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Inspection on 27/07/06 for Tyndale Nursing Home

Also see our care home review for Tyndale Nursing Home for more information

This inspection was carried out on 27th July 2006.

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

Prospective residents and their representatives are able to visit the home and have an informative Service User Guide before making a decision to move into the home and residents benefit from being assessed by the home before admission to see if it can meet their needs. Pre-admission assessments should be signed and dated by the person conducting them. Residents are able to have visitors at any time and keep links with the local community. Visitors seen during the inspection were satisfied with the provision of care at the home. Residents are able if they choose to continue to handle their own finances and are able to access their personal records should they wish to do so. Comments received from residents and relatives via surveys and during the inspection included: `I like living here`, `I enjoy the garden`, `I feel very happy in this home` `the food is good`, `the staff are very nice`, `the staff are kind and helpful` and `on the whole I am very happy here.

What has improved since the last inspection?

No requirements and recommendations were made at the last inspection. Since the last inspection fund raising has been completed and a mini bus has now been purchased. This transport will be used by all the services within the grounds but will increase the opportunity for social and recreational trips and visits.

What the care home could do better:

One requirement and four recommendations have been made following this report. These are outlined in detail at the end of the report. The requirement relates to ensuring that all people at the home are supported to undertake oral hygiene are regular periods. Staff stated on the day of the inspection that there were inadequate numbers of slide sheets, used to help people move when in bed. It has been recommended that the number and availability of this equipment is reviewed to ensure that the needs of the people living at the home are met. Staff expressed concerns about the numbers of staff on night duty when the dependency of people living at the home is high. The management have been asked to review these levels. All people living at the home have a plan of care. The plans are not developed and reviewed with the individual and are ambiguous in parts. These need to be developed to ensure that staff are clear of the individual needs of the people living at the home. Although staff stated that people can ask for an alternative if they did not like what was on the menu a number of people living at the home stated they would not like "to bother anybody" so would not ask for something else. The management therefore need to ensure that an active choice is offered at mealtimes.

CARE HOMES FOR OLDER PEOPLE Tyndale Nursing Home 36 Preston Road Yeovil Somerset BA21 3AQ Lead Inspector Justine Button Unannounced Inspection 27th July 2006 09:30 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 Tyndale Nursing Home DS0000043153.V310463.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. Tyndale Nursing Home DS0000043153.V310463.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tyndale Nursing Home Address 36 Preston Road Yeovil Somerset BA21 3AQ 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) 01935 474520 01935 706624 janipaul@aol.com Mr Christopher Michael Bruce Wharton Mrs Amanda Susan Wharton, Mr Anthony Nicholas Roger Wharton Mrs Pauline Purnell Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Tyndale Nursing Home DS0000043153.V310463.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Up to 27 elderly persons of either sex, not less than 60 years, who require general nursing care Up to two persons of either sex, between the ages of 18-60 years, who require general nursing care To provide day care for up to 2 persons per day between the hours of 0700 and 1700 Up to 3 places for personal care Date of last inspection 29 November 2005 Brief Description of the Service: Tyndale is a 27-bedded care home providing nursing and personal care for older people. The home is in Yeovil, which has all the facilities of a medium sized town including hospital, shops, theatre, churches and other leisure facilities. There are smaller shops and a park within walking distance. The home is situated on a site, which also includes a sheltered housing complex and residential care home. This affords service users from all three facilities the opportunity to socialise and maintain friendships should they move into different areas for care. Tyndale is an old converted house with a purpose built extension, built in 1987, attached by a short walkway/entrance hall. Accommodation is provided in 17 single and 5 double bedrooms on two floors, the first floor being accessible via a shaft lift. There is an attractive, large front garden that looks onto the main road and a quieter courtyard garden accessed from the lounge. Tyndale Nursing Home DS0000043153.V310463.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Key Inspection was unannounced and took place over one day and was conducted by one inspector, which amounted to 7.5 inspector hours. There were 25 residents living at the home at the time of this inspection. Prior to the inspection the manager had completed a questionnaire about the service. A tour of the premises took place where a selection of bedrooms and all communal areas were seen. The inspectors consulted with at least 10 service users, 2 visitors and 5 staff during the inspection. During the inspection the inspectors observed interactions between staff and residents. The inspectors would like to thank the residents, manager and staff for their time during the inspection process. What the service does well: What has improved since the last inspection? Tyndale Nursing Home DS0000043153.V310463.R01.S.doc Version 5.2 Page 6 No requirements and recommendations were made at the last inspection. Since the last inspection fund raising has been completed and a mini bus has now been purchased. This transport will be used by all the services within the grounds but will increase the opportunity for social and recreational trips and visits. 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. Tyndale Nursing Home DS0000043153.V310463.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 Tyndale Nursing Home DS0000043153.V310463.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3. Standard 6 is not applicable to this service. Quality in this outcome group was good. Residents are able to make an informed choice of whether to stay at Tyndale from the information available to them. Residents were assessed prior to admission to ensure the home can meet their needs. Residents have a contract of terms and conditions, which informs them of what to expect including the fees and what is not included. EVIDENCE: The home displays the CSCI inspection report Guide, which reflects inspectors. The guide Tyndale Nursing Home Statement of Purpose for the home including the last in the reception area. A copy of the Service User the homes Statement of Purpose, was given to portrays the running structure of the home exactly, DS0000043153.V310463.R01.S.doc Version 5.2 Page 9 which enables prospective residents and/or their representatives to make an informed choice on any decision of living at the home. Four care plans were sampled as part of the case tracking process. Evidence of the home assessing residents before admission was seen. This enables the home to ensure it can meet the residents’ needs prior to admission. As discussed all assessments undertaken should be signed and dated. Recently admitted residents spoken to as part of the case tracking process confirmed that a representative of the home, prior to admission, had seen them. The inspector assessed individual contracts of the residents’ case tracked. Each had a contract either from Social Services or the home. The contracts indicate the fees to be paid and what is included. There is a trial period of 4 weeks. There is an administration fee of 5 for all people who receive free nursing element of care costs. This cost is not detailed in the contract however people moving into the home are now informed of this additional cost in a separate letter prior to admission. Fee levels are currently between £500-£958. The fee level is dependant on the assessed need of the individual. Tyndale Nursing Home DS0000043153.V310463.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 Quality in this outcome group was adequate. Each resident had an individual plan of care. Residents would benefit if these were individualised and person centred. Medication administration, storage and recording practise were adequate. Staff showed respect towards residents and allowed their privacy and dignity to be maintained in regard to personal care. The home had policies and procedures, which inform staff how they should handle dying and death, had been relayed to staff. The wishes of residents about arrangements after death were recorded. EVIDENCE: Six care plans were sampled, personal details and contacts were recorded. Service users had recorded care needs assessments and subsequent reviews of care. The plans of care related to the care given for people who live at the Tyndale Nursing Home DS0000043153.V310463.R01.S.doc Version 5.2 Page 11 service (case tracking). There was evidence in the care plans of input by the community health care professionals such as the chiropodist, dentist, optician and continence advisor. Out patient appointments and GP visits were recorded. Staff need to avoid ambiguous statements in the care plans. Statements seen included “ensure adequate fluids or turn regularly”. The plans of care need to be specific e.g. how much fluid or how frequently the person needs support to change position. The registered nurses need to ensure that the use of medical terminology is avoided. Both of these measures will ensure that clear guidance is given to care staff. There was limited evidence that individuals living at the service have been involved in the development and review of the plans. This is seen as good practise and helps to ensure that people have care delivered in the way that they would wish. The homes procedures for the management and administration of medication was examined at this inspection. The home uses the monitored dosage system (MDS) with pre-printed medication administration records (MAR). Medicines are administered by the registered nurse on duty. Medicines were found to be securely stored. MAR charts were completed to a good level. Staff need to ensure that they offer care and support in all aspects of personal hygiene. During the inspection the inspector visited some of the bedrooms. In at least six of the bedrooms the toothbrush was dry and the top of the toothpaste was hard. This leads the inspector to believe that people had not been supported to clean their teeth or dentures. Pressure relieving equipment was seen in use and all manual handling was risk assessed for the individual service users in their care plans. Service users who were spoken with confirmed that they felt well cared for and that they are treated with dignity. Staff were observed knocking on bedroom doors prior to entering. Tyndale Nursing Home DS0000043153.V310463.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome group was adequate. Activity provision at the home was adequate. Individual residents social care profiles were completed. Staff interaction with residents was mainly task orientated. Residents’ rights and choices were promoted. Residents are encouraged to maintain links with their families and friends. Visitors are made welcome at the home. Service users are offered a choice of nutritious well-balanced menus promoting their health and well-being. EVIDENCE: In the care plans viewed an assessment of social needs was seen in all cases. The plans relating to recreational needs had been reviewed. Records of activities attended were maintained. People spoken to during the inspection gave a mixed view on the provision of activities, with some stating there was a Tyndale Nursing Home DS0000043153.V310463.R01.S.doc Version 5.2 Page 13 lot to do and other stating that the range of activated was limited. At the time of this inspection there was no activity on offer. The last two news letters were viewed these advertised activities such as a summer fayre, keep fit, bingo, arts and crafts and a film club. The home has recently purchased a mini bus this will allow the provision of social outing and visits to be increased. The home has an open visiting policy and people living at the home confirmed that visitors were welcomed. All meals are prepared and cooked on the premises. Copies of a two week menu were made available to the inspector. The menu appeared wholesome and varied. The main meal is served at lunch time with a lighter cooked meal at tea time. A choice of menu is not routinely offered although some people said they would ask for an alternative if they did not like what was served. Some people however stated that they would just leave the meal if they did not like it as “they would not like to bother anybody”. The management need to ensure therefore that a choice is actively offered. The inspector was informed that milky drinks and snacks were offered in the evening. Special diets are catered for. The inspectors observed soft diets being served to those with an assessed need. These were seen to be attractively presented. Sweets were available for those requiring a diabetic diet. Staff were observed assisting service users in a manner which was relaxed, unhurried and respectful. The kitchen, although clean and tidy on the day of the inspection, is quite old and in a poor state of repair in parts. The management confirmed that this area is due for refurbishment and upgrading in the near future. The majority of Service users able to express a view were positive regarding the meals available and stated that there was always plenty to eat. The weather on the day of the inspection was warm and humid. Staff need to consider the availability of drinks. Tea and coffee are served at all meals and in the mornings and afternoons. It was however observed that some people did not have access to fluids outside of the “official” drink rounds. This is particularly relevant in the warm summer months. Tyndale Nursing Home DS0000043153.V310463.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18 Quality for this outcome group was good. Residents and visitors to the home have the information to enable them to make a complaint or raise concerns. Arrangements for protecting residents from harm or abuse were good. EVIDENCE: The home has a complaints procedure, which can be seen on request. The home has not received any complaints since the last inspection. The CSCI have not received any complaints about the home since the last inspection. Residents and visitors spoken to knew who to raise concerns with. The home has a Whistleblowing policy. Staff spoken to stated that they had received formal abuse awareness training. This ensures staff have an understanding of the local policies and steps to take should they suspect abuse. No new staff have been employed since the last inspection. Recruitment files sampled evidenced that the home had obtained a POVA First checks before staff commenced employment to protect residents from any risk of harm. Tyndale Nursing Home DS0000043153.V310463.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26. The outcome for this area is adequate. The environment at Tyndale is suitable to meet the needs of residents. There is a lack of storage space at the home, which gives the home a cluttered look in some areas. The home is clean and inviting, making a pleasant home for residents to live. The gardens are attractive and are used for social events involving the other homes on the site giving a community feel at the complex. EVIDENCE: Tyndale is a large house converted to meet the needs of nursing residents. There is both a shaft and stair lift to the first floor. The gardens are pleasing Tyndale Nursing Home DS0000043153.V310463.R01.S.doc Version 5.2 Page 16 and accessible for wheelchair users. Furnishings in bedrooms and communal spaces are homely and inviting. The home has three communal bathrooms but one is not used. Staff reported that the number of bathrooms in use is sufficient to meet the bathing needs of the current residents. One ground floor bathroom has been upgraded recently to improve the disabled facilities for bathing and showering and the bathroom is now attractive and inviting. There are some shared rooms at the home and appropriate screening is provided in these rooms. Bedrooms are lockable if residents wish to hold their room key and lockable storage space is provided in rooms for valuables and this is recorded in resident’s care plans. The home has suitable adaptations and equipment provided for nursing needs. The proprietor was present for part of the inspection. The proprietor and the manager discussed with the inspector plans to refurbish part of the building in the near future. This will include the kitchen, lounge, dining room, staff room and to increase the availability of storage. Staff spoken to during the inspection stated that they had all the necessary equipment to support the people living at the home with the exception of hoists and slide sheets (both used in moving and handling). A hoist is currently shared between the ground and upper floor (as one hoist is broken). Staff explained that this means that the hoist has to be taken in the lift between floors. Consideration should be given to replacing the broken hoist as soon as possible so that there is one available on each of the floors. Staff stated that although they had a number of slide sheets (used to help people turn in bed) they did not feel there were adequate numbers available. It is suggested that the management review the availability of this equipment and if required additional sheets are purchased. Tyndale Nursing Home DS0000043153.V310463.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 The outcome for this area is good. The staff team is a cohesive unit and appear to work well together to meet resident needs. There are sufficient numbers of staff rostered on duty to achieve this goal and staffing levels are flexible, increasing if resident dependency rises. Residents and relatives spoke highly of staff attitudes and attributes. There is a strong commitment to the development of the staff team at the home through staff training. Recruitment practices are robust, thus providing protection for vulnerable adults at the home. EVIDENCE: Copies of four weeks staffing rosters were submitted to the CSCI on request prior to the inspection for scrutiny. Comments from residents and relatives in the vast majority of cases said that staffing levels at the home are sufficient. There have been occasional periods due to unavoidable staff sickness where the staffing compliment has fallen for a short period whilst a replacement is sourced for the shift. The registered manager monitors resident dependency levels via monthly clinical dependency analyses and she has adjusted staffing levels accordingly should dependency levels rise. Staff during the inspection questioned the required numbers of staff at night. They expressed concern that there are two members of staff on during night Tyndale Nursing Home DS0000043153.V310463.R01.S.doc Version 5.2 Page 18 time hours and given that the night staff are required to do some additional tasks such as some laundry and the dependency of the people living at the home they did not feel this was adequate. It is recommended that the management review the night staffing levels. There is a high percentage of staff holding NVQ awards at and beyond level 2 at the home. Care staff are supported to progress to levels 3 and 4. Both the registered manager and her deputy hold NVQ levels 4 in care home management. Both are registered nurses. This commitment to staff accredited professionalism in the home is commendable. Staff recruitment was discussed, staff records examined via the pre-inspection questionnaire and by examining 3 staff recruitment records. Staff recruitment is systematic and protects residents from potential abuse. The home has an annual staff training plan and individual staff training records, which includes identifying and planning for staff training to meet individual staff training needs. There is recorded observed clinical practice at the home, which is good practice. There has been a good staff training exercise in 2005 in recognition and prevention of abuse, other staff training has included mandatory fire and moving and handling training, care and nurses have also received several useful clinical update training sessions. Tyndale Nursing Home DS0000043153.V310463.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 38 Quality for this outcome group was good. Residents are benefiting from an experienced, knowledgeable acting manager. Residents have an opportunity to manage their own finances if they wish and facilities are provided for security. Where the home manages money on residents’ behalf a good system is in place to record all transactions, however a pooled ‘resident bank account’ is used to hold all individual monies. Residents are protected by the health and safety checks in place. EVIDENCE: Tyndale Nursing Home DS0000043153.V310463.R01.S.doc Version 5.2 Page 20 It was evident from the findings at this inspection that the manager has worked very hard to maintain standards and comply with regulations. Staff and residents told inspectors that they found the manager open and approachable. A Policies and Procedures Manual is in place at the home. Recorded evidence was seen that staff had been made aware of the policy folder. All staff are issued with a handbook, which contains a breakdown of the policies. Finances kept on behalf of residents were assessed as part of the case tracking process. Evidence was seen of a robust system being in place to protect resident’s personal finances and record all transactions. All health and safety checks were in place and up to date. Staff accidents were recorded. According to staff spoken to and staff training records all staff had received mandatory training including manual handling, food hygiene, fire awareness, infection control and first aid. Tyndale Nursing Home DS0000043153.V310463.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 2 3 3 3 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 3 3 X 3 X X 3 Tyndale Nursing Home DS0000043153.V310463.R01.S.doc Version 5.2 Page 22 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. 1 Standard OP8 Regulation 12 (3) Requirement It is required that the manager ensures that all aspects of service users personal hygiene, including oral hygiene are met. Timescale for action 09/10/06 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 OP7 Good Practice Recommendations It is recommended that the service user care plans are reviewed to ensure that they avoid any ambiguous statements and give clear guidance to the care staff. Service users should be involved in the development and review of their plans of care. 2 3 OP15 OP22 It is recommended that all service users are offered an active choice at meal times. It is recommended that the number and availability of slide sheets is reviewed to ensure that there are adequate numbers to meet the needs of the service users residing at DS0000043153.V310463.R01.S.doc Version 5.2 Page 23 Tyndale Nursing Home the home. 4 OP27 It is recommended that the number and or duties of the night staff are reviewed to ensure that adequate numbers of staff are on duty to meet the needs of the service user group. Tyndale Nursing Home DS0000043153.V310463.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Tyndale Nursing Home DS0000043153.V310463.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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