Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 01/05/07 for The Wells Nursing & Residential Home

Also see our care home review for The Wells Nursing & Residential Home for more information

This inspection was carried out on 1st May 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

What the care home does well

What has improved since the last inspection?

CARE HOMES FOR OLDER PEOPLE The Wells Nursing & Residential Home Henton Wells Somerset BA5 1PD Lead Inspector Stephen Humphreys Unannounced Inspection 10:00 1st May 2007 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 Wells Nursing & Residential Home DS0000003304.V335626.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 Wells Nursing & Residential Home DS0000003304.V335626.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Wells Nursing & Residential Home Address Henton Wells Somerset BA5 1PD 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) 01749 673865 01749 676878 sharon@avoncare.wanadoo.co.uk Avon Care Homes Ltd Mrs Rachel Mary Collins Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places The Wells Nursing & Residential Home DS0000003304.V335626.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Elderly persons of either sex, not less than 60 years, who require general nursing care. May accommodate up to 4 persons aged 40 - 59 years with a physical disability, who require nursing care (PD). Date of last inspection Brief Description of the Service: The Wells nursing and personal care home is registered with the Commission for Social Care Inspection for up to 40 people with nursing and personal care needs. The Wells Nursing Home can be found on the main road through the village of Henton approximately two miles from the City of Wells. The accommodation is on two floors with a passenger lift to the first floor where 25 of the 40 bedrooms are located. All the bedrooms are single occupancy, some with en-suite facilities, which includes a wash hand basin and toilet. On the ground floor there is a lounge, a dining area and a conservatory. There is a garden at the rear of the building with an open outlook and views across to the Mendip Hills. The garden is lawned and flat, the river Axe runs along the bottom of the garden. The home offers all nursing and personal care services to older persons over 65yrs. Experienced registered nurses and carers deliver nursing and personal care. There is a full complement of administration, catering and ancillary staff to support the registered manager of the home. The current fees are: Nursing From £644:00 – to £686 Personal Care only: £518:00 To £560 The Wells Nursing & Residential Home DS0000003304.V335626.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first key inspection of The Wells Care Home for 2007 /2008 using the Commission for Social Care Inspection Inspecting for Better Lives methodology. The inspection was unannounced and carried out over one day. The inspector was able to meet with the registered manager during the inspection and discuss matters of the home. At the time of this inspection there were 40 people being accommodated in the home. The inspection process involved talking at length to the people, relatives, staff members, observing care practices, reviewing care and administrative records. The inspection methodology used by the Commission for Social Care Inspection enables the inspector to make a judgement on the quality of the service delivery based on the outcomes for people. The outcome of the discussions with the people and relatives during the site visit was very positive with comments received like,” …very pleasant responsive staff … they always smile”. “It’s lovely here”, “Staff are always helpful and nothing is too much trouble”. The Commission for Social Care Inspection has not received any concerns about this home since the last inspection. What the service does well: The registered manager has developed and maintains a high standard of personal and nursing care delivery through a dedicated staff team and leads from the front. All the people spoken to felt that their individual needs were met. The standard of record keeping in the home is very good and the administration team provide good customer care service. The care delivery, although mostly task orientated, showed evidence of person centred care on an individual basis. The registered manager has introduced end of life – advanced care plans and uses the gold standard framework method of care planning for people who need palliative care. The Wells Nursing & Residential Home DS0000003304.V335626.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Wells Nursing & Residential Home DS0000003304.V335626.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 Wells Nursing & Residential Home DS0000003304.V335626.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service and their relatives receive up to date information on the homes services in a statement of purpose. People who use the service can be assured the nursing and care needs will be identified in needs based assessment carried out by the registered manager. EVIDENCE: A copy of the statement of purpose was on display at the main entrance to the home. The inspector was able to read the document. The information was current and written in plain English. The registered manager should also have the statement of purpose available in different formats including large print and audio. The Wells Nursing & Residential Home DS0000003304.V335626.R01.S.doc Version 5.2 Page 9 Results of a recent satisfaction survey indicated that respondents felt they had sufficient information about the home to make a choice. Many of the people spoken to said that they were in hospital prior to moving into the home and were not able to visit therefore their relatives chose the home for them. One relative spoken too said they had assistance from the social worker in making a choice about the home. Relatives felt that they could make a decision on visiting the home and from the verbal information provided by the registered manager during the visit. The registered manager carries out a needs based assessment prior to admission on all prospective people. The registered manager uses the activities of daily living model of care to carry out the needs based assessment on all people who wish to use the service. The assessments of the people the inspector looked at in detail had not been revisited since their admission to reflect current state of physical or mental well being. The inspector discussed this with the registered manager. To ensure the persons care needs are being met the assessment needs to reflect the current state of the person’s physical well being. A large proportion of the care staff are from overseas, many have nursing skills and are experienced in delivering nursing care to older persons. People spoken to said they felt their care needs were being met fully, relatives who spoke to the inspector confirmed this. To ensure the persons nursing and care needs are met the registered manager has introduced a key worker system and the level of staffing has been increased by one in the morning. The Wells Nursing & Residential Home DS0000003304.V335626.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): 7,8,9,10,11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be assured that a plan of care will be developed that includes all their care needs and wishes for end of life procedures. People are not involved in the development of the care plan as much as should be. EVIDENCE: The registered manager strongly believes in involving people in the development of their care plan. Due to the frailty of people coming into the home not all people are involved as should be. Evidence of people involvement was seen in the care plans reviewed by the inspector. This only amounted to consent for bed rails and importantly an agreement on the end of life wishes of the person. The Wells Nursing & Residential Home DS0000003304.V335626.R01.S.doc Version 5.2 Page 11 The registered manager is fully versed with and attends regular meetings about the gold standard framework care plans. Evidence of the gold standards framework (Liverpool pathway) method of care planning was seen being used for very frail and people who have palliative care needs. This method ensures that people’s wishes at end of life are carried out and respected. Each person has a care plan that includes risk assessments and nursing / personal care interventions. The plan is easily understood but it is developed using a medical / nursing model of care. Evidence of person centred care is recorded about the person’s wishes and feelings however this could be developed further by moving away from the medical model and the task orientated process. The daily report is completed and dated, however the record does not identify the specific care carried out to meet the desired outcomes of the individual. At this inspection three care plans were reviewed in detail and the inspector was able to speak to two of the people and one visiting relative and the social worker. The social worker said they were happy with the standard of the care delivered in the home and had no concerns to complain. The care plan complies with clinical guidelines however the registered manager is encouraged to make it into a working record and involve the individual in the development. Staff were observed carrying out personal care to persons respectfully and sensitively. Comments received from people included “ …staff are very pleasant and responsive – they always smile”. One relative commented, “We feel that all the staff do their best to keep everyone happy”. There was adequate pressure relieving equipment through out the home. Four mobile lifting hoists, two assisted baths and sixteen beds had bed rails fitted. People are visited as required by the GP, optician, chiropodist and other health care professionals. A professional visitors record is maintained in each care plan. Nutritional screening is recorded along with the need for a special diet. Weight monitoring is carried out monthly. The inspector found that three people who had been admitted to the home in very frail conditions had greatly improved through the care they have received. The care plans recorded improvements in nutrition and weight gains. The Wells Nursing & Residential Home DS0000003304.V335626.R01.S.doc Version 5.2 Page 12 Staff have skills and ability to support and encourage people to be involved in their care plan through the further development of the key worker system. Evidence of review and updates were recorded in each care plan however the record stated “no change “ in many cases. This is not a person centred care approach. The care plans are not seen as working tools. The medication procedure followed by the nursing staff is the Nursing & Midwifery Council standard. The receipt, storage, administration and disposal of medicines were reviewed. No errors were found with the controlled drugs procedure. Security and storage of oxygen cylinders was satisfactory. A sign was seen on the door of a person who had use of an oxygen concentrator. Risk assessment and a self-administration of medicines policy was seen in the persons care plan. People said staff treat them with respect and dignity is preserved at all times. Staff were observed to knock on doors before entering and speaking politely to people. There are clear policies on care of the dying and staff use the gold standard framework procedures. The Wells Nursing & Residential Home DS0000003304.V335626.R01.S.doc Version 5.2 Page 13 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): 12,13,14,15.Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The daily routines are mainly task orientated but staff try to provide a service that is flexible as possible. EVIDENCE: The evidence to support a varied and flexible lifestyle in the home was difficult to find. The registered manager tries to plan the routines and activities in the home in a way that meets choice and wishes of the people but finds it difficult due to the varied dependencies of the people in the home. Since the last inspection quality satisfaction surveys have been carried out. Respondents were mostly dissatisfied with the quality of social activities. Activities are available but limited and only available to low dependency people. The Wells Nursing & Residential Home DS0000003304.V335626.R01.S.doc Version 5.2 Page 14 The registered manager has reviewed and updated the policies and procedures to promote peoples independence since the last inspection. The inspector observed staff encouraging people to mobilise and eat with assistance to maintain their level of independence. Only eight people were observed to take their lunch in the dining room. Other people chose to eat in their rooms. Only three people where observed to use the ground floor lounge during the day to watch the television. During this visit the hairdresser was using part of the lounge for doing ladies hair. Other people spoken to preferred to stay in their rooms. Whilst speaking to a person in their room, an activities plan was observed to be on the dresser however the person did not appear to know it was there, as it was slightly unsighted from where they sat. On the reverse of the activities programme was the menu. When asked about meals the response was “you eat what they give you”. The resident confirmed relative’s visiting is unrestricted. One person said, “she felt a lot better for being in the home, she was starting to eat again, staff were very nice and the food was ok”. Another person confirmed outings each week to attend church and other outings to Dunster, Western Super Mear and a mystery tour. “The staff are very good, you want something, you get it”. The inspector observed and spoke to people who preferred to remain in their rooms. Staff only visited them whenever they pressed the call bell. Of the three people only one preferred to watch a television, no other form of stimulation was evident other than books and magazines. The staff level is reduced in the afternoon to four carers, which does not enable a person centred care culture to develop in the home. The menus appear to be well balanced. Special diets are prepared and carers assisted people to eat their meal in a sensitive manor. Five people required a diabetic diet. The carers serve the meals from a hot trolley and take the meals to the people. The geography of the home is such that the hot trolley is parked in the corridor and meals are taken to people around the home. Meals taken to rooms were covered appropriately. The Wells Nursing & Residential Home DS0000003304.V335626.R01.S.doc Version 5.2 Page 15 Frail people had intake and output record charts to record the fluid and food intake. No concerns were heard about the meals, however the registered manager is encouraged as a matter of good practice to ensure the chef involves the people in the development of the menus. The menu of the day is displayed in areas of the home where people can see it. The Wells Nursing & Residential Home DS0000003304.V335626.R01.S.doc Version 5.2 Page 16 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. This judgement has been made using available evidence including a visit to this service. Recruitment policies and procedures are in place to protect people from abuse. People can be assured that the registered person will take any concerns or complaints seriously. EVIDENCE: The Commission for Social Care Inspection has not received any concerns regarding The Wells care home since the last inspection. The registered manager informed the inspector that no complaints had been received in the home. Although this is a good indication of satisfaction the registered manager is encouraged to have a logbook available to record any concerns. None of the people or relatives spoken to had any complaints regarding the care service. The social worker said he was very happy with the standard of service in the home. All those spoken to said they would take any concerns or complaints to the matron. The Wells Nursing & Residential Home DS0000003304.V335626.R01.S.doc Version 5.2 Page 17 A copy of the complaints procedure was displayed in the main entrance to the home. Recruitment policies and procedures are in place to protect people from abuse. Training of staff in the area of protection is regularly arranged by the homes training officer. Training videos were easily accessible and available to staff. People can be assured that the registered person will take any concerns or complaints seriously. The Wells Nursing & Residential Home DS0000003304.V335626.R01.S.doc Version 5.2 Page 18 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): 19,26 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People are comfortable in a clean and warm environment. Regular maintenance is now being carried out on the home. EVIDENCE: The service provides a mixed homely and clinical environment. Since the last inspection the registered person has introduced a rolling programme to improve the decoration, fixtures and fittings but occasionally there are slippages to timescales. This has occurred with the installation of the regulator valves onto the hot water outlets and to the refurbishment of a wet room on the ground floor. There are a number of en-suite rooms in the home. The registered provider has planning permission to extend the home. To ensure the environmental The Wells Nursing & Residential Home DS0000003304.V335626.R01.S.doc Version 5.2 Page 19 standard of the home is up to date the registered provider is encouraged to progress the plans for the home. People can personalise their rooms. The inspector observed some very homely rooms, with personal items including organ and piano and other equipment of interest. People said they were comfortable, the home was clean, warm and well lit at night. The hot water temperatures are recorded each time a person has a bath. A new assisted bath has been installed since the last inspection. The inspector observed all safety precautions were in place during a tour of the home. The Wells Nursing & Residential Home DS0000003304.V335626.R01.S.doc Version 5.2 Page 20 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): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager ensures the staffing levels are maintained and that the recruitment and selection procedure is robust. People who use the service can be confident of the staff that care for them. EVIDENCE: The registered manager ensures the staffing levels are maintained and that the recruitment and selection procedure is robust. On a daily basis the staffing complement consists of the registered manager and two registered nurses plus five carers in the morning and four in the evening. Night staff is one registered nurse and two carers. The staff rotas were checked and found to be correct. Recruitment of overseas staff has enabled the registered manager to maintain a full staffing complement. Recruitment of local staff is on-going and fruitful of late however the registered manager has to rely on recruiting from overseas. Several of the overseas staff are qualified nurses who do not meet the requirements for registration in this country and are working as experienced carers. The Wells Nursing & Residential Home DS0000003304.V335626.R01.S.doc Version 5.2 Page 21 The staff are experienced in caring for older persons and also receive in-house training. There is a staff room that contains resources for training and updating knowledge in health and social care. Five staff files were checked during this inspection. All the staff files are kept securely in the administrator’s office. All the files contained all the required checks and information to meet the national minimum standards. The nurses and carers spoken to during this visit fully understood their roles. The Wells Nursing & Residential Home DS0000003304.V335626.R01.S.doc Version 5.2 Page 22 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): 31,33,35,36,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. . People can be assured of strong leadership and that the home has sound policies and procedures for staff to follow. The record keeping is of a high standard. The registered manager ensures safe practices through mandatory training and quality assurance checks. EVIDENCE: The home has an experienced Registered Nurse Manager. The people and relatives spoke highly of the Manager, reflecting on her approachability and kindness. The Wells Nursing & Residential Home DS0000003304.V335626.R01.S.doc Version 5.2 Page 23 There is administrative support to assist the Manager with contracting and staff recruitment. Peoples contracts and personal finances were not seen at this inspection as the inspector was informed that no changes have been made to the system in place. The standard of record keeping by the administrator and the registered manager is of a high standard. Improvement in this area has occurred since the last inspection. The general policies and procedures have been reviewed and up dated. The registered manager has set up a semi-formal quality assurance system that includes accident audits monthly and resident satisfaction surveys. The registered manager has plans to introduce monthly medicine audits and to prepare action plans for areas that need improvement. Staff are supervised in their daily work and regular staff meetings are held for the three groups of staff, care staff, registered nurses and the domestic team. Since the last inspection formal supervision has been fully established and will be a part of the overall staff appraisal system. Supervision notes are recorded and stored in a confidential file. Since the last inspection a maintenance person has been employed. Maintenance and servicing records examined were up to date. Since the last inspection thermostatic regulator valves have been fitted to hot water outlets where people can attain full body emersion. The installation of more regulator valves to hot water outlets is planned when the plumber returns from absence due to an injury. The regulator valves must ensure the flowing hot water temperature does not exceed 43C. Inspection of the kitchen found the temperature records completed satisfactory along with other safe practice procedures. The registered person is encouraged to introduce the safe business safe food procedure as promoted by the food standards agency. The Wells Nursing & Residential Home DS0000003304.V335626.R01.S.doc Version 5.2 Page 24 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 2 X 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 X X X X X 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 3 X 3 3 X 3 X 3 The Wells Nursing & Residential Home DS0000003304.V335626.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? no 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2 3. Refer to Standard OP1 OP3 OP7 Good Practice Recommendations The registered manager should have the statement of purpose available in different formats including large print and audio. The registered manager should ensure the needs assessment is updated to reflect the current state of the person. The registered manager should ensure more personal involvement in the development of the individuals care plan. The registered manager should review the daily routines of the home to provide flexible person centred care. The registered person is encouraged to introduce the safe business safe food procedure as promoted by the food DS0000003304.V335626.R01.S.doc Version 5.2 Page 26 4 OP12 5 OP38 The Wells Nursing & Residential Home standards agency. The Wells Nursing & Residential Home DS0000003304.V335626.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Wells Nursing & Residential Home DS0000003304.V335626.R01.S.doc Version 5.2 Page 28 - 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!