CARE HOMES FOR OLDER PEOPLE
Tordarrach Nursing Home 11 Hall Road Wallington Surrey SM6 0RT Lead Inspector
Alison Ford Key Unannounced Inspection 22nd May 2007 10:30 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 Tordarrach Nursing Home DS0000019129.V337217.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. Tordarrach Nursing Home DS0000019129.V337217.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Tordarrach Nursing Home Address 11 Hall Road Wallington Surrey SM6 0RT 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) 020 8669 1494 020 8669 3533 tordarrach@yahoo.co.uk Dr R Obaro Mrs Ayodele Obaro Mrs Victoria Olufunto Akindele Care Home 20 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (0), Learning disability over 65 years of age (1), of places Old age, not falling within any other category (0) Tordarrach Nursing Home DS0000019129.V337217.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. One (1) place for a service user under 65, in the Dementia (DE) category. One (1) place for a service user in the Learning Disability (Over 65) category (LD[E]). 15th August 2006 Date of last inspection Brief Description of the Service: Tordarrach is a home providing nursing care to older people, the majority of whom have dementia. The home is a domestic style property enlarged and converted to provide accommodation for up to 20 residents over the age of 65. It is situated in a pleasant tree-lined road in Wallington, close to local amenities. Communal space and bedrooms are arranged over the ground, first and second floors and there is passenger lift serving all floors. There are eight single and six double bedrooms. The home has a large dining room with adjacent lounge. There are toilet and bathing facilities on each floor a large, accessible garden to the back and parking facilities at the front. At the time of this inspection fees ranged from £575:50 - £627:50 per week with any additional charges payable being agreed prior to admission. A copy of the inspection report can be obtained from the home, from The Commission for Social Care Inspection or via the internet. Tordarrach Nursing Home DS0000019129.V337217.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This report was written following an unannounced visit to the service undertaken as part of the inspection process for the year 2007/2008. Consideration has also been given to information received from other sources such as comments from people who use the service and their relatives, notifications, concerns and complaints. All of those standards thought by The Commission for Social Care Inspection, to be key to the inspection process were assessed. A tour of the premises was undertaken and many of the seventeen residents currently living in the home and several members of staff were spoken with. A visitor also offered their opinions of the home and the care that residents receive there. Various records that the home is required to keep, as evidence of its commitment to the protection and health and safety of its residents, were seen and also a sample of care plans which identify the help and support that residents need and show how their assessed health care needs are met. Personnel files of new members staff were checked to make sure that they contained all of the necessary documentation that helps to ensure the protection of residents and staff training schedules were looked at to evaluate whether the training that is provided is relevant to their needs. Menus and kitchen records were also seen. Prior to the visit comment cards, routinely sent by The Commission, had been received from five people who use this service and all of the feedback had been positive. No complaints have been received since the last inspection. What the service does well:
This home provides care for up to twenty elderly people many of who have advanced stages of dementia. The atmosphere in the home is very friendly and welcoming and all of the residents spoken with were complimentary about the staff and the homes manager. On the day of the inspection most of the residents were in the lounge enjoying organised activities together. All of them appeared well cared for and one resident commented that “ you couldn’t find a better place “ and “they were living with a lovely group of people”. Tordarrach Nursing Home DS0000019129.V337217.R01.S.doc Version 5.2 Page 6 Others said how lovely the staff were and “ everyone is always helpful “ During the inspection staff were observed to have sufficient time to spend talking with residents as they cared for them. Before moving in to the home an assessment is undertaken, to ensure that potential residents needs can be met. These assessments then form the basis for individual care plans which detail the help and support that will be required. In some of those plans that were seen, relatives had been encouraged to participate in this process. The plans are reviewed regularly so that all staff are aware of how residents prefer to be cared for and they are up to date. A key worker system is in operation in the home, which also contributes to continuity of care, helps build relationships between staff and residents and gives staff an insight into resident’s particular problems. Several staff are undertaking a dementia awareness course, which will help them understand the needs of the people that they are caring for. Activities are organised for residents who wish to join in, religious services are held during the week and some residents are able to go out during the day with friends or relatives. Residents said that they liked the food served in the home; this includes a hot snack supper if they would like it. The chef talks with them on a regular basis to ensure that they are enjoying their meals and menus are currently being revised in accordance with their preferences. All of the people who use this service are encouraged to make choices within their daily lives as much as they are able to and their families and friends are welcome to visit them. In order to make them feel more at home, they have been encouraged to bring some of their possessions with them to personalise their bedrooms which are all very pleasantly decorated. Records kept by the home and relating to ensuring the protection and health and safety of residents and staff were generally in good order. Staff turnover is generally low and there are very few complaints made about the service. What has improved since the last inspection?
The majority of those concerns raised at the last inspection have been complied with. In order to maintain the health and safety of residents and staff, fire safety measures have been improved and infection control issues have been addressed. Some redecoration has been undertaken in the home in accordance with a planned programme. New beds and a hoist have been ordered
Tordarrach Nursing Home DS0000019129.V337217.R01.S.doc Version 5.2 Page 7 Several members of staff have been undertaking further training in dementia awareness. This will help them to understand more about the needs and behaviour of the residents that they care for. What they could do better:
So that prospective residents and their families have all of the information that they need to help them decide if the home will suit them, The Statement of Purpose needs to be updated to reflect the current situation in the home. The Service User Guide will also need to be developed and a copy given to every resident as a guide to the services that they might expect in the home. When residents are first admitted in to the home there must be evidence that they have been asked about their wishes in the event of them becoming more unwell or their death. All staff will then be aware of the procedures to be followed in this event. In order to show that residents are receiving a healthy well balanced diet in sufficient quantities a record must be kept of the food that they actually eat. It was also recommended that picture menus would help those residents who are confused to make choices about the meals that they would like. Although some redecoration has taken place within the home, bathrooms would now benefit from being refurbished to ensure that bathing remains a pleasurable experience for the people who live in the home. The laundry also now needs to be upgraded to so that facilities are in line with professional guidance. The Registered Manager is currently not allocated any additional time to deal with the daily running of the home. This lack of time has also led to care staff not receiving any formal supervision which is essential to monitor staff performance and identify future training needs. This must now therefore be given serious consideration. Tordarrach Nursing Home DS0000019129.V337217.R01.S.doc Version 5.2 Page 8 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. Tordarrach Nursing Home DS0000019129.V337217.R01.S.doc Version 5.2 Page 9 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 Tordarrach Nursing Home DS0000019129.V337217.R01.S.doc Version 5.2 Page 10 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): Standards 1,3,6 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The people who use this service can expect that an assessment will be undertaken prior to them moving into the home to ensure that their healthcare needs can be met however, the information that they receive about the home is limited. This home does not offer intermediate care. EVIDENCE: The home has a comprehensive and detailed Statement of Purpose, which sets out the aims and objectives of the service, and a copy of this is displayed in the entrance hall of the home. Some amendments need to be made to ensure that it reflects the current management structure and more details about the fees charged by the home. Tordarrach Nursing Home DS0000019129.V337217.R01.S.doc Version 5.2 Page 11 There is also a Service User Guide however; a copy of this must be given to each person who uses the service. It is recommended that this should be kept in their bedroom so that it becomes a useful reference tool for the future. There was evidence available to show that a careful assessment is made prior to a resident moving into the home to ensure that it will be suitable for them. They could visit the home prior to admission if they were able however; their frailty often makes this difficult. Their relatives are encouraged to visit on their behalf and participate in the admission process. Tordarrach Nursing Home DS0000019129.V337217.R01.S.doc Version 5.2 Page 12 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): Standards 7,8,9,10 Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. The people who use this service all have an individual care plan, documenting the help and support that they require, so that all members of staff are aware of how they prefer to be cared for. These plans ensure that residents assessed health care needs remain met even though they may change. Residents can be confident that they will be treated with respect and dignity and medication policies and procedures are in place to ensure their safety. EVIDENCE: All residents have a comprehensive care plan and four of these were examined at this inspection. They all contained assessments of physical and mental
Tordarrach Nursing Home DS0000019129.V337217.R01.S.doc Version 5.2 Page 13 health, risk assessments, continence and tissue viability assessments. Entries in them show that other healthcare professionals are consulted as required. Assessment of those at risk of developing pressure sores is undertaken regularly so that appropriate interventions and equipment are used. The key worker system in use in the home helps care staff gain a greater understanding of residents needs. There was limited information available regarding the wishes of residents and their relatives in the event of them becoming unwell or dying. This information must be available in the care plans. There was some evidence that residents families had been able to contribute to care plans and this must be encouraged whenever possible. Personal care is given in residents own rooms and visitors could be received there if they wished although, those spoken with at the time of the inspection were happy to sit in the lounge. Staff were observed treating residents respectfully and comments were made about how kind the staff were. All of the residents appeared clean and well cared for and relatives agreed that this was always so. Medication rerecords and storage were seen to be in order and procedures for disposal of unwanted drugs are in line with current legislation. Trained nurses administer all of the medication in the home; no resident currently in the home is able to manage this for themselves. Tordarrach Nursing Home DS0000019129.V337217.R01.S.doc Version 5.2 Page 14 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): Standards 12,13,14,15 Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. The people who use this service are offered activities, which suit their preferences, and expectations and they are encouraged to exercise their choice over their daily lives as much as they are able. Their relatives and friends are encouraged to visit and maintain their relationships with them. They enjoy the food served in the home and the also the opportunity to comment on and influence the menus. EVIDENCE: The advanced stages of dementia of many of the residents, limits the amount of choices that they are able to make and the activities that they can participate in. Those able to express their preferences agreed that they enjoyed the quizzes and musical entertainment. Three members of staff have undertaken a course to enable them to run chair based exercise sessions and residents enjoy these. Some residents are able to go out if accompanied and enjoy a stroll down the road or a visit to church.
Tordarrach Nursing Home DS0000019129.V337217.R01.S.doc Version 5.2 Page 15 Relatives and friend are encouraged to visit the home and join in social occasions that are held. On the day of the inspection care staff were playing a game with several residents and later were seen dancing in the lounge with them. The chef now has regular meetings with the residents to find out which dishes they would like to see on offer and is developing new menus. Specific dietary needs can be catered for and all of the residents agreed how much they enjoyed their meals. It was recommended that daily menus should be displayed in the home and picture menus developed to aid those with cognitive impairment to make choices about what they would like to eat. There must be a record kept of the food that is eaten by residents in the home to provide evidence that they are enjoying a healthy well balanced diet. Tordarrach Nursing Home DS0000019129.V337217.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): Standards 16,18 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The people who use this service say that they are confident that any complaints would be taken seriously and dealt with appropriately however there is no easily accessible method for them to register their concerns. There are procedures in place within the home to ensure that residents are protected from harm. EVIDENCE: An appropriate complaints procedure is in place in the home and there is a copy on the wall in the entrance hall. Residents and relatives that were spoken with all agreed that they could raise any concerns with Matron and she would deal with them however the complaints book to record any issues that might arise was not readily available. This was rectified and it was put out in the hall during the inspection visit. The Commission has received no complaints about the home since the last inspection. All staff have received training in recognising and reporting adult abuse and all have appropriate clearance from The Criminal Records Bureau. The home has a
Tordarrach Nursing Home DS0000019129.V337217.R01.S.doc Version 5.2 Page 17 policy regarding the protection of vulnerable adults and any concerns would be referred to the appropriate agency. Tordarrach Nursing Home DS0000019129.V337217.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): Standards 19,26 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The people who use this service live in a comfortable, clean and safe environment, which suits their needs, and they have been encouraged to bring in their own possessions to enable them to personalise their rooms and feel at home EVIDENCE: The home, a converted private house, is situated in a pleasant tree-lined road and is clean, homely and generally well maintained. Ramps facilitate access in through the front door and out to the attractive large garden A tour of the home was undertaken and it was found to be clean and odour free. Resident’s bedrooms are pleasant and they have all been personalised by their occupants. Residents have all been offered lockable facilities in their
Tordarrach Nursing Home DS0000019129.V337217.R01.S.doc Version 5.2 Page 19 rooms and some of them have accepted these. Automatic door closers operating in the event of a fire have also been fitted where resident wish to leave their bedroom doors open. Soap dispensers, and paper towels are now available by all hand basins to enable staff to wash and dry their hands. Some water damage was noted in two bedrooms however an assurance was given that this is in the process of being repaired. Two bathrooms would now benefit from redecoration and refitting in order to ensure that bathing is a pleasurable experience for the people in the home. The laundry area has always been very cramped and far from ideal and it was noted that the flooring and walls are now very dilapidated. The area would benefit from upgrading although there are apparently plans to re - site these facilities. Tordarrach Nursing Home DS0000019129.V337217.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): Standards 27,28,29,30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The people who use this service can be sure that sufficient numbers of appropriately trained staff will be on duty in the home in the home to meet their needs and that recruitment policies and procedures are generally in place to protect them EVIDENCE: The home is staffed 24 hours a day by a trained nurse supported by care staff. In addition there are catering and domestic staff in sufficient numbers to provide a quality service to residents. Staff training has been undertaken with sessions including, effective communication, wound care and caring for residents who have had a stroke, in addition to mandatory training. Some care staff are now undertaking an NVQ qualification in dementia awareness. An assurance was given that appropriate checks are made prior to new staff commencing employment, however the files of three new staff members were seen and one was incomplete. CRB clearance had been undertaken and apparently other information had been obtained. However this was not
Tordarrach Nursing Home DS0000019129.V337217.R01.S.doc Version 5.2 Page 21 available. Evidence that this has been undertaken and is satisfactory must be available for inspection. Tordarrach Nursing Home DS0000019129.V337217.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): Standards 31,33,35,38 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The people who use this service can be sure that the home is managed by a person who is fit to be in charge although, their opportunities to comment on and influence the running of the home are limited. They can be sure that there are procedures in place that would generally maintain their health and safety. EVIDENCE: The Registered Manager of the home is a trained nurse and demonstrated an awareness of the issues experienced by the residents of the home. Everyone that was spoken with commented on her kindness and she was receptive to the inspection process.
Tordarrach Nursing Home DS0000019129.V337217.R01.S.doc Version 5.2 Page 23 Off duty rotas showed that when she is on duty she is also the designated trained nurse in the home. In order to discharge her responsibilities fully, a requirement is again issued for her to be given some supernumery time. Supervision of staff has started however, this is still task orientated with care staff being assessed as they support residents. There must also be allocated time for them to sit with a more senior member of staff to discuss their progress and identify any future training needs. This can only be achieved fully if the Registered Manager is given time away from direct care. There is also an expectation from the Commission, that managers of services should have gained the Registered managers Award or its equivalent. Further inspections will be looking for evidence that procedures are in place to allow this to be achieved Since the last inspection issues raised in response to kitchen inspections from the Environmental Health Department have been complied with although repairs are still needed to the floor. It is understood that this is in hand. A new quality assurance monitoring form was distributed to relatives this year however the results that were collected still need to be collated and displayed so that current and prospective users of the service can see them. There must also be more opportunity for the residents, relatives and representatives of residents to meet together and discuss their views of the home and comment on and influence the care that is provided. It is intended that meetings will be arranged for this. Some money is kept on behalf of residents and records of this were seen and were easy to understand and correct. The temperature of the hot water in the bathrooms is recorded prior to anyone having a bath however, to prevent any untoward incidents occurring, it must also be recorded on a weekly basis and a record kept. The pre-inspection questionnaire provided evidence that equipment in the home is maintained on a regular basis to ensure the health and safety of staff and residents. Tordarrach Nursing Home DS0000019129.V337217.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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 3 Tordarrach Nursing Home DS0000019129.V337217.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? 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 OP3 Regulation 4 Requirement The Statement of Purpose must be updated to reflect the current situation within the home and include information about the range of fees, so that prospective users of the service will have all of the information that they need to help them decide if the home will suit them. There must be a copy of the Service User Guide available to every resident so that they have all of the information that they need about the home. Care plans must contain information about resident’s wishes in the event of them becoming unwell or dying so that all staff are aware of what they would prefer. A record must be kept of the food that is actually eaten by residents to show that they are receiving a healthy balanced diet in sufficient quantities for their needs. The complaints book must always be readily available so that anyone who wishes to raise
DS0000019129.V337217.R01.S.doc Timescale for action 30/08/07 2 OP3 5 30/08/07 3 OP8 15 30/08/07 4 OP15 Schedule 4 (13) 30/08/07 5 OP16 Schedule 4 (11) 22/05/07 Tordarrach Nursing Home Version 5.2 Page 26 6 OP19 23(2)(d) 7 8 OP26 OP29 16(2)(j) 19 9. OP31 18(2) any concerns is able to do so easily. Bathrooms in the home now need redecorating and refurbishing to ensure that bathing is a pleasurable experience for residents. The laundry now needs to be upgraded so that it complies with professional guidance. Staff files must contain all of the information needed to show that the necessary checks have been carried out before they are employed. The Registered Provider must ensure that the homes manager is allocated some supernumerary time. (Previous timescale 15/11/06 not met) There must be evidence to show that the Registered Manager will be undertaking The Registered Managers Award as part of their commitment to ongoing development. All care staff must have access to formal supervision at least six time a year in order to monitor their performance and identify any future training needs. Hot water temperatures in the bathroom must be recorded weekly to ensure that they remain around 43 Celsius to minimise the risks of scalding of residents. 30/08/07 30/08/07 22/05/07 30/08/07 10 OP31 9(2)(i) 30/08/07 11 OP36 18(2) 30/08/07 12 OP38 13(4)(c) 30/08/07 Tordarrach Nursing Home DS0000019129.V337217.R01.S.doc Version 5.2 Page 27 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 OP15 Good Practice Recommendations It is recommended that picture menus could be introduced to help residents who may be confused to decide what they would like to eat. Tordarrach Nursing Home DS0000019129.V337217.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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
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