Inspection on 18/08/06 for Wade House

This inspection was carried out on 18th August 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Wade House 25/07/07

Wade House 04/01/06

Wade House 07/02/05

Wade House 11/08/04

Wade House 26/02/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Wade House Wade House Violet Hill Road Stowmarket Suffolk IP14 1NH Lead Inspector John Goodship Key Unannounced Inspection 18th August 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Wade House DS0000037227.V308939.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. Wade House DS0000037227.V308939.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wade House Address Wade House Violet Hill Road Stowmarket Suffolk IP14 1NH 01449 626250 01449 626251 karen.curle@socserv.suffolkcc.gov.uk 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) Suffolk County Council Ms Karen Curle Care Home 30 Category(ies) of Dementia (8), Old age, not falling within any registration, with number other category (22) of places Wade House DS0000037227.V308939.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th January 2006 Brief Description of the Service: Wade House is a Residential Care Home providing personal care and accommodation to 30 older people. It is registered to provide care for eight people with dementia and twenty-two older people over the age of sixty -five. The home is owned and managed by Suffolk County Council. It is situated in the town of Stowmarket in a residential area with shops and other local amenities nearby. The home is purpose-built on two floors, which are accessed by stairs or by passenger lift. Externally there are two garden areas and a two parking areas. One garden is directly accessible to service users accommodated within the dementia care unit. All bedrooms are single occupancy with no en-suite facilities, seven bedrooms have under 10 square metres usable floor space. At the time of the inspection the fees charged were £359.00 per week. Wade House DS0000037227.V308939.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and was the first one under the Commission’s policy “Inspecting for Better Lives”. The purpose was to inspect at least all the key national minimum standards identified under each outcome group overleaf. The visit lasted 7.5 hours. The inspector toured parts of the home, in particular the special needs unit Willow, and spoke to several residents in all parts of the home and some visitors. Survey questionnaires were sent out to residents and relatives. 8 were returned by relatives and one by a resident. Their comments have been included in this report in the appropriate sections. The manager was available throughout the inspection, and staff helped to show the inspector around the home, and introduced him to residents. A sample of care plans, staff files, and maintenance records were examined. What the service does well: What has improved since the last inspection? What they could do better: Wade House DS0000037227.V308939.R01.S.doc Version 5.2 Page 6 More information in the statement of purpose would give a fuller picture of the home’s ability to meet changing needs. The medication policy still needs to be updated to follow the latest guidance. The temperature of the drug room should not go above 25°C. No person must be admitted to the home whose diagnosis is outside the home’s current registration categories. Residents or their relatives or appropriate professionals must give consent in writing to any restrictive or invasive procedure. Towels must not be stored on open shelves in bathrooms. This is a crossinfection hazard. The home must have an up-to-date Fire Risk Assessment. 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. Wade House DS0000037227.V308939.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 Wade House DS0000037227.V308939.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): 1,3,4,5, Standard 6 is not applicable. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents and their relatives have several opportunities to check that the home will be suitable, and to contribute to the assessment of needs. However residents have been admitted outside the registration categories of the home, without evidence that their special needs can be met. EVIDENCE: There was a copy of the home’s Statement of Purpose and the Service Users Guide on a table in the vestibule. The manager stated that these were not given to each individual resident upon arrival, although some visitors had said at the previous inspection that they had been given a copy of the Service Users’ Guide. The previous inspection report recommended that the Statement of Purpose should be revised to give information on how the home would meet the needs of residents whose mental or physical health deteriorated. This had not been done. Wade House DS0000037227.V308939.R01.S.doc Version 5.2 Page 9 When there was a vacancy, the notification of the vacancy went to the Care Home Placement Team who kept a database of the demand for places. They forwarded names to social workers and the process for admission to the home started. Pre-admission meetings were held with relatives present as well as the prospective resident. One-day visits to the home were usually made prior to the meeting. The home’s assessment started at the same time, working from the social worker Compass assessment. These meetings were not recorded although there was a proforma which could be used. One relative said that they had visited the home unannounced before a decision on the home had been made, and were made welcome by staff, and allowed to see over the home. There was a longer “look/see” visit to the special needs unit, Willow, to get a better understanding of the person’s needs and to assess the reaction of existing service users. The home used an adapted version of the STARS assessment tool. The manager and the deputy undertook the assessments. For short-term care, an admission meeting would be set up within 48 hours. There was a bed dedicated to short-term care. It could be accessed for up to four weeks per annum. Booking spreadsheets were shown to the inspector. The home only booked stays for up to two months ahead as people’s needs and situations could change. The home was full on the day of inspection, with thirty residents. One was in hospital with a fractured hip after a fall. This had been reported to the Commission. The Certificate of Registration was displayed but was not being complied with regarding the categories of residents. The manager was required to review the diagnoses of all residents to identify those outside the registration categories. Wade House DS0000037227.V308939.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be assured that their care needs, and health care needs, will be fully identified, monitored and action taken to refer to specialists when necessary. Residents are protected by the home’s medication procedures. Residents are treated with respect and dignity by the staff, but cannot be assured that their consent will be formally obtained with respect to potentially restrictive or invasive procedures. EVIDENCE: The report of the previous inspection had required the medication policy to be updated to reflect nationally recognised good practice. This had not been fully done. More information on each drug was now included with the MAR sheets, but the policy still did not reflect the 2003 revision of the Royal Pharmaceutical Society guidance: The administration and control of medicines in care homes and children’s homes. Following a requirement from the previous inspection, the home had installed a new medicine fridge. Temperatures were recorded and seen to be within the Wade House DS0000037227.V308939.R01.S.doc Version 5.2 Page 11 safe range. It was noted that the drug room could get very warm. It was 30°C on the day of inspection. The inspector pointed out that bottles of medication usually had to be kept under 25°C. There was a risk assessment in the front of some MAR sheets, eg one resident who could spit tablets out afterwards, and one who secreted them away. The assessments included ways for staff to minimise risks, such as close observation and positive encouragement, and a reminder to destroy any tablets not taken. One resident took one of their tablets in a cup of tea with the agreement of the GP. This had been recorded. There was a sample of all signatures at the front of the sheets. All sheets examined were signed and up-to-date. The controlled drugs cabinet was checked. It only contained Temazepam. The stock tallied with entries in CD book. One person receiving short-term care used their inhaler themselves. There were instructions in the care plan on how carers should monitor their competence to administer. In discussion on the care needs of residents, it became apparent that there might be some on the mainstream unit who had been diagnosed with dementia. In addition, one of the care plans examined listed a diagnosis of bipolar affective disorder for a resident. These would be outside the current categories permitted by the certificate of registration. The manager was asked to review all diagnoses and report back to the Commission. Three care plans were examined. All were organised on a similar pattern. All files included the pre-admission assessment. This was very thorough and compiled mainly during the pre-admission meeting with the prospective resident and their relatives, thus enabling a full picture of the person and their needs to be compiled. There was evidence of regular monthly reviews, including separate night care reviews. Longer-term reviews were held, some with relatives, social workers and medical staff as appropriate. It was noted that decisions at a review affecting the care tasks had been transferred onto the care plan for staff to follow. Risk assessments included those for pressure area care, continence and the use of bedrails. There was no consent form for the use of bedrails for two residents in their files, although there were records that the need for these restrictive items had been discussed with next of kin. NHS professionals were involved as appropriate and their visits were recorded. These include the speech therapist who had treated a resident for swallowing difficulties, and the dietitian to review a resident’s weight. The home used the Malnutrition Universal Screening Tool for all residents. It was changes in appetite and weight which had triggered the referrals to the speech therapist Wade House DS0000037227.V308939.R01.S.doc Version 5.2 Page 12 and dietitian. The home had a weighing chair which allowed all residents to be weighed even if they could not weight-bear. One resident had been assessed as needing nursing care and the social worker was trying to find a suitable placement. In the meantime, the home was allocating extra care time for the needs, including regular turning (on a special mattress supplied by the district nurse), feeding liquids through a syringe. Instructions for this were in the care plan. There was no evidence of consent to this procedure. The special needs unit, Willow, had eight places. The staff on duty were able to describe the residents’ needs fully. They were seen to be interacting with them in a friendly and encouraging way. There were photos of each person on their bedroom door. One resident was a smoker. There was a risk assessment for this activity which enabled them to smoke in designated areas. There was a storeroom for the activities materials. The team leader reported that the favourite activities were bingo and cake making. In the bathroom, towels were stored on open shelves, which was an infection hazard. There was access to the garden from Willow. Staff said the garden was used occasionally. It was secure and there were no restrictions on those living on Willow either to go in the garden or to visit other parts of Wade House. However because of the security systems, staff would always be aware when a resident had left the unit. Two visitors were sitting in the garden with their relative who was a Willow resident. They said that they were very happy with the care provided. Staff knew the preferences of their relative and gave them just enough support to allow them to keep some independence. Wade House DS0000037227.V308939.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Residents are supported to remain active and stimulated, with open access for visitors. Residents are provided with nutritious and well-presented food which they help to choose, and they are monitored to ensure they remain properly fed. EVIDENCE: The activities organiser was away on long term sick leave. Staff were continuing to provide a varied programme. Dominoes and card games were popular according to staff. One senior carer said that it was better not to preplan an activity, but to see what residents wanted to do on the day. The home used the services of a visiting exercise instructor but could now only afford him once a month. There was a materials store room on Willow for those residents. Staff on this unit were sitting with residents, talking and going through the daily paper with them. All activities have to be paid for from the amenity fund, eg materials. There was no separate budget for this. The provider paid the salary of the activities organiser. Wade House DS0000037227.V308939.R01.S.doc Version 5.2 Page 14 Following comments from a residents’ survey in June 2006, two staff had been asked to review the breakfast and supper times and the staffing cover needed. As a result, supper had been put back to 5.45pm. This would allow some more time for activities beforehand. No change had been made to staffing shift times. A further survey was planned for October to ask for suggestions for the winter menu. A relative said that the food was good. They stayed for lunch twice a week when visiting their relative. Cold drinks were available by each chair in the sitting areas. The cook came in while the inspector was talking to residents in Bluebell to check on lunch choices. Today was fish and chips, and cherry pie and ice cream. Alternatives were offered and two chose these. It was noted that during lunch, all the residents in the dining room could feed themselves with a little support and encouragement. One person was still being encouraged to finish their meal after everybody else had left. Several visitors were in the home during the inspection, making regular visits. They all commented that they were made welcome by the staff. Wade House DS0000037227.V308939.R01.S.doc Version 5.2 Page 15 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): 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents know how to raise concerns and staff are trained to protect them from abuse. EVIDENCE: The home had received three complaints since the last inspection. Records showed that they were dealt with satisfactorily and within the timescales of the home’s policy. The complaints procedure called “Having your say” was clearly displayed in the home. The manager was an Adult Protection trainer, and organised in-house training in the protection of vulnerable adults. Staff also received training on their SCILS courses and on NVQ courses. Recruitment checks on staff’s identities and histories further protected residents. Wade House DS0000037227.V308939.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,24,25,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean and comfortable for residents and visitors with facilities that are suited to their needs. Residents cannot be assured that the home is as hygienic as possible until a cross-infection hazard has been eliminated. EVIDENCE: The provider was planning to change the entrance to the home to separate the area used by smokers so that visitors need not go through it. The vestibule provided a large space for residents and visitors to access the various parts of the home. It contained information for residents, relatives and staff on the CSCI and its reports, on accessing welfare benefits, on what was happening in the home. Because of the review of residential care being undertaken by the County Council, information about this process was displayed. There was also a list of resident and staff meeting dates and minutes. Information on staff training opportunities was displayed. Wade House DS0000037227.V308939.R01.S.doc Version 5.2 Page 17 The home was secured by the use of keypad entry systems. Movement between Willow and the rest of the home was monitored by an alarm. Redecoration was on-going. Evidence of recently decorated areas was seen. The corridor in Willow was due to be decorated next, as the wallpaper had started to peel off, some of it torn off by some residents. The sitting room at the front, Bluebell, was comfortably furnished. Four residents were sitting there with a relative. There was a small sink with cupboards and working surfaces at one end. It was clear that this was not used, which the manager confirmed. However the front of the drawers was peeling away and spoilt the otherwise homely feel to the room. The temperature of the hot water tap was 43°C. A new hairdressing area had been set up behind screens at the end of one lounge. In the bathroom of Willow, towels were stored on open shelves, which was an infection hazard. Wade House DS0000037227.V308939.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. 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. Residents are protected by the recruitment procedures, training programmes and competences of the staff. EVIDENCE: There were vacancies for 2 night carers at the time of the inspection. Adverts had been placed, and copies were on the manager’s desk ready to be distributed as widely as possible in the surrounding area. Agency staff usage had been much reduced, and now was about 9 hours per week. At previous inspections, over 50 of staff were qualified to NVQ Level 2 or above. Qualifications were listed in the Service Users’ Guide. Three files of recently appointed staff were examined. All contained the required references and identification documents. Criminal Record Bureau disclosure certificates had been obtained before they had started work. Records of induction training courses either completed or in progress through the provider’s own training section were inspected. Wade House DS0000037227.V308939.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): 31,33,35,36,37,38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home operates to County Council policies for the best interests of residents. EVIDENCE: The manager had been at Wade House since May 2003 and became the registered manager in November 2005. She was qualified at NVQ Level 4 and had attended course in dementia care mapping. The manager showed the inspector the changes to the format to be used by the provider to record monthly visits, as required by the regulations. The changes included a documentation checklist, customer and staff information, and a peer review. The last peer review, which included discussions with Wade House DS0000037227.V308939.R01.S.doc Version 5.2 Page 20 residents, occurred on 16 August 2006. Satisfaction with the service was expressed by those interviewed. Staff meetings were held monthly. This was confirmed by a team leader, and minutes were seen in the vestibule. Residents’ meetings were held but the manager said that residents preferred to speak to her on a one-to-one basis. The dates of both these meetings were displayed in the vestibule. The provider’s Risk Assessment Team had visited the previous week and their report was awaited. Part of their report would provide a fire risk assessment in a new style to meet the Fire regulations. There was an up-to-date Fire Risk Assessment in the old style ion place at the time of inspection. The fire log was inspected. It was up-to-date with fire drills recorded, including the names of staff on duty, emergency lighting checks in April 2006,weekly alarm system tests, and monthly extinguisher checks. The inspector was shown the report of the Environmental Health Officer who had visited in April 2006. All items were rated satisfactory. It was noted that HACCP (Hazard Analysis and Critical Control Points) temperature controls were in place. Maintenance records for portable appliance testing, and lift servicing showed that inspections were up-to-date. Supervision records were seen. Staff had confirmed at previous inspections that a programme of supervision was running. Some staff commented that they would raise any concerns they had during supervision. The Certificate of Registration was displayed but was not being complied with regarding the categories of residents. The manager was required to review the diagnoses of all residents to identify those outside the registration categories. The home did not handle money on behalf of residents. The Statement of Purpose and Service Users Guide confirmed this. Lockable cabinets were available in bedrooms for residents to keep valuables securely. Wade House DS0000037227.V308939.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 2 X 3 1 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 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 3 17 X 18 3 3 3 X X X 3 3 2 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 X 3 3 X 3 Wade House DS0000037227.V308939.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 5(2) Requirement The registered person must supply a copy of the service users’ guide to each service user. The registered person must not admit service users whose classification is outside the home’s registration. An application to vary the registration must be made immediately. The medication policy and procedure must be updated and reflect nationally recognised good practice. This is a repeat requirement from the last inspection to be actioned by 31/03/06. The registered person must seek consent to any equipment or procedure which restricts the freedom and dignity of the service user. The registered person must eliminate hazards to crossinfection. Timescale for action 30/09/06 2. OP4 14(1) 18/08/06 3. OP9 13(2) 30/11/06 3 OP10 12(4)(a) 30/09/06 4 OP26 13(3) 30/09/06 Wade House DS0000037227.V308939.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP1 Good Practice Recommendations The Statement of Purpose and Service User Guide should include details about how the home meets the needs of residents whose mental or physical health deteriorates. This should include any assessments, techniques, therapies and/or other professionals’ advice, the home can implement. The registered person should keep a record of when the service users’ guide is issued to new admissions. The registered person should ensure that the temperature in the drug room does not exceed 25°C. All towels should be stored in closed cupboards. 2. 3. 4. OP1 OP9 OP26 Wade House DS0000037227.V308939.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Wade House DS0000037227.V308939.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. 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!