Inspection on 30/07/07 for The Salisbury

This inspection was carried out on 30th July 2007.

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 Salisbury 14/08/06

The Salisbury 06/10/05

The Salisbury 23/06/05

The Salisbury 15/12/04

The Salisbury 26/04/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE The Salisbury 20 Marine Crescent Great Yarmouth Norfolk NR30 4ET Lead Inspector Ginette Amis Unannounced Inspection 30th July 2007 10:50 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 Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Salisbury Address 20 Marine Crescent Great Yarmouth Norfolk NR30 4ET 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) 01493 843414 Dr Suman Nagpal Dr Sunita Nagpal, Dr Surrinder Batra, Mrs Indira Batra Mrs Karen Bradnum Care Home 26 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (26), of places Physical disability (1) The Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Twenty six (26) older people of either sex may be accommodated. One service user with a physical disability, who is under 65 years of age and is named on the Commission`s records, may also be admitted, at any time, provided care needs have been assessed and these can be met at The Salisbury. No other person under the age of 65 years is to be admitted. Six service users over the age of 65 years, with dementia, may be accommodated provided care needs have been assessed and these can be met at the Salisbury. The new manager must complete specialist dementia care training within 6 months of date of registration and NVQ level 4 in care management within 18 months of date of registration. 14th August 2006 3. 4. Date of last inspection Brief Description of the Service: The Salisbury is a care home providing care and accommodation for up to 26 older people and is situated approximately one mile from the centre of Great Yarmouth. Accommodation is provided on two floors and there are 16 single bedrooms, four with en-suite facilities, and five shared rooms. There are two lounges and a dining room and a pleasant secure garden to the rear of the building. The home made the Commission aware of its current scale of fees on 14 August 2006. The fees charged are from £262 to £378 per week. Extras such as toiletries, newspapers, hairdressing and chiropody are not included and the home expects that residents will pay for these separately. The Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out by using information from previous inspections, information from the providers, the residents and their relatives, as well as others who work in or visit the home. This report gives a brief overview of the service and the current judgement for each outcome group. The over riding impression gained from the inspection visit was of work in progress and of a service that aims to improve. It was unfortunate that work was still not concluded on care planning. . What the service does well: What has improved since the last inspection? The assessment and care planning documentation remained in the process of being transferred to a new improved format. However a significant proportion of residents ‘ assessment and care plan documentation had been documented into an expanded new format The requirement made at the previous inspection for residents’ social and emotional needs to be assessed and addressed within a care plan framework had been met and efforts made to provide suitable one to one stimulation, entertainment and activities. Members of staff had received training to protect vulnerable adults from abuse and in care for people with dementia. The Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 Page 6 Some further redecoration of the care home had taken place, a lock had been fitted to a side door that was previously unprotected and new carpeting had been fitted in the hall and corridors. 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 summary of this inspection report can be made available in other formats on request. The Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 and 6 Quality in this outcome area is adequate. The introduction of a new assessment and care planning process, that included an assessment of all aspects of residents’ needs, represented a considerable improvement in standards and once the new format has been applied to everyone resident at the care home, including short stay residents, the outcome might readily be judged as good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A new brochure had been produced for persons enquiring about residency. at The Salisbury . A recommendation was made for IT systems to be improved to facilitate updating such documents and to permit e mail and internet access. “Assessment For Good Care Planning” documentation had been introduced since the previous inspection and the transfer of residents’ information to these files was in process. Where the new documents had been completed, they contained a useful range of information, were well compiled with full details of all care needs, including social care needs as required at the last The Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 Page 9 inspection. The transfer of all residents’ information remained however work in progress – see section on Health and Personal Care. The files belonging to a couple admitted initially for short term care were examined and found to be inadequate. In future any resident admitted for a short stay must have a full assessment of their needs in place, available to staff at the time of their entry to the home. (Requirement). The file of another recently admitted resident was found to contain appropriate information. The Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 and 9 Quality in this outcome area is adequate. The assessment and care planning documentation has continued to improve, but as yet is incomplete. If the work in progress had been finished this would have raised the standard to good. It was felt the standard applied to the administration of medication was good and that residents were being appropriately cared for in a friendly and considerate manner. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The files of 5 residents were examined and included those for short stay residents, plus one resident who had come more recently to live at the Salisbury. Evidence of improved care planning was noted. This included the required assessment of social and emotional needs, and a well-defined plan of action for meeting residents’ needs. Two of the residents’ whose files were examined were later interviewed and both spoke highly of the care they received, saying they felt their needs were met and that every effort was made to ensure their health maintained and well being assured. Both stated that medical assistance was always promptly made available when required. The Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 Page 11 A Community Nurse visiting the care home was spoken with and said she had no complaints whatsoever about the Salisbury and considered it a “nice home.” Throughout the day, interactions between staff and residents were conducted in a friendly, cheerful but respectful manner. The good rapport between the manager and residents was very obvious and residents themselves said they considered staff very caring. A number of residents were spoken with informally and two interviewed in private. One resident said, “I couldn’t wish to be in a nicer home. There isn’t anything I could say against a single member of the staff team, they’re all really lovely.” Relatives of residents at the Salisbury also voiced this opinion, one commenting on how well an aunt with dementia was cared for, another describing staff as “extremely kind and considerate”. A requirement was made for the work in progress updating residents’ assessments and care plans to be completed as a matter of priority as this has been work in progress for nearly two years It was evident that much work had been done to ensure care plans were more up to date and that all areas of need had been covered. It was recommended that once all the information about residents’ needs had been transferred to the new system, these records alone should be kept in daily use. Medication was found to be well-organised, stored and documented and carefully administered by members of staff trained to do so. There were 3 residents who took charge of their own medications, (Creams and Inhalers) and each was suitably risk assessed and monitored. Other medication was mainly held by the home in monitored dose system, within a purpose built trolley. A Controlled Drugs Store and Drugs fridge were both in place. PRN medication was safely stored and labelled. A record of the signature of staff authorised to give medication was held. The care home had introduced its own monthly monitoring system that included some random checks on staff administering medication and weekly and monthly stock checks. Medication had been very recently subject to an external audit by the Great Yarmouth Teaching Primary Care Trust. A member of staff was observed administering medication and this was done in an appropriate manner. An accident book was examined and the manager was able to explain how she regularly studied any patterns of accidents that might occur with certain residents with a view to minimising any risks. However no written records of these assessments were kept and it was recommended such audits be recorded as a matter of course. The Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14 and 15. Quality in this outcome area is good. Residents enjoyed the relaxed, friendly atmosphere, their association with the staff group, the activities organised for them and were particularly appreciative of the food. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents and staff were observed throughout the day of the inspection visit and it was noted that the atmosphere was relaxed and cordial, with staff taking the time to chat with residents in a friendly manner as they went about their duties. Assessment had identified that many residents benefited from one to one contact with staff and the manager stated that she always made sure this was made available. A record was kept in the staff room of time spent in this manner along with other activities provided by the care home. During the morning of the visit the hairdresser was in attendance. Later, some residents took advantage of the nice weather that day to go in the garden, 2 spending most of the afternoon there, reading and talking. A member of staff was observed doing a jigsaw puzzle with a resident. Another member of staff related taking residents along the sea front when the weather was favourable. Two residents spoke at length about the musical entertainment recently enjoyed, and the reminiscence sessions provided, both The Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 Page 13 of which they hoped would be repeated. Another was looking forward to going out with the manager and there was considerable interest expressed by residents in the forthcoming wedding of two staff members to one another. The cook in charge was spoken with and he voiced good knowledge of residents and their dietary preferences and needs. Non of the current residents at the home had any special food requirements but the new assessments provided evidence of this being assessed and daily records and social needs assessments showed that likes and dislikes were noted and catered for. Residents were observed taking their breakfast (there were 2 late risers in the dining room together late morning) and their lunch. Lunch was served in the dining room which was fresh and clean, well furnished and had a cheerful bright aspect with views to the sea side. The meal was nicely presented and appeared appetising and smelled good. The quantities of food available were good and all residents spoken with said they liked the food, considered themselves well fed and stated too that they were always offered adequate choices. None of the residents observed had any problem eating their food unaided though staff were constantly on hand being attentive though not overly so. The meal was taken in a leisurely manner with some residents lingering to finish their conversations. Later in the afternoon tea and biscuits were offered and one lady said there were always lots of biscuits to be had and you could ask the cook for a cup of tea any time and get one. The Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. Residents were protected by the care home’s policies and procedures and confident they could speak with the manager about any concern they might have. Staff were appropriately trained to protect vulnerable adults. This judgement has been made using available evidence including a visit to this service. EVIDENCE: An appropriate complaints procedure was on view in the main foyer and the manager stated that each resident had received their own copy of this document. The manager also said she continued to speak regularly with all residents regarding their satisfaction with the service and to discover if they had any concerns. A complaints record log was in place and provided evidence not only of the concerns that had been raised since the last inspection but how these had been dealt with and resolved. From discussion with the manager it was evident she was well aware of her responsibilities regarding the welfare of residents and other members of staff and had some experience in dealing appropriately with difficult issues. Residents spoken with were unclear over what was meant by a complaints procedure but said they knew very well they could speak to the manager over any problem they might have and were particularly keen to emphasise how approachable she and the care home’s owner were. The manager reported that the majority of staff members had just completed a training course with the local Primary Care Trust regarding the protection of vulnerable adults from abuse. Those who had been unable to attend were booked on a course scheduled to take place in September 2007. Staff spoken The Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 Page 15 with said they had found the course useful and informative. Notices were on display in the staff office bearing helpline phone numbers for anyone concerned about issues relating to abuse. All members of staff were CRB checked and staff records examined contained evidence of this. The Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24 and 26 Quality in this outcome area is adequate. While some considerable improvements had been made to the environment, and others were possibly on their way, there remained some work to be done before the premises (house and garden) can be deemed at a good standard. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises was conducted at the start of the inspection visit. Most areas seen were found to be safe, clean and relatively tidy and there were no unpleasant odours. It was apparent that a programme of redecoration was being pursued that included repainting of some bedrooms since the previous inspection. New replacement carpets had been laid in the corridors and stairs. The manager had just received news of a grant that would enable new furniture to be bought for the lounge area. While it was clear that efforts were being made to improve the environmental standards, the effect was in some ways compromised by a lack of attention to detail. For example, the lounge areas were cluttered by a great many The Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 Page 17 wheelchairs stacked in recesses and a recommendation was made for a more suitable storage area to be found. Some curtains had come adrift from their hangers. Spillage from the hatch in the newly painted dining room had not been properly cleaned away. Some door handles were loose. The rubber seat on one of the bathroom hoists was split and unpleasant looking. Access to the back garden was by a steep ramp, with handrails. There was similar access at the front door. It was evident how the garden was not being used to the best advantage, being safe and secluded but rather overgrown and unkempt looking. The manager agreed that the care home would benefit from having in place a plan for the general upkeep and redecoration of the premises, including the garden and it was recommended this should be agreed with the proprietor so that needed, on going works could be approached in a time bound, budgeted manner and executed according to this plan. It was possible that the provider’s wish to build an extension to the property might influence the way the grounds were made use of. These plans were not yet completed so planning permission had not been sought. A recommendation was made for a lock to be fitted to the laundry door so this could be kept locked when not in use. The side door to the premises had already been secured with a coded lock as had the front door. The 5 rooms offered for shared occupancy were still used as doubles, though one was occupied by a couple. The continued use of double rooms is not ideal for people who have cognitive problems and it may be possible for these rooms to be used as singles once the extension is built. The Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. The manager had sustained staffing levels and continued to ensure staff received appropriate training to equip them to perform their duties. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the inspection visit the manager was interviewing applicants for the deputy post, as the currently employed deputy would be leaving to take up a managers’ post at the end of the week. The manager reported how once this post was filled the care home would have its full quota of staff again. She related how, since having resolved a problem with a member of staff earlier in the year, the home and staff group had been a much happier and more settled place. From observation and conversation with members of the staff team this seemed to indeed be the case. The care home was appropriately staffed by adequate numbers of carers. The manager worked Monday to Friday and in her absence senior staff were left in charge. The situation regarding NVQ accreditation remained unchanged with 4 members of staff having NVQ Level 2. There were still 6 members of the care team enrolled to commence this accreditation in September 2007. 90 of the care team had recently completed training in care for people with dementia. Those remaining would complete this training with the PCT in September. Members of the team reported having undergone recent fire The Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 Page 19 training and first aid and there were certificates displayed in the front hallway. All the care team had Food Hygiene certificates. Examination of a random selection of staff records showed that appropriate recruitment procedures had been followed. Members of staff spoken with and observed appeared to have a good grasp of their residents’ needs and were particularly kindly in their disposition towards them. The Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is adequate. While it was evident the care home had been working conscientiously to raise standards, the manager had not yet been able to meet the conditions set on her registration for completion of accreditation and training. The care home’s proprietor had failed to comply with Regulation 26 and there appeared insufficient evidence that care of the premises was co-ordinated between manager and proprietor. However, the manager’s ability to deal with difficult situations, to develop a good team and to provide residents with an acceptable standard of care is to be commended. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager reported that she now expected to complete her Registered Managers’ Award NVQ Level 4 by the end of 2007. The pressure to complete this course combined with the need to manage the care home effectively had left her little time in which to seek further dementia care training. The Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 Page 21 However the manager stated she was committed to doing so as early as possible in 2008. The manager is reminded that she is in contravention of her Conditions of Registration and she must advise CSCI of her progress in booking herself onto a course. The safe keeping of residents’ cash records were examined and found to be in order. The care home continued to make available the findings of its quality assurance reviews, last conducted March 07 and had demonstrated that it acts upon these findings. No evidence of the provider having completed any Regulation 26 visits was available and the manager was not aware of any such inspection having taken place. The provider must commence regular monthly inspection reports of visits to the care home in line with Regulation 26 and submit a copy of her report both to the manager and to CSCI. The Proprietor and manager must also ensure that they monitor the buildings and ensure that it is maintained to an acceptable standard. A fire risk assessment was almost to the point of completion and provided a thorough guide. The Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 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 3 X 2 X X 1 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X 2 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 The Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 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 OP6 Regulation 14 (1) Requirement Residents admitted for a short stay must first have their needs assessed and the assessment and subsequent care plan must be available for use. The work in progress to review all residents care plans and transfer information into the new format must be completed as soon as possible The registered manager must meet the conditions of her registration (September deadline will not be met) The provider must commence making monthly inspection visits to the care home and provide a copy of their report to the manager and CSCI Timescale for action 30/07/08 2 OP7 15 (2) 31/10/07 3 OP31 9 (2) b i 31/12/07 4 OP31 26 30/09/07 The Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 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 OP1 Good Practice Recommendations Improved IT access should be made available to facilitate the updating of documents, policies and procedures and enable e-mail and internet use. Updated assessments and care plans should alone be kept in circulation for the avoidance of confusion Audits of accident records should be documented A suitable area away from lounges should be found in which to store wheelchairs. The provider and manager should construct a time bound and budgeted plan for the future maintenance and refurbishment of the premises, including the garden. A lock should be fitted to the laundry door. 2 3 4 5 6 OP7 OP8 OP1 OP19 OP26 The Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Salisbury DS0000027419.V347589.R01.S.doc Version 5.2 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!