Please wait

Please note that the information on this website is now out of date.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

Inspection on 24/05/05 for Waltham Hall Nursing & Residential Home

Also see our care home review for Waltham Hall Nursing & Residential Home for more information

This inspection was carried out on 24th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

The home has varied skill mix of staff who able to meet the needs of the residents. Many of the staff are from the surrounding area and have worked at the home for quite a while. The care provided by the staff is of a good quality and appreciated by the residents and health professionals. The home is clean and tidy, with a good standard of furniture both in communal areas and in residents` rooms. Residents` rooms are spacious and comfortable with room for their own possessions. The gardens are vast with many rooms overlooking country surroundings giving the home a peaceful and relaxed atmosphere. The care staff have built up sound, friendly relationships with the residents which assists them in providing care and for residents to feel at ease to chat. Visitors and relatives are made welcome and community contact is promoted with residents and relatives having the confidence that the complaints procedure ensures that any complaints will be listened to by the management. Nursing assessments of residents health needs are generally good with the nurses providing the lead for the rest of the staff.

What has improved since the last inspection?

Discussions with the registered manager indicated that there had been no changes from the last inspection. There were no requirements or recommendations made at the last inspection.

CARE HOMES FOR OLDER PEOPLE Waltham Hall Nursing & Residential Home Melton Road Waltham on the Wolds Melton Mowbray, Leicestershire LE14 4AJ Lead Inspector Mrs Janet Browning Unannounced 24 May 2005 09:30 th 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 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. Waltham Hall Nursing & Residential Home C51 S1931 Waltham Hall V215375 240505.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Waltham Hall Nursing & Residential Home Address Melton Road Waltham on the Wolds Melton Mowbray Leicestershire LE14 4AJ 01664 464865 01664 464881 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Claregrange Limited Patricia Jane Groom CRH 61 Category(ies) of Old Age, not falling within any other category registration, with number (OP) 61 Both, Physical disability over 65 years of places of age (PD(E)) 61 Both, Terminally ill over 65 years of age (TI(E)) 2 Both Waltham Hall Nursing & Residential Home C51 S1931 Waltham Hall V215375 240505.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: a) To be able to admit the named person of category PD as agreed in correspondence, dated September 2000, with previous registration authority. b) To be able to admit the named person of category PD as agreed in correspondence, dated March 2002, with previous registration authority. c) To be able to admit the named person of category PD named in variation application no: V11698 dated 25 August 2004 for periods of respite care. d) No one falling within category TI(E) may be admitted into the home where there are 2 persons of category TI(E) already accommodated within the home. e) To be able to admit the named person subject of variation Application number V19881 dated 29/04/05. Date of last inspection 4th January 2005 Brief Description of the Service: Waltham Hall is a care home providing personal care and accommodation for sixty-one older people which includes residents who have a physical disability. The premise is located a few miles away from the town centre of Melton Mowbray, being easily accessible by both private and public transport and having a large car park. Residents have access to shops, pubs, the post office and other amenities. The home is a purpose built two-storey building with a third floor for staff members only. There is level entry access to the premise and access to both floors used by residents are accessible by use of the passenger lift or stairs. A number of facilities are available namely an adequate number of washing, bathing and toilet facilities including a choice of dining and lounge areas. The premise consists of twenty-six single bedrooms without ensuite and thirty-one single bedrooms with ensuite facilities. The home has two double bedrooms with ensuite facilities. The home has a large garden to the front side and rear of the building which is well maintained and which is accessible to all residents residing in the home. The home has views over the surrounding countryside. Waltham Hall Nursing & Residential Home C51 S1931 Waltham Hall V215375 240505.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During this unannounced inspection which lasted eight hours, five residents were case tracked whereby their care notes were looked at alongside a review of the care they received. There was an opportunity to talk with five residents and one relative and four members of staff throughout the day. Records and notes kept within the home were also examined. Comment cards were received before the inspection with a pre-inspection questionnaire completed by the home; five comment cards from community health care professionals, two from General Practitioners, two from residents and three from relatives and visitors. What the service does well: What has improved since the last inspection? What they could do better: Although the assessment process is adequate for the residents’ health and emotional needs, social needs and daily routines are not being identified or indications that residents are being consulted. This is essential to provide Waltham Hall Nursing & Residential Home C51 S1931 Waltham Hall V215375 240505.doc Version 1.30 Page 6 guidance for care staff of the residents’ normal daily routine or their preferences and wishes of social needs, especially for those residents who are confused or unable to communicate their needs. Care plans for health and emotional needs are adequate, but as social needs are not being identified on assessment, there are no care plans for social needs, when social needs are present. Care plans and risk assessments are not always being evaluated effectively, in that changes identified in daily records are not being reflected in a change of care plan or risk assessment. Medication procedure is generally good, but all staff require updating on the correct procedure at all times and the storage of medication for self-administration requires reviewing. Not all staff are aware of the correct procedures in the protection of vulnerable adults and who to report to and the home’s recruitment procedure is not robust enough to ensure the safety of residents. The CSCI required that the home acted immediately on these two issues. Some consultation process is made with residents to establish their opinions on the home’s service, but is not adequate enough to ensure a full picture is obtained. This process has caused a change in food menu, but the choice of hot food at lunchtime is inadequate to meet residents’ preferences. Safety in the home is taken seriously, but the security of the front door is a concern. The front door is locked at night, but, with no security system during the day, any visitor has general access. This is a large home and visitors sometimes have to then search for staff who are busy elsewhere. 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. Waltham Hall Nursing & Residential Home C51 S1931 Waltham Hall V215375 240505.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Waltham Hall Nursing & Residential Home C51 S1931 Waltham Hall V215375 240505.doc Version 1.30 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 standard(s) 3, 4 and 6 Although the home has the facilities to meet residents’ needs, the assessment process is insufficient to ensure that all their needs will be met. EVIDENCE: The care records examined did not have photographs of the residents which could cause problems in verifying identity. The assessment process gave adequate details of residents’ physical status and corresponding physical and emotional needs but care notes examined were lacking in detail for the residents’ social needs or daily routine. For example, one resident, who had some difficulties in communicating, stated; • “No-one’s asked me what time I want to get up or go to bed. I prefer to stay in bed a bit longer.” This resident’s care notes also did not have details of consultation of preferred times of getting up and going to bed. A relative also stated that she had concerns about her mother being got up early and not being consulted about the preferred times of getting up or going to bed. Care notes examined did not give full details of social activities and life histories, which is especially relevant for those residents who are not able to voice their own choice due to confusion. Waltham Hall Nursing & Residential Home C51 S1931 Waltham Hall V215375 240505.doc Version 1.30 Page 9 The home demonstrated it has the capacity to meet the needs of residents with appropriately trained staff and equipment. Care assistants spoken to do not read the care plans, relying on a transfer of information from nurses at handover, which can rely on a good memory or note taking. The indications were that they were generally aware of the assessed needs of the residents and were knowledgeable on how to meet those needs. The home does not provide intermediate care. Waltham Hall Nursing & Residential Home C51 S1931 Waltham Hall V215375 240505.doc Version 1.30 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 standard(s) 7, 8, 9 and 10 Indications are that the home provides good nursing care, but evaluations of the effectiveness of the care provided is variable thus not ensuring that any changes in residents’ needs are being identified or met. Some aspects of the medication procedure is insufficient to ensure that residents’ safety is being maintained. EVIDENCE: Care plans for residents’ physical needs were of a general good quality, but the evaluations and risk assessments were not always being updated monthly and some needs identified on assessment were still being evaluated when the need no longer existed. For example, one resident admitted to the home over four years ago was still having a care plan evaluated for “adapting to life in a nursing home”. On talking with the resident, it was evident that he was fully adapted to life in the home. Nursing needs were identified and indications were that they were being met. For example, one highly dependent resident case tracked, was admitted with pressure sores and the indications were that the care given was assisting with their healing. Also the home had links with many varied health professionals as indicated by comment cards received. Examples of comments received; • “My mother is happy…we are pleased with the standard of care.” Waltham Hall Nursing & Residential Home C51 S1931 Waltham Hall V215375 240505.doc Version 1.30 Page 11 “Good nursing care” – from Community Health professional “One of the better homes in terms of care.” – from Community Health Professional. Social needs were not always identified on assessment, so care plans were not always evident giving guidance on how to meet any social needs. For residents who were able to express their preferences, staff spoken to were able to establish what they required. However, for one resident case tracked who had confusion, it was difficult to know for certain what her social needs were. Staff spoken to stated that she liked company, but was “too noisy” for the other residents and therefore mainly stayed in her room. There was no guidance on how this social need could be met. The medication procedure was generally good, but indications were that night staff were not always documenting when administering medication, with gaps evident on the medication sheet for one resident case tracked. One resident who previously was self-medicating, stated that he use to keep his medication by the side of his chair, not in a locked cupboard. He was now having medication administered by staff, but still had medication for constipation by his chair. This is unsafe practice. The carers were generally heard and observed treating residents with respect and residents spoken to, indicated that they felt that their dignity and privacy was maintained. The residents spoken to found the carers to be friendly and created a sociable tone. • “Staff care for you and it’s a nice atmosphere.” However, although the outcome for residents spoken to was positive, it was evident that some of the terminology used by the carers, although unintentional, could be demeaning in nature. For example, one carer was heard to say to a resident; • “You have been a good girl this morning, haven’t you.” And a relative spoken to also stated; • “The carers are good, but I have sometimes heard them talking to residents as though they are babies.” • • Waltham Hall Nursing & Residential Home C51 S1931 Waltham Hall V215375 240505.doc Version 1.30 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 standard(s) 12, 13, and 15 Community contact is promoted by the home ensuring contact is maintained for residents. Meals are generally good, but could offer more choice to ensure that all residents’ meal preferences are satisfied. EVIDENCE: The home provides an activities organiser two days a week and on the day of inspection an entertainer was visiting the home to provide Old Time Music. This was advertised throughout the home with staff reminding residents during the day and assisting them to the upstairs lounge for the activity. One resident was observed having a telephone in his room with his own CD player and books. One resident stated that he was not fully aware of all activities and felt that there could be more. Two comment cards received gave mixed responses to activities. The downstairs dining room overlooked a vast garden and countryside creating a peaceful, relaxed atmosphere with music playing during mealtimes. During the inspection, the lunchtime meal was a fried lunch. One resident who was a vegetarian had her own option. More fried lunches was a request from a residents’ meeting. Only five residents attended. One resident was observed complaining about an item of the fried lunch that he did not want or like. A carer was surprised that he didn’t like it, but did remove it. A choice of hot meals may have prevented this. One resident stated; • “I don’t particularly like the meals, tasteless and we don’t get a choice of hot meal.” Waltham Hall Nursing & Residential Home C51 S1931 Waltham Hall V215375 240505.doc Version 1.30 Page 13 The lack of choice of hot meal at lunchtime was evident from menus supplied in the pre-inspection questionnaire. The residents meeting had identified the food as being “bland and unappetising” which the home were trying to address. Residents are able to have links with the community and stated that they enjoy the gardens when the weather is warmer. Fetes are held during the summer months. Relatives were observed coming and going throughout the day with no restrictions and are able to visit in private. Indications are that they are made welcome by the staff and relationships are built. Waltham Hall Nursing & Residential Home C51 S1931 Waltham Hall V215375 240505.doc Version 1.30 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 standard(s) 16 and 18 Complaints are handled objectively and relatives are confident that their concerns are listened to. The junior and senior staff are not fully aware of the correct procedures of reporting any suspicion or allegation of abuse to ensure that residents are protected from risk of harm. EVIDENCE: The home maintains a complaints book, and the complaints procedure was evident in the reception area. CSCI are identified within this, but under the old name and without telephone contact. Any complaints investigations are held mainly within residents’ care records so it was difficult to ascertain outcomes. One complaint was examined and the indications were that the manager was dealing with this both sensitively and effectively. Relatives and residents spoken to knew the complaints procedure and felt that the manager deals with complaints appropriately. Residents spoken to indicted that they felt safe living at the home, but care assistants and a nurse spoken to were not fully aware of the correct procedure for reporting suspicions of abuse. They had not received any training on adult protection and, although the home had a copy of the Department of Health’s guidance document “No Secrets”, were not aware of this document or the term whistleblowing. Complete awareness, especially by senior staff, is essential in protecting residents from risk of harm. Waltham Hall Nursing & Residential Home C51 S1931 Waltham Hall V215375 240505.doc Version 1.30 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 standard(s) 20, 21, 22, 23 24 and 25. The communal areas and individual rooms are such that generally residents have access to a safe and comfortable environment. EVIDENCE: The rooms of the residents case tracked were clean and comfortable with personal possessions on display. Furniture within the rooms was of a good standard and gave a homely feel with many having pine wardrobes and matching chest of drawers. One resident case tracked had brought in her own chair and mattress when admitted for her health needs. Another resident spent a lot of time in his room and found it very comfortable having his own belongings around him. The indications were that the home had specialist equipment for moving and handling residents and mobility aids, with adequate numbers of bathrooms. The communal areas, such as the lounges and dining areas were pleasantly furnished and, although the large layout of the home could cause difficulties, the indications were that staff ensured that residents in the communal areas were supervised. During the inspection the home was clean and tidy with fresh flowers evident. Waltham Hall Nursing & Residential Home C51 S1931 Waltham Hall V215375 240505.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29 Staffing levels were in sufficient numbers and skill mix at the time of inspection, with indications being that residents’ needs were being met, but the recruitment procedure needs to be more robust to reduce the risk of harm to residents. EVIDENCE: Three staff members’ recruitment records were examined and found to be incomplete. For example, a nurse was employed with checks made against the nursing register but not against the Protection of Vulnerable Adults register as required. Two records only had one written reference and it was difficult to ascertain the authenticity of references, as they were not on headed paper. Not all recruitments records checked had photographic evidence of the person’s identity. A requirement was made for the home to act upon this immediately and to review their recruitment procedure. Although comments were received from both residents and relatives that there was shortage of staff within the home, both during the inspection and from documentation received, the indications were that staff numbers within the home met the recommended levels as laid down in the Department of Health’s residential forum. The skill mix within the home of nursing staff, senior carers and care assistants indicated that it was adequate to meet the residents’ needs. Assistants are employed for mealtimes to assist with both serving meals and assisting any residents with their meals if required, which was observed during lunchtime, thus ensuring that needs at mealtimes were being met. Waltham Hall Nursing & Residential Home C51 S1931 Waltham Hall V215375 240505.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 37 and 38 The manager performs quality audits within the home, but they are not robust enough to ensure that the home is run in the best interests of the residents. Health and safety promotion is generally good, but all aspects of security need to be examined to ensure that both residents and staff are protected from risk of harm. EVIDENCE: Residents’ opinions are obtained via residents meetings, which raises issues that the home acted upon. The last meeting was held in January 2005 with a turnout of five residents, which is low. There was no further evidence of how the home ensures that all residents’ opinions are sought using other quality audit systems. There was no evidence produced of the home obtaining the views of relatives or other agencies involved with the home. The manager had audit tools for monthly audits within the home but these were not always updated. The manager demonstrated evidence of the development of residents’ care linked to the residents’ care plans. For example, new pressure relieving Waltham Hall Nursing & Residential Home C51 S1931 Waltham Hall V215375 240505.doc Version 1.30 Page 18 mattresses were being used following tissue viability study days, both for the prevention of pressure sores developing and for the comfort of the residents. Records were being maintained adequately, securely and efficiently. Maintenance records and fire records were also maintained sufficiently with the manager taking personal responsibility for checking hot water temperatures and acting immediately if any are too high. Carers were observed performing moving and handling safely and all staff spoken to had received updates on this as well as fire drills and other mandatory training. However, the front door security does cause some concern. It is locked at night, but during the day any person could gain access into the reception area and other parts of the home without being checked, especially during busy times of the day when staff are occupied. It was noted that visitors to the home are not always completing the signing in register. Front door security has been raised by comment cards received from two community health professionals with comments such as • “I have often entered without anyone being aware who I am.” • “The front door needs better security. Somebody could get in, attack a confused, elderly resident and we would be none the wiser.” Other comments from community health care professionals were that they sometimes had to search for staff when visiting the home. Waltham Hall Nursing & Residential Home C51 S1931 Waltham Hall V215375 240505.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 2 COMPLAINTS AND PROTECTION x 3 3 3 3 3 3 x STAFFING Standard No Score 27 3 28 x 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x 2 x x x 3 2 Waltham Hall Nursing & Residential Home C51 S1931 Waltham Hall V215375 240505.doc Version 1.30 Page 20 No 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 3 Regulation 12 (1) (a) & (3); 17 (1) (a) Requirement Timescale for action 21/07/05 2. 7 3. 9 4. 5. 18 29 6. 33 7. 38 All assessments must include details of residents social welfare including wishes and choices of daily routine and include photo identity of residents. 14 (2), 15 All assessments and care plans (2) ( c) must be reviewed effectively and any changes in needs be documented and care plans revised as necessary. 13 (2) All administration of medication must be documented correctly and all medication, including self-administered, is stored securely. 13 (6) The home must ensure that all staff are trained in adult protection. 19 (b) (c) The home must ensure that all Schedule correct information is obtained 2 as in Schedule 2 and are satisfied as to the authenticity of references obtained before employing a person to work in the care home. 24 (1) (3) The home must develop a quality assurance system to consult and gain opinions of residents and relatives of the services the home provides. 13 (4) ( c) The home must risk assess the C51 S1931 Waltham Hall V215375 240505.doc 21/07/05 21/07/05 Immediate Immediate 21/07/05 21/07/05 Page 21 Waltham Hall Nursing & Residential Home Version 1.30 access security of the front door. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard 9.2 10 15.7 16.3 Good Practice Recommendations The home is recommended that all residents assessed as being safe to self-administer medication, have a lockable space to store medication. The home is recommended to provide update training for staff on treating residents respectfully at all times. The home is recommended to offer a choice of hot meal at lunchtime. The home is recommended to record investigations and any actions taken in their complaints record book Waltham Hall Nursing & Residential Home C51 S1931 Waltham Hall V215375 240505.doc Version 1.30 Page 22 Commission for Social Care Inspection The Pavillions 5 Smith Way, Grove Park Enderby, Leics LE19 1SX 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 Waltham Hall Nursing & Residential Home C51 S1931 Waltham Hall V215375 240505.doc Version 1.30 Page 23 - 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!