Inspection on 24/09/08 for Waratah House

This inspection was carried out on 24th September 2008.

CSCI found this care home to be providing an Good service.

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.

Other inspections for this house

Waratah House 12/11/09

Waratah House 12/06/07

Waratah House 18/04/06

Waratah House 28/11/05

Waratah House 23/05/05

Waratah House 08/11/04

Waratah House 10/06/04

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Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

CARE HOMES FOR OLDER PEOPLE Waratah House Sanderstead Road Sanderstead Croydon Surrey CR2 0AJ Lead Inspector Liz O`Reilly Key Unannounced Inspection 24th September 2008 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 Waratah House DS0000025866.V372703.R02.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. Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Waratah House Address Sanderstead Road Sanderstead Croydon Surrey CR2 0AJ 020 8651 0222 020 86577694 thewaratah@btconnect.com 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) Mr James Emmanuel Kwabena Safo Mrs Jawaixa Goliath Care Home 54 Category(ies) of Dementia (25), Mental disorder, excluding registration, with number learning disability or dementia (29) of places Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia - Code DE (Maximum number of places: 25) Mental Disorder, excluding learning disability or Dementia - Code MD (maximum number of places: 29) The maximum number of service users who can be accommodated is: 54 12th June 2007 2. Date of last inspection Brief Description of the Service: Waratah House is situated in the Sanderstead area of the Borough. The property consists of a large detached building, with two additional annexes. There is a large patio to the rear of the home, with car parking facilities. The home lies on a very busy main road, (which, it has to be said, is not pedestrian friendly), and is on a bus route and close to a rail station. The home provides care for older people living with dementia or mental health needs. Information on what the home can provide is available in the Service User Guide, which is made available to current and potential Service Users. Additional information can be found in the home’s Statement of Purpose. Fees for this service are £450 - £500 per week. Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This unannounced inspection was carried out by two regulation inspectors over two days on 24th September and 1st October 2008. We spoke to six people who use the service, five members of staff and the manager. The manager completed their own self assessment of the service (AQAA) setting out what the service does well, what could be done better and plans for improvements over the next twelve months. We have used information from all of these sources as well as observations to reach the judgements made in this report. What the service does well: What has improved since the last inspection? The environment has been improved with the addition of new bedrooms, the redecoration of many areas of the home and the installation of new flooring. A new training room has been provided for staff on the top floor which will include information on good practice. The management of medication has improved with good records now kept. Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 6 The CCTV in use has been amended to only focus on the entrances to the service and does not intrude on the privacy of people who use the service. At the last key inspection concerns were raised about the clothing of people who use the service. We found staff to be paying attention to the way people were clothed and everyone we saw was wearing appropriate clean and well maintained clothing. Staff continue to improve the care planning process with care plans now more person centred. Staff files are now in good order which assists in safeguarding people who use the service. 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 Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 8 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 Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 &6 People who use this service experience good outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Care is taken to gain information about individuals before they move in to make sure that the service can meet their needs and that this service is the right place for them. EVIDENCE: Before anyone is admitted to the service the manager visits them to carry out an assessment of their individual needs. In addition where a local authority is involved in the admission the service receives a copy of the Care Management assessment. These assessments assist in making sure that the service can meet the needs of each individual. We looked at a sample of care notes and found pre admission assessments were used to set up initial care plans and were reviewed on a regular basis. Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 10 The manager informed us that they were planning to try and involve individuals and their relatives or friends more in the admission process to improve the service. And to provide more information to people before they move in on what they can expect from the service. This service does not provide intermediate care. Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use this service experience good outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Care plans are person centred and contain clear information on the needs, strengths and preferences of individuals. Staff respect the privacy and dignity of people who use the service. Individuals have access to healthcare services. EVIDENCE: We looked at a sample of five care plans and found they contained good information on the strengths and needs of individuals. This was backed up by discussions with staff who were found to have a good understanding of the needs and abilities of the people they were supporting. We also spoke to people using the service who confirmed the accuracy of what was recorded in the care plans. Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 12 Staff have taken time to find out the individual likes and dislikes of individuals. The social, cultural and emotional needs of people using the service are acknowledged in the plan of care. We found care plans were reviewed on a regular basis with changes noted. In order to make sure that information is kept up to date and agreed with the person concerned staff should arranged to discuss reviews at regular agreed intervals with the individual and their representative. Evidence of this consultation should be recorded on the care plan. The records we saw indicated that staff were less confident in discussing relationships and sexuality with people who use the service. This is an area which could be further developed through training. Consideration could be given to support people to work towards set goals through the care planning process. This may assist individuals in gaining more confidence and independence and act as a record of achievement as well as support. Staff keep daily notes for each individual. We found these notes tended to focus on the physical care provided. This could be expanded to include information on the social and emotional support provided. Each person who uses the service is allocated a keyworker from the staff group. A record of one to one keyworking activities is kept. We found these records could be more person centred and the keyworking sessions could be more regular. This would assist in ensuring that the needs and wishes of individuals are being met. Individual risk assessments are in place which ensure that people who use the service are supported in a considered way to take part in day to day activities. We found that these assessments did not always include information for staff on individual triggers or tactics to use in relation to aggressive behaviour. We did find this information in care plans however. We looked at a sample of medication records. These were up to date and well maintained. To make sure that medication can be tracked staff should ensure that any medication carried forward from one month to the next is noted on the administration sheet. People who use the service have good access to health care services. Staff are working with the GP practices to make sure that an annual medication review is carried out as a minimum. The service has good access to district nurses and community psychiatric services who they can call on for advice and support. Those people who use the service who are able to do so visit local GP surgeries with staff support. Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 13 The weight of individuals is monitored with action taken should there be any marked weight loss or gains. We observed good interactions between people who use the service and staff. Staff were seen to respect the privacy and dignity of individuals. We saw staff working with people in a considerate and gentle manner. Discussions with staff confirmed that they are aware of the importance of treating people as individuals and respecting their wishes. Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who user this service experience adequate outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use this service have the opportunity to take part in a variety of activities. This is an area which could be improved by promoting activities of daily living, designing activities around the individual interests of people. The food provided is of good quality but more care needs to be taken to make sure any alternatives offered are real alternatives. EVIDENCE: We found a programme of activities on display in the service. However the activities written up on the notice boards were not followed at the time of our visits. Staff should make sure that only those activities which are going to take place are advertised in the service. We did see staff spending time with individuals talking and listening and an activities session was set up by staff in the afternoon. Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 15 A hairdresser and an aromatherapist visit the service once a week. Staff have arranged for a professional bingo caller to visit on a regular basis which, staff report, has made this activity more interesting for people using the service. We asked a number of people what they liked to do during the day and they told us “I read the paper”, “I keep to myself”, “I go out to a club every week” and “I like watching TV” Trips out are arranged and the service has access to a mini bus which allows for more ad hoc trips to be taken. Arrangements had been arranged for a group of people to go to the Fairfield Halls to see the Glen Miller Orchestra. A group of six people were going for a short break in Worthing in the near future. Arrangements are made for a number of people to attend local day centres which assist in meeting the cultural needs of individuals. Regular visits are made to the service by representatives of local religious groups. Consideration should be given to tailoring activities to individual interests. Staff should be provided with training on meaningful daily living activities for people living with dementia and mental health needs. Consideration should be given to adding more interactive items in lounges and corridors. This was discussed with the manager at the time of this inspection. We found little recording of activities in the daily record. Staff should make sure that records are not simply about the physical care provided. The menu for the day was written up on a notice board in the dining room. This may not be easily accessible to everyone who uses the service. Consideration should be given to how information on the food available could be made more accessible. We did see staff tell people what was on offer at lunchtime. The meal available on this day was chicken pie or chicken risotto. As both meals included chicken we do not feel this is offering a real alternative and the menu should be reviewed. Staff did take time to note if anyone was not happy with the food they had chosen and two people were provided with another meal at the table when they decided they did not want what was on the main menu. Staff take care in setting tables in an attractive way. Consideration should be given to making meal times a more social event and increasing independence at meals. This could be achieved by reviewing the way in which meals are presented and served and considering staff joining with people who use the service at the meal. Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 16 The cook informed us that she is aware of the cultural, religious and medical dietary needs of the people using the service. Discussions with staff indicated that the individual likes and dislikes of people are well known. These were also recorded in the care planning. It was recorded that one person particularly liked curry and the record of food showed this was provided regularly. Snacks or dried fruit and chocolate bars are available in the lounges which offers people the opportunity to eat when they wish and assists with preventing weight loss. Discussion with staff indicated they had a good understanding of the importance of people making their own choices and how they can support people to do this. We observed staff putting this knowledge into action at meal times and throughout our visit. Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use this service experience good outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Clear procedures are in place for responding to complaints. Staff understand their role in reporting any concerns raised with them. People who use the service feel confident that they will be listened to is they are not happy. EVIDENCE: We saw the complaints procedure was on display in the service. People who use the service we spoke to felt that staff listened to them and “sorted out” any problems or concerns they had. The service keeps a record of any complaints received along with actions taken and outcomes. We looked at this record and found no outstanding complaints. Staff spoken to had a good understanding of their responsibilities to report any allegation or suspicion of abuse. Copies of the local authority safeguarding policies and procedures are available in the service. All staff are provided with training on safeguarding vulnerable people. The manager stated that she aims to raise safeguarding at each team meeting and to have regular discussions with people who use the service to remind them of their rights. Leaflets on safeguarding people have been distributed to Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 18 people who use the service and their relatives. This will assist in ensuring that people continue to know how to respond to any concerns. Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23 & 26 People who use this service experience good outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use this service are provided with a comfortable well maintained environment. Improvements to the environment are on going. Consideration should be given to providing a more user friendly environment for people living with dementia. EVIDENCE: Since the last inspection of the service a number of new bedrooms have been completed and added to the registration of the home. These rooms with en suite facilities have been finished and decorated to a high standard. Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 20 Many of the communal rooms in the home have been redecorated and fitted with new flooring. The majority of bedrooms have also been redecorated. The manager informed us that people can decorate their rooms to their own taste. People who use the service, when asked about their rooms, told us, “I have all I need” and “I like my room”. The kitchen flooring has been replaced and new cookers installed. Consideration should be given to making the environment more interactive for people with dementia. This was discussed with the manager at the time of this visit. We found all areas clean and odour free during out visits. Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use this service experience adequate outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Sufficient staff are available on duty to meet the needs of the present group of people using the service. Staff are provided with good opportunities for training. Pre employment checks are now in place for all staff which assists in safeguarding people who use the service. EVIDENCE: We found staff to be well organised and knowledgeable about the needs of the people they were supporting. Staff informed us that they were offered good opportunities for training which assists in ensuring that people are supported by well informed staff. The record of staff training should be updated so that the staff training needs of each individual can be easily assessed. This will ensure that staff receive appropriate training to meet their needs and are provided with up dates at the right times. The service has access to the care homes support unit from the local authority who can offer advice and training. Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 22 Staff have been provided with training on dementia care and mental health needs. We were informed that a number of staff completed the dementia option in their NVQ training. This specialist training needs to be on going and at a level appropriate to their role in the service. This will ensure that staff are kept up to date with good practice in mental health and dementia care. As the service provides support to people with visual impairment consideration should be given to accessing training on supporting these people. Staff have been provided with training on person centred planning. This was seen to be evident in the improvements made in the care planning. The manager informed us that all junior staff have completed or are working towards NVQ2 and all senior staff have NVQ3 or higher qualifications On the first visit to the service staff records were not in good order. Evidence of the appropriate pre employment checks were not in place. The service was given seven days to put this right. When we visited for the second time the staff records were all up to date and included all the information required by regulation. This information assists in ensuring the safety of people using the service and the improvements made must be continued. Staff we spoke to felt well supported by the senior staff team. One to one supervision is provided from a more senior member of staff and regular staff meetings take place. This assists in making sure that staff are working in line with the organisations aims and objectives and gives staff the opportunity to discuss any concerns they may have. We observed staff working well as a team and dealing with what could have been a very difficult situation with tact and discretion. We saw staff supporting each other in their work. Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 People who use this service experience good outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The manager has the skills and experience to run this service. People who use this service feel they are listened to. Staff make regular checks to ensure the health and safety of people who use the service and visitors. EVIDENCE: The manger has completed NVQ level 4 and is working towards the Registered Managers Award and has significant experience working in the care sector. The manager and staff group have worked well over the last two years to improve the service. Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 24 Arrangements are made for people who use the service to meet together with the manager or senior staff to discuss issues. We noted that a agenda was on file for the last two meetings but the minutes of the meeting in April of this year was not available. Consideration should be given to how these meetings could be improved and to making sure that information on what actions had been taken following each meeting is provided at the beginning of the next meeting. This will ensure that people who use the service know that they are listened to and action is taken. To assess the quality of the service they provide the organisation sends out surveys to people who use the service and other professionals every six months. Any concerns raised from these surveys are dealt with by the manager. The manager is still in the process of pulling this information along with her own self assessment to produce an annual review of the service. This annual review should assess progress made, feedback from surveys, actions taken and plans for the next twelve months to develop the service. People who use the service can deposit small amounts of money with the service for safekeeping. We examined a sample of the individual finance records. The records were found to be well maintained, up to date and accurate. Staff support a number of people who use the service to manage their budgeting on a weekly basis. This is carried out with the agreement of the individuals concerned and assists them in making sure they have sufficient funds to meet their individual needs. Staff carry out regular checks on the building and equipment to ensure the health and safety of people who use the service, other staff and visitors. Weekly tests are carried out on the fire alarm system and the temperature of hot water throughout the building. Regular fire drills are carried out and arrangements are being made for all staff to receive fire training in November of this year. Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 25 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 3 X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard OP7 OP7 OP12 OP12 OP15 Good Practice Recommendations Arrangements should be made with individuals and or their representatives to agree reviews to their care plan on at regular intervals. Consideration should be given to goal setting as part of certain care plans. Consideration should be given to providing training on meaningful activities to key members of staff. Staff should record activities as well as the physical care provided. A review of meal times should be carried out to look at how people are informed of what is on offer, the alternatives available, increasing independence and making meal times a more social occasion. Staff training on dementia and mental health care needs to be on going and at a level appropriate to the role of staff in the organisation. The record of pre employment checks needs to be kept up to date to ensure the safety of people using the service. DS0000025866.V372703.R02.S.doc Version 5.2 Page 27 6. 5. OP30 OP29 Waratah House 6. 7. OP33 OP19 An annual review of the service and development plan should be produced. Consideration should be given to including more interactive items in the communal areas of the home for people living with dementia. Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 28 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Waratah House DS0000025866.V372703.R02.S.doc Version 5.2 Page 29 - 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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