care records, which was well presented and maintained. Wound treatment records were examined. These did not clarify the actual treatment of the wound, and type of dressing used. There was a safe system in place for the receipt, storage, administration and disposal of medicines. Medication Administration records were checked and found to be in good order. Each service user had a photograph on their file, and all medication checked was correctly labelled and dated. The manager confirmed that consideration is still being given to moving the clinical room to a larger room. There were no service users administering their own medication at the time of the inspection. Examination of the accident records showed that care staff are completing the records following an accident, however, the information contained within the record is very poor, which could render the record open to dispute. The Inspector discussed the importance of accurate and thorough recording with the manager during the inspection visit. During the visit the Inspector noted that staff demonstrated a personal empathy with residents through a respectful, yet friendly discourse. The Old Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 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): Standards 14,15 Service users are encouraged to exercise choice and control over their life as far as is possible, and encouraged to bring into the home personal possessions. Service users were offered a varied and nutritious choice of meals from a rotating menu. The menu for the day was displayed in the dining room. The dining room was dull and uninviting, there were no tablecloths and or place mats on tables, and tables were bare. EVIDENCE: The daily routine was discussed with staff and several service users and was seen to be flexible to acknowledge individuality, yet present a focal point for residents to offer the security of consistency. Service users’ life-styles and interests were recognised through care plans and case tracking, and were documented as far as possible to enhance a position of supported independence. Service users who wish to bring in personal possessions are encouraged to do so. This was evident during the Inspector’s tour of the building. Staff held a friendly and sympathetic interaction with service users in lounge areas, and at lunchtime in helping those who required assistance. The Old Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 Page 13 Service users were offered a varied and nutritious choice of meals from a 2week rotating menu. The menu for the day was displayed in the dining room. However, the dining room was dull and uninviting, there were no tablecloths and or place mats on tables, and tables were bare. Staff spoken with confirmed that during meal times they would offer discreet assistance to those who required it, and that the choice of dining room, lounge or bedroom was at the discretion of service users. COSHH signs and notices were in evidence with cleaning chemicals securely stored. The Old Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 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): Standard 16,17,18 Service users and their families are able to express their concerns and/or complaints. Staff were aware of their right to express their grievances and of Whistle –blowing procedures. The policies and procedures in place, protect service users from abuse. Staff confirmed that their training has clarified their responsibilities in regard to the protection of service users from abuse, of all natures. EVIDENCE: The manager and staff spoken with confirmed that the home has a clear complaints policy, identifying the CSCI as a resource to approach with a complaint or grievance. There had been one complaint received by CSCI since the last inspection. This was discussed in detail with the manager during the inspection and was satisfactorily resolved. A complaints book is maintained which shows a responsible approach in handling complaints appropriately. An Advocacy service is available to those who require it as indicated in the Statement of Purpose, although no one is formally represented at this time. Service users’ legal rights are protected by the systems in place, including a contract, the continual assessment of care planning and policies in place i.e. the complaints procedure. The Old Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 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 the following standard(s): Standards 19,20,21,22,23,24,25,26 The location of The Old Vicarage is conveniently placed for a care home. The external state of repair and maintenance is generally good, and the interior state of repair is at a satisfactory standard. Most bedrooms were appropriately maintained, and in a good state of decoration. Some bedrooms were in need of re-decoration, and replacement furnishings. Communal areas are furnished and decorated to a good standard to present a homely and comfortable environment, apart from the dining room, which needs some cheerful pictures, flowers, and placemats. Bathrooms and toilets are suitably equipped and adapted. The domestic services in the home were seen to be of a very high standard, much to the credit of the staff. The home was clean and tidy, with no malodours. The Old Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 Page 16 EVIDENCE: The home is well appointed, and has the benefit of being in close proximity to local community facilities, including shops, pubs, and the local church. It provides a safe, comfortable, and homely environment. There is an area for visitors to park, and a small garden for service users to use in appropriate weather. Pathways and fencing were in good repair. Internally, the home has ample fittings of hand and grab rails in adequate, well-lit corridors. Wheelchair users can safely access all areas of the home. Bedrooms seen were generally well maintained, and some remedial work has taken place since the last inspection, including the repair of the Parker bath. It is the policy of the home that on bedrooms becoming vacant, each room is reappraised for redecoration. The Inspector noted that there were several physically ill service users being nursed in bed. The facilities and arrangements were seen to be satisfactory. Communal areas were pleasantly furnished with facilities to accommodate social or reflective needs, in a homely setting. Some of the furniture still needs renewal. Toilets are accessible to all, and within close proximity to all communal areas, the standard and presentation of all the toilets and bathrooms were of a high quality, clean, and odour-free. Policies for handling soiled and infected linen were satisfactory. The nurse-call alarm system was satisfactorily tested. The heating arrangements throughout the home are by central heating with guarded radiator or low surface temperature convection. The water temperature was finger tested by the Inspector, and deemed to be safe. However, a thermometer in each bathroom is recommended. The domestic services in the home were seen to be of a very high standard. There was no evidence of malodours, or unsightly debris anywhere throughout the home. The laundry area was clean and very well organised. The laundry door has been fitted with baffle handles to prevent access by service users. The Inspector noted that the quality of the bed linen, towels, flannels and counterpanes was generally poor. The Old Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 Page 17 Procedures were in place for managing soiled/infected linen with the provision of alginate bags to minimise handling and cross-infection. COSHH signs were evident, for dealing with chemical cleaners, which were used appropriately throughout the home. Some electrical items did not display the appropriate PAT identification stickers. The manager later confirmed that PAT testing is due to take place in February. The Old Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 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): Standards 27,28,29,30 The home’s overall staffing coverage has been maintained with the use of agency staff, and existing staff working more than their usual contracted hours. The manager confirmed that procedures for recruiting and appointing staff had significantly improved since the last inspection, with the assistance of the home’s administrator. Supervision was discussed with staff. Staff spoken with confirmed that supervision is now up and running, however, no evidence was put forward for the Inspector to view. EVIDENCE: Staff rotas were examined, and four members of staff were interviewed. Staffing levels are based on the dependency levels of service users in the Home and these are reviewed on a regular basis. However the rotas showed that staff were still working in excess of contracted hours. Staff spoken with confirmed their willingness to work long hours, sometimes without a day off to ensure coverage. Steps should be taken to ensure that all staff have at least one day a week off, and recognised periods of rest during long shifts. There was also an over reliance on agency staff to maintain coverage due to difficulties in recruiting both registered nurses and carers. The Old Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 Page 19 There is no recognised deputy care manager at the home, although coverage has been arranged for the care manager’s maternity leave from Morecare. The manager overseeing the home, confirmed that an RMN has been appointed to assist her in managing the home. Discussions with staff were positive, and showed a clear determination that they belong to a committed team. The home employs a full time administrator – shared with the sister home, and a part time gardener/maintenance person. The manager confirmed to the Inspector that there are currently 4 staff undertaking the NVQ level 2 award, and 2 care staff with NVQ level II award. This equates to a maximum commitment of 40 assuming that all will complete training. It is reported that the home’s care manager hopes to commence level IV on return from maternity leave. The manager later provided an outline staff-training schedule, which confirmed to CSCI that there are plans for specific training (amongst other courses) in wound care, palliative care, and dementia care. This will be monitored at the next inspection. Staff spoken with confirmed that they are receiving regular supervision. However, no recorded evidence was put forward for the Inspector to view. This remains a requirement, and will be monitored at the next inspection. The Old Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 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): Standards 31,32,33,36,37,38 Morecare has provided a manager for the home whilst the usual care manager is on maternity leave. The current manager has a commitment to service users and staff, which was demonstrated at this unannounced inspection. Staff supervision has historically been unrecorded, clinical and practice based, rather than the formalised regular supervision that is required by the National Minimum Standards (NMS). Care records seen were of a satisfactory standard. They offered an informative and meaningful record and plan of care for service users. Random samples of policies and procedures were inspected and found to be appropriate. A staff training schedule has been outlined for the coming year. The Old Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 Page 21 EVIDENCE: The registered care manager overseeing the home, also manages the sister home, she is an RGN, and has been appointed to do so by Morecare. There is no recognised deputy care manager to support the current manager. However, the manager confirmed during the inspection that an RMN has been appointed, and will be assisting her in the management of the home. The home still has difficulty in recruiting, and there have been seasonal sickness problems. On her return, it is reported that the usual care manager - Mrs Witherington will be undertaking a management qualification relevant to her role, and in line with the NMS, in the near future. The inspector found that staff and service users were interacting well in an informal and relaxed atmosphere. Staff encouraged and included service users in the afternoon’s activities in a friendly and constructive manner. At the last inspection the usual care manager agreed to address the development issues of risk assessment, maintenance and renewal for discussion at the next inspection. This will be discussed at the next inspection, when the usual care manager will have returned from maternity leave. The manager currently overseeing and managing the home, provided the CSCI with an outline training schedule for staff. There are plans in progress for further training, which will include (amongst others) fire, wound care, palliative care, and dementia. An outline programme has been established, and will be monitored at the next inspection. Staff supervision was not evidenced during this inspection, and this remains a requirement. Bed linen, towels, and flannels need reviewing and replacing. The Old Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 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 X 3 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 2 2 2 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 3 3 3 X X 2 3 2 The Old Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 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 OP7 Regulation 15, Sch 3 (1)(b) 12,13 Requirement Care plans must contain an up to date risk assessment, which is then put into action. Equipment that is identified through a risk assessment process e.g. cot sides, must then be put into place and used. Cot sides, where fitted, must have appropriate padded bumpers in place. That staff must work hours commensurate to Health and Safety recommended standards, to comply with employment legislation and to ensure the safety of service users. Previous timescale 21/08/05 Not met NVQ targets must be met Care staff must receive supervision 6 times yearly as per the National Minimum Standard. That accident forms offer a full report and record of the event. Previous timescale of 21/08/05 not met Timescale for action 10/01/06 2. OP8 10/01/06 3. OP27 38(4) 10/01/06 4. 5. 6. OP28 OP36 OP38 18(1ci) 18(2) Sch 3.3(j) 01/04/06 30/04/06 30/04/06 The Old Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 Page 24 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. 4. 5. Refer to Standard OP7 OP8 OP15 OP25 OP24 Good Practice Recommendations Care plans need to be signed by the service user or their relative. Wound treatment records should clarify the actual treatment of the wound, and type of dressing used. Dining tables to have placemats, condiments, and some wall decorations e.g. flowers to brighten the room. Bathrooms should have hot water thermometers. That a review of bed linen supplies, towels and flannels, is undertaken, and that these are replaced, or renewed as appropriate. The Old Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Vicarage Nursing Home, DS0000022358.V275840.R01.S.doc Version 5.1 Page 26 - 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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