Inspection on 20/04/06 for The Rookery Care Home

This inspection was carried out on 20th April 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 Rookery Care Home 19/04/07

The Rookery Care Home 28/02/06

The Rookery Care Home 27/09/05

The Rookery Care Home 08/03/05

The Rookery Care Home 17/01/05

The Rookery Care Home 10/02/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE The Rookery Care Home 130 Church Street Eastwood Nottingham NG16 3HT Lead Inspector Sharon Rosenfeld Unannounced Inspection 20th April 2006 07:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Rookery Care Home DS0000008801.V289590.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 Rookery Care Home DS0000008801.V289590.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Rookery Care Home Address 130 Church Street Eastwood Nottingham NG16 3HT 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) 01773 713176 01173 770258 Lightdawn Limited Mrs Joanne Lesley Elizabeth Craig-Humphreys Care Home 30 Category(ies) of Dementia (30), Old age, not falling within any registration, with number other category (30) of places The Rookery Care Home DS0000008801.V289590.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal care for residents of both sexes whose primary needs fall within the following Categories Older people ( Not falling within any other category). Thirty (OP 30) Dementia (DE 30) The total number of persons for whom accommodation and care is provided shall not exceed Thirty (30) 28th February 2006 2. Date of last inspection Brief Description of the Service: The Rookery Care Home is an extended converted detached house. It is located on the outskirts of Eastwood town centre within a residential area. It is close to local facilities such as shops, banks and the medical centre. There are good local public transport links. The accommodated is over two floors. There are 24 single and 3 double rooms. Both stair lift and passenger lift are provided. Care is provided for older people and people with a form of dementia. The Rookery Care Home DS0000008801.V289590.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 took place over 11 hours on 20th April 2006. There were 26 residents accommodated in the home. The inspection methodology used was ‘case tracking’ where three residents with different care needs were selected to have their care tracked. Six staff, the registered provider/manager and the person employed to undertake quality-monitoring exercises were also spoken with. A partial tour of the building took place. What the service does well: What has improved since the last inspection? The staff have recently attended training to help them understand the special needs of people with dementia. One staff was able to describe how the training has helped to improve the quality of care provided to residents with this condition. One staff member was also able to describe the ways in which people are assisted to mobilise around the home safely. The Rookery Care Home DS0000008801.V289590.R01.S.doc Version 5.1 Page 6 The presentation of meals for people who need support with eating has improved. Individual food portions will no longer be mixed together but will be presented in a way that retains each items individual colour and flavour. The cleanliness of the home has also improved; no mal-odours were noticed during this visit. 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 Rookery Care Home DS0000008801.V289590.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Rookery Care Home DS0000008801.V289590.R01.S.doc Version 5.1 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. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The assessments of individual resident’s needs are good and ensure that up to date information is available to inform care planning. The home does not provide intermediate care. EVIDENCE: Individual records are kept for each of the residents and the inspection of three of these files showed that pre-admission assessments were in place. Additional assessments of need have taken place periodically and have been recorded. The people case tracked receive funding from social services. Their records contained the appropriate community care assessments. Additional assessments had been undertaken periodically to determine their level of need in areas such as moving and handling; mobility and risk of falls and the risk of developing pressure sores The manager does not confirm in writing to prospective residents or their representatives that the home can meet their assessed needs. The home does not provide intermediate care services. The Rookery Care Home DS0000008801.V289590.R01.S.doc Version 5.1 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): 7, 8, 9, 10. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The health and personal care needs of residents are explained in a personal care plan and are met by staff that are generally well trained to meet individual needs. Some training has been provided to help staff work in line with the managers stated philosophy of care. EVIDENCE: A total of five of the resident’s records were examined. All of them contained a care plan. The care plans were written under standard headings. Some of the care plans described the resident’s needs but did not explain the action staff are expected to take to meet needs. One resident had her own copy of her care plan. Another resident’s file contained minutes of meetings between her representative, the homes staff and other healthcare professionals. This demonstrated that consultation about care had taken place. The Rookery Care Home DS0000008801.V289590.R01.S.doc Version 5.1 Page 10 The records showed that resident’s receive, advice and treatment from healthcare professionals such as district nurses; general practitioners (GP); dentists and chiropodists. Some people receive National Health Service (NHS) chiropody treatments, which indicates that their entitlement to free NHS care is promoted. The records also indicated that the care staff sometimes apply dressings to wounds. The limitations of staff involvement in healthcare tasks such as these are not clearly defined and a policy and procedure must be developed that clarifies the boundaries of staff responsibilities in these areas. The home keeps good records of when referral to external healthcare professionals may be required but does not confirm that such referrals are made. The requirement made at the previous inspection, to review the care of one resident with swallowing difficulties has been met. The home has not acquired a nutritional assessment tool and the staff have not yet received guidance about how to assist residents with swallowing difficulties to eat as safely as possible. Some care plans are written in a person centred way that identifies the persons remaining strengths. This is good practice and should be reflected in all care planning. One staff member was able to describe how the training she recently received in dementia care has enabled her to understand the basic principles of person centred care. She demonstrated insight and empathy toward people diagnosed with dementia. The home has procedures in place for the management of medicines. A monitored dosage system (MDS) is used. The staff responsible for the administration of medicines during the daytime have received training. The registered provider/manager has confirmed that all staff will be trained in the management and administration of medicines. Not all of the night staff have received this training but they were delegated responsibility for the administration of a short course of medication for one service user. One staff member was observed administering medication. She was knowledgeable about the procedures and about individual residents needs. The home has a good system to ensure that staffs’ attention is drawn to prescribed medication that is not contained in the MDS. There are a number of improvements required however. The directions on one drug indicated it must be stored in the refrigerator. This had not been noticed and it was being stored incorrectly. The person doing the drug round signed to confirm the medication had been taken before it had been administered. The medication storage areas including the trolleys are not included on the cleaning schedule and require more thorough attention to ensure they are maintained in hygienic conditions. The Rookery Care Home DS0000008801.V289590.R01.S.doc Version 5.1 Page 11 The feedback from residents about the ways that staff treat people with respect was generally positive. Staff were also directly and indirectly observed offering residents choice and acting on their wishes. One person said she decides when to get up in the morning and what time she retires to bed. She also confirmed the staff consider her feelings when they are helping her with personal care tasks. The homes pay telephone was not in use. One resident was able to use the office telephone and this was said to be usual practice. The GP was called to one resident whose health had deteriorated. He was being cared for in a restraint chair in the quiet lounge. The consultation took place in the lounge. A discussion about where people are cared for when they are ill or near to death took place with the registered provider/manager and was inconclusive. It is recommended that clear guidance; policies and procedures are developed about how staff are to ensure that residents who are sick or near to death should be cared for in comfort and with dignity and that their individual wishes are observed. The Rookery Care Home DS0000008801.V289590.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): 12, 13, 14, 15. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Social activities are well organised and provide enjoyable stimulation for the majority of residents. Meals are nutritious and balanced. EVIDENCE: The home has a programme of activities that are planned in advance. One resident talked enthusiastically about the entertainers that perform on a regular basis. She said most people participate and confirmed this type of entertainment happens on a regular basis. Other residents are supported to pursue their hobbies. One person knits regularly and another enjoys reading and writing notes. They said they try to retain their interests to keep their minds active. Relatives, friends and representatives of residents are welcomed into the home at any time. One person spoken with continues to have responsibility for the management of her own finances. The Rookery Care Home DS0000008801.V289590.R01.S.doc Version 5.1 Page 13 Four people were spoken with about the quality of meals. They all confirmed that the meals were consistently enjoyable and of good quality. The staff were observed to offer a choice of meal at teatime. Improvements have been made to the presentation of meals for people with swallowing difficulties. The meal served was appetising, nutritional and was enjoyed by the residents. The staff assisting residents to eat generally did so with a high degree of sensitivity. People were encouraged to eat and were offered assistance where necessary. The staff also encouraged independent eating throughout the meal. One person who used a spoon to eat did not have her meal appropriately prepared by cutting it into smaller, manageable portions to enable her to eat it herself. She left part of the meal as a result. It is recommended that staff be delegated responsibility for particular residents to ensure that this does not happen and to ensure adequate monitoring of residents food intake. The Rookery Care Home DS0000008801.V289590.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): 16, 18. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Residents know about the complaints procedure and feel confident about raising concerns with the registered provider/manager. There is a vulnerable adults procedure however the staffs’ limited knowledge of this does not ensure people will be protected. EVIDENCE: One complaint was being investigated by the provider/manager at the time of the last inspection. This complaint has since been concluded and was not upheld. Two further complaints have subsequently been made. One was referred to the commission and concerned the administration of medication by un-trained staff. This inspection found that this has occurred and therefore the complaint is upheld. Another has been referred to Social Services for investigation and is not yet concluded. One resident was spoken with about the complaints procedure. She is confident that her concerns would be listened to. The quality assurance process includes a process of consultation about various aspects of life at the home. It covers the accessibility and interpretation of the complaints procedure and gives people an opportunity to comment on how things might be improved at the home. The Rookery Care Home DS0000008801.V289590.R01.S.doc Version 5.1 Page 15 The staff were interviewed about their knowledge of adult protection and whistle blowing procedures. They were aware of the different forms of abuse and confirmed they would report any suspicions to the provider/manager. One staff member recognised that abuse could take place between residents. The staff were not aware of the detail of local procedures and who to contact should they require advice and support from an external independent agency. The records show that one resident was hit by another resident and suffered a swelling on the leg. The provider/manager must ensure that assaults of this nature are addressed using the adult protection procedures. The Rookery Care Home DS0000008801.V289590.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The registered provider/manager continues to make improvements to the home to provide a pleasant, comfortable place to live. EVIDENCE: The home is comfortable and generally well maintained. Improvements have been made to address the mal-odours that were noticeable at the previous inspection. Three bedrooms were seen. These were highly personalised and pleasantly decorated and furnished One resident said she was happy with the standard of accommodation and with the new conservatory and dining arrangements. The Rookery Care Home DS0000008801.V289590.R01.S.doc Version 5.1 Page 17 The rear garden is now more easily accessible from the new conservatory and was being enjoyed by a resident and her family. The signage at the home for people with dementia and other cognitive impairments requires review and should be addressed to assist their remaining capacity. Some of the chairs in the lounge areas are heavily soiled and require cleaning. One resident said she was happy with the laundry arrangements. The clothes worn were well laundered and pressed. The laundry was assessed at the previous inspection and met the requirements. The staff have not received training in Infection Control and this is required. The Rookery Care Home DS0000008801.V289590.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): 27, 28, 29, 30. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The numbers and skill mix of staff employed during the day is appropriate for the needs of the residents. The deployment and numbers of staff in the early hours of the morning has not been evidenced as sufficient to meet the needs of the residents. EVIDENCE: The registered manager/provider requested additional staff to work to help facilitate the inspection process. The duty rota showed staff were available in numbers that were appropriate to meet the needs of the residents. The rota also indicates the delegated responsibilities of staff on each shift. There are two waking night staff and one additional person is on call. The night staff are responsible for undertaking a range of domestic tasks during the night. The registered provider/manager has stated that these tasks are secondary to the responsibility staff have toward the supervision and care of the residents. The Rookery Care Home DS0000008801.V289590.R01.S.doc Version 5.1 Page 19 The night staff undertake two hourly checks on residents, the last check being at between 5:00 am and 5:30 am. If people are awake and require assistance due to continence problems, they are usually assisted to get dressed at this time. On the day of the inspection fourteen people had been assisted to get up and were seated in the lounge at 07:00 am. The registered provider/manager could not evidence how the residents were appropriately supervised whilst the two night staff were upstairs assisting other people to get washed and dressed. A staff member must be available to supervise and assist residents at all times. The required minimum of 50 of the care staff have achieved their National Vocational Qualification (NVQ) to level 2. Three people have achieved level 3. The registered manager is currently studying for the Registered Managers Award. The files of two new staff were seen. They contained evidence that a check had been received to confirm they were not included on the Protection of Vulnerable Adults list which would preclude them from undertaking this type of work. Their Criminal Record Bureau Enhanced Disclosures had not been received however and they cannot be confirmed in post until this has arrived. In the mean time the provider/manager must ensure that an appointed member of staff who is suitably qualified and experienced supervises them. A record must be kept to evidence that this has taken place. The home has received information from Skills for Care that will inform the induction programme. Staff undertaking their induction programme must also be supervised by a suitably experienced and qualified staff member. The Rookery Care Home DS0000008801.V289590.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): 31, 33, 35, 38. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The provider/manager is fit to be in charge of the care home. Systems are in place to ensure that the home is managed in the best interests of the residents however up to date good practice guidance needs to be introduced regarding some aspects of care. EVIDENCE: The registered provider/manager is well respected by the staff. One staff said she is approachable and feels confident to give her opinions on ways that the service might be improved. The registered provider/manager has undertaken periodic training to update her skills and is currently training for the Registered Managers Award. The Rookery Care Home DS0000008801.V289590.R01.S.doc Version 5.1 Page 21 An external facilitator manages the aspect of the quality assurance process that involves residents. Their views are sought through one to one meetings on a wide range of issues relating to life at the home. The outcomes are analysed and fed back to the registered provider/manager who then produces an action plan to address any issues of concern or suggestions for improved practice. Relatives and staff views are also canvassed using other facilitators. Wherever possible the residents or their relatives manage their own personal finances. Some cash sums are managed for the payment of hairdressing and chiropody etc and records are kept about these. Records were seen to confirm that the equipment and facilities at the home are appropriately maintained. The staff were receiving refresher training in moving and handling skills. Some newer staff were attending an introduction to moving and handling and a back care course. An experienced and qualified provider of training in this area facilitates this. Some staff have not received infection control training. The records of one staff member confirmed that appropriate training had taken place in all other mandatory topics. The accident records seen did not reflect the number of falls recorded in the daily record book. This means that appropriate risk assessments and interventions to reduce the number of falls and protect residents are not carried out. Some resident’s freedom of movement is restricted for their own safety. The home has now received a copy of guidance produced by the commission on the use of furniture as a method of restraint and this guidance must be implemented. The Rookery Care Home DS0000008801.V289590.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 X 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 The Rookery Care Home DS0000008801.V289590.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 Requirement Residents and where appropriate their representatives must be given opportunities to consider, how they want to plan for their increasing infirmity, terminal illness and death. Care plans must reflect decisions made to restrain people as means of securing their welfare. (see guidance given) Medication must be stored according to the instructions given and in hygienic conditions. Staff must not administer medication unless they have received appropriate training. Nutritional assessments and assessments for the use of aids and equipment to assist people to eat must be undertaken. (This remains unmet from the last inspection). The registered provider/manager must ensure that staff are aware of adult protection procedures and that residents are protected from abuse by other residents. A full assessment of residents night-time needs and of staff DS0000008801.V289590.R01.S.doc Timescale for action 31/05/06 2. OP7 13 31/05/06 3. 4 4 OP9 OP9 OP15 13(2)(3) 18(1)(c) 13, 14. 31/05/06 30/04/06 31/05/06 5. OP18 13(6) 31/05/06 6. OP27 18 31/05/06 The Rookery Care Home Version 5.1 Page 24 7. 8. OP19 OP38 13, 23 13(3) 18(1)(c) 17(2) 9. OP38 work responsibilities must be made to ensure adequate numbers of staff are employed and to ensure residents are appropriately supervised at all times The registered provider/manager 30/06/06 must ensure that the furniture at the home is kept clean. The registered provider/manager 31/07/06 must ensure that staff receive training in the control of infection. The registered provider/manager 30/04/06 must ensure that all accidents including falls are recorded in the accident book 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. 6. 7. Refer to Standard OP3 OP30 OP7 OP7 OP9 OP9 OP19 Good Practice Recommendations The Registered Manager should implement a recognised specialist assessment tool in relation to dementia care such as the Dementia Care Mapping Tool. Staff should receive training in Dementia Care Mapping. The registered provider/manager should keep up to date with information from the End of Life programme available from the Department of Health. The CSCI guidance on the use of restraint techniques should be implemented into practice. The resident’s photographs in the medication administration record should be named to ease recognition. The home should replace the British National Formulary at least once each year. A review of the signage at the home should take place to ensure it meets the needs of people with dementia. The Rookery Care Home DS0000008801.V289590.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Rookery Care Home DS0000008801.V289590.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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!