Inspection on 28/02/06 for The Rookery Care Home

This inspection was carried out on 28th February 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 20/04/06

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, Rehana Rashid Unannounced Inspection 28th February 2006 08:00 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.V284415.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.V284415.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.V284415.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The number of persons for whom residential accommodation with both board and care is provided at any one time shall not exceed THIRTY (3) The residents shall be within registration category I & MP/E One Identified resident shall be 60 years of age or older Date of last inspection 27th September 2005 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 4 double rooms. Both stair lift and passenger lift are provided. Care is provided for older people who may or may not be diagnosed with a form of dementia. The Rookery Care Home DS0000008801.V284415.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 7.5 hours and was the second statutory unannounced inspection of the year. Inspectors looked around some parts of the building and a number of records were examined. Seven of the twenty-eight residents and six of the staff were spoken with. The employer’s liability insurance certificate had expired. The registered provider/manager confirmed she was insured and would establish why she had not been sent another certificate. The home does not have a current registration certificate as the provider said it was sent on request to the department of health. Another certificate will be issued with amendments agreed with the registered provider/manager to the conditions. The registration certificate must be displayed in a prominent position in the home at all times. What the service does well: The home has some good examples of care planning. Good use is made of local community health care resources and relationships with local healthcare teams appear effective. The staff are generally well trained and work hard to fulfil their responsibilities. Records show that the home has been risk assessed for the health and safety of residents and staff. The programme of entertainment is enjoyed and valued by the residents. Meals for people taking a ‘normal’ diet are nutritious and well presented. The residents spoken with said they enjoyed the food provided. The manager and staff were directly and indirectly observed interacting positively with the residents. They were polite and courteous and appeared to have good relationships with them. The Rookery Care Home DS0000008801.V284415.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: The registered provider/manager must make sure that the concerns set out below are put right. The following concerns must be dealt immediately. These concerns related to the deployment of staff and management of mealtimes. This must be reviewed to ensure that people with swallowing and eating problems receive consistent supervision, encouragement and assistance. An immediate requirement letter was left with the provider/manager of the home to request that urgent action is taken with regard to this. The assessment, care planning and care of residents who have swallowing difficulties or other problems that affect feeding themselves independently must be referred for assessment by a dietician and speech and language therapist. Residents with the aforementioned difficulties must be weighed regularly. The Rookery Care Home DS0000008801.V284415.R01.S.doc Version 5.1 Page 7 The review of care plans and risk assessments must improve in response to changing needs. Records must be available on all staff training and recruitment checks for inspection by CSCI. The staff must use the training they have received to improve their practice, this particularly relates to safe moving and handling of residents. 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.V284415.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 Rookery Care Home DS0000008801.V284415.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): Not assessed on this inspection. Standard 3 was met when last assessed. EVIDENCE: The Rookery Care Home DS0000008801.V284415.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): 7, 9, 10, 11. Care needs are generally clearly identified in care plans. Risk assessments are not routinely undertaken in response to resident’s changing needs. Some practices do not promote the privacy and dignity of residents. EVIDENCE: During the inspection three of the residents files were randomly selected. The care plans were generally clear and appropriate describing the resident’s needs and the action staff must take to meet these needs. Some areas of improvement are however needed. One care plan indicated that following a hospital admission the resident was discharged back to the home on a pureed diet. The home was given instructions to follow during meals due to the resident having difficulties with swallowing. However the risk assessment on the file was not updated to reflect this and there was no indication whether the resident was to be reviewed by the speech and language therapist. No evidence on the care plan was identified to establish whether or not the home had made contact with the community dieticians to ensure that an appropriate nutritional diet was being provided. Furthermore, the instructions received from the hospital had not been accurately transferred into the care plan and were not being followed by the staff. The resident’s weight had not been monitored regularly. The Rookery Care Home DS0000008801.V284415.R01.S.doc Version 5.1 Page 11 Another plan was updated stating the resident has a broken ankle following a fall. The risk assessment was not reviewed and updated having regard to the change of circumstances. The registered manager advised the inspectors the care plans and risk assessments are in the process of being updated to reflect the change in residents needs. The residents access relevant services from local healthcare professionals such as the general practitioners, district nurses, and dentists. The community psychiatric nursing team also supports some people. Two of the files did not contain photographs of the residents; this was raised and the registered manager agreed to address this. The way that staff preserve the privacy and dignity of residents needs further consideration. A terminally ill resident was receiving individual care from one staff member. Whilst this is both sensitive and supportive she did however spend her last hours sitting in a communal area of the home. It is important that relatives, staff and service users be supported to offer comfort to a resident who is dying. This should take place in the privacy of the resident’s own room where they are surrounded by their own personal belongings. Residents care plans describe the funeral arrangements. The sensitive issue of death, where the person wishes to spend their last days and with whom is not discussed in further detail. Residents and their relatives must be offered the opportunity to express their wishes in planning for increasing infirmity, terminal illness and death. Some people are restrained in their chairs for reasons of their own wellbeing. The guidance on the use of restraint will be shared with the home and the registered manager should implement this into practice. This will be assessed at the next inspection. The Rookery Care Home DS0000008801.V284415.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, 15. Social activities were well-organised and provided enjoyable stimulation for the majority of residents. Meals are nutritious and balanced for those on a ‘normal’ diet but the home is not meeting the needs of people who require support when eating or who require a liquidised diet. EVIDENCE: The home has a programme of activities planned in advance. A singer and musician entertained the residents and this was thoroughly enjoyed. People were stimulated into participation and one person said this type of entertainment happens on a regular basis. Six people were spoken with about the quality of meals. Five people said they looked forward to meal times and enjoyed the choices offered. The inspection of the kitchen revealed that deliveries of fresh fruit, vegetables and meat were received twice weekly. Frozen vegetables are not routinely used. The meal presented to people who receive a ‘normal’ diet was appetising, nutritional and appreciated by the residents. One person, who received a pureed meal, was not satisfied. The liquidised vegetables and meat were mixed together and served in a bowl. This does not present food in an attractive and appealing way and does not preserve the individual flavours of the dishes served. The cook had some very useful advice on diabetic diets that was received directly The Rookery Care Home DS0000008801.V284415.R01.S.doc Version 5.1 Page 13 from a meeting with the dietician. This is good practice. The advice of a dietician has not however been sought in relation to the provision of pureed meals for people with swallowing problems and the cook said she had no guidance on this. Thickeners were prescribed for two people however their prescriptions were being shared and this is illegal. The management and deployment of staff at mealtimes requires review. Some people with higher dependency needs sit in a very busy area at mealtimes as staff are delivering plates of food from the kitchen past these people to the other dining areas. Their meal times are not therefore spent in a relaxed environment where there are fewer distractions. Some people require prompting, assistance and monitoring at meal times because they have dementia. Staff feedback and resident records confirmed that one person had swallowing difficulties. He was discharged from hospital with advice stating he should be observed whilst eating, be in an upright position and alert. This advice was not acted upon. The registered manager stated his condition had dramatically improved since returning home however the instructions from the hospital should be followed until a speech and language therapist has reviewed his needs again. Staff need to follow good practice guidance when assisting people with swallowing difficulties to eat. Some people were observed to spill large quantities of food on their clothes and on their table. The amount of food ingested was not effectively monitored. Staff were extremely busy during this period and no one was allocated responsibility to observe encourage and assist these people to eat in a manner that preserved their dignity. By the time one staff member was available to assist one of the residents to eat, her meal had gone cold. Non-slip place mats aren’t in use to stabilise plates on the table and make independent eating easier. Nutritional assessments were not evident in the care plans. These must be acquired from the community dietician and used to inform practice. The issues described were discussed with staff who validated observations made and agreed a review was necessary. An immediate requirement was made to review the management of mealtimes, the resources needed and the deployment of staff to ensure that all resident’s needs are appropriately met. The Rookery Care Home DS0000008801.V284415.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 Concerns raised are not handled within given timescales. EVIDENCE: The requirement that concerns raised will be addressed within 28 days must be included on the complaint procedure and adhered to unless there is a good reason why this cannot be achieved. One complaint has been referred to the registered manager to investigate. The CSCI has agreed an extension on the time taken to investigate this. The Rookery Care Home DS0000008801.V284415.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): 19, 26. The registered provider/manager continues to make improvements to the home to provide a pleasant, comfortable place to live. EVIDENCE: The registered manager has replaced some of the carpets to the ground floor a large conservatory has been added to the property, which has been converted into a dining room. The old dining room is now a sunny, welcoming quiet lounge which two people said they very much enjoyed using. The old laundry space has been refitted as a hairdressing salon. The garden is currently being landscaped ready for use during the summer months and there are plans for further improvements. The Rookery Care Home DS0000008801.V284415.R01.S.doc Version 5.1 Page 16 The bedrooms are well fitted and personalised. Two rooms, have strong malodours that aren’t being successfully addressed using current methods. The laundry is situated in the basement of the home and is fitted with a sealed floor, washing machines that are capable of managing heavily soiled items that meet infection control guidelines . The Rookery Care Home DS0000008801.V284415.R01.S.doc Version 5.1 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 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, 29, 30. Staff training files indicated staff are receiving appropriate training that should ensure they are competent to do their jobs. Staff are consulted and can influence decisions about practice. EVIDENCE: As part of the inspection process three staff files were examined as well as the staff-training file. The files highlighted some weakness in the homes policies and procedures around recruitment. One staff file inspected contained no references, whilst two references were contained in the other two staff files. This was discussed with the registered manager who was confident they had been received. She said she would look into this matter, locate the missing references and fax them to the CSCI. There was no documentary evidence on the most recently employed staff member’s file to confirm whether a CRB application has been made, upon discussion with the registered manager she confirmed that a Protection of Vulnerable Adults (POVA) application has been made and she would fax the document to the CSCI. The registered manager was informed about the requirement to maintain a record of the experienced staff member who must supervise the work of the employee employed under POVA until a satisfactory criminal records bureau disclosure is received. The third file inspected contained a CRB disclosure. Two out of the three files contained the required photographic identification. The registered manager was advised to keep all of the required information together on staff files. The Rookery Care Home DS0000008801.V284415.R01.S.doc Version 5.1 Page 18 All staff training information is held centrally. Staff training records were examined which demonstrated staff training had been completed in various areas. For instance a member of staff’s record showed she has attained training in the following areas, Food Hygiene, Health & Safety in the workplace, National Vocational Qualification Level Three and Adult Protection. One member of staff spoken with was able to substantiate this, stating she feels she has received relevant training, which enables her to carry out her job. The training record of one staff member who is the key worker for a resident who was case tracked could not be located. This was raised with the registered manager who stated this staff member has just submitted her course work for the National Vocational Qualification level Two to the assessors. Photocopied evidence of training provided should be retained at the home. Upon further examination of the files the inspector was unable to find evidence of induction for staff. Inappropriate moving and handling techniques (under arm lift) were observed on two occasions during the inspection. This was raised with the registered manager who stated all staff had received manual handling training and she will be raising this at the next team meeting. It is recommended that this be addressed in a timely manner and arrangements be made for refresher training where necessary to ensure safe moving and handling techniques be adopted at all times. There were appropriate numbers of staff on duty however if the review of mealtimes does not improve care for people who require assistance and monitoring when eating, the numbers of staff employed at meal times will need to be reviewed. The Rookery Care Home DS0000008801.V284415.R01.S.doc Version 5.1 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 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): 32, 33, 35, 36, 38. Some staff practice, already identified in this report needs to be reviewed and managed more effectively. Quality assurance systems, verified by an independent person means that the home receives unbiased feedback. Systems are in place to protect the resident’s financial interests. Evidence was not available to confirm that supervision takes place regularly. EVIDENCE: Discussions with staff are undertaken in relation to care practice and routines. Some of these discussions were influenced from feedback at the last inspection and concern how early people are assisted to get up in the morning. Continuous quality monitoring is undertaken at the home. Letters and questionnaires are given to an independent external person to collate and review. Feedback is then given to the registered manager and the residents and relatives via a newsletter. The Rookery Care Home DS0000008801.V284415.R01.S.doc Version 5.1 Page 20 The registered manager safeguards some of one resident’s money. Written and computerised records of transactions are maintained. A selection of staff files were viewed to ascertain whether or not staff receive regular supervision. In one file there was evidence that formal supervision had taken place twice and in another file it was documented supervision had taken place once. This was discussed with the registered manager who stated staff are supported and supervised as and when required. She reported that she had not yet written up the record of the last supervision sessions she did. It is recommended that staff receive regular supervision based on the criteria as specified in standard 36.3 of the national minimum standards. The home keeps good maintenance records of the home and confirmation from different professional bodies that systems meet health and safety requirements. The Rookery Care Home DS0000008801.V284415.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 2 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 2 3 X 3 2 X 3 The Rookery Care Home DS0000008801.V284415.R01.S.doc Version 5.1 Page 22 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 12, 13, 14, 15. Requirement Assessments of residents needs must be kept under review and having regard for changes in circumstances be revised as necessary. Care plans must be updated in line with these reviews. Assessments and instructions about care from healthcare professionals must be recorded in the care plan and acted upon. The appropriate healthcare professional must be contacted to review instructions given. An assessment of people with swallowing and eating difficulties by a dietician and speech and language therapist must be requested. The weight of people with swallowing and eating difficulties must be monitored regularly. Residents and where appropriate their representatives must be given opportunities to consider, if they wish, how they want the home to plan for their increasing infirmity, terminal illness and death. DS0000008801.V284415.R01.S.doc Timescale for action 03/04/06 2 OP7 13, 14, 15. 13/03/06 3 OP7OP8 13, 14, 15. 13/03/06 4 5 OP7OP8 OP7 12, 13, 14, 15. 15 13/03/06 31/05/06 The Rookery Care Home Version 5.1 Page 23 6 7 8 OP7 OP15 OP15 13 16 12 9 OP15 13, 14. 10. OP26 16 11. OP27 18 12 OP29 7, 9, 19 13 OP30 18 Care plans must reflect decisions made to restrain people as means of securing their welfare. Liquidised or pureed food must always be prepared and presented in an appetising form. The management of mealtimes and deployment of staff must be reviewed. Residents with eating and swallowing difficulties must be supported and observed at all times. Nutritional assessments and assessments for the use of aids and equipment to assist people to eat must be undertaken. The Registered Manager must ensure that the home is kept free of offensive odours. (This remains unmet from the requirements made at the previous inspection). A full assessment of residents nighttime needs must be made that will inform the number and deployment of night staff. (This remains unmet from the requirements made at the previous inspection) A selection of POVA and CRB certificates must be retained for inspection before being destroyed under the Data Protection Act 1998. If destroyed a record of the date they were received and the reference number must be retained. A record of the staff who supervise people recruited on a POVA check must be made. A record of the induction and training staff have completed must be available for inspection. 28/04/06 13/03/06 13/03/06 03/04/06 03/04/06 03/04/06 13/03/06 28/04/06 The Rookery Care Home DS0000008801.V284415.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. Refer to Standard OP3 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. Advice should be sought about the information to gather to plan for terminal illness and death from specialists in this field. 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. Staff should receive training in Dementia Care Mapping. 2. 3. 4. 5. OP7 OP7 OP9 OP30 The Rookery Care Home DS0000008801.V284415.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.V284415.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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