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Inspection on 24/01/07 for Watlington and District Care Home

Also see our care home review for Watlington and District Care Home for more information

This inspection was carried out on 24th January 2007.

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

What has improved since the last inspection?

Staff have had training in caring for people who are confused or agitated and were observed using appropriate skills and techniques. There were no unpleasant odours in any part of the home. A deputy manager was appointed who has now gone on to become the Manager.

What the care home could do better:

Following the pre-admission assessment and decision for admission to the home being made, a letter confirming that the home is able to meet the needs of the individual must be sent to the prospective resident. The new care planning documentation needs to be introduced to improve the quality and clarity so that the best care is provided. Wound care needs to be reviewed and a protocol developed to ensure a scientific approach, and good outcomes for the residents. More attention needs to be made into finding out about residents preferences with regard to social and recreational activities and their preferred life styles before admission to the home. A review of the procedure for carrying out residents wishes at the time of their death needs to be carried out. The complaints procedure needs to be amended to reflect that people can approach the Commission at any stage of a complaint or concern.

CARE HOMES FOR OLDER PEOPLE Watlington and District Care Home Hill Road Watlington Oxfordshire OX49 5AE Lead Inspector Philippa MacMahon Unannounced Inspection 24th January 2007 09:15 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 Watlington and District Care Home DS0000056018.V320489.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. Watlington and District Care Home DS0000056018.V320489.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Watlington and District Care Home Address Hill Road Watlington Oxfordshire OX49 5AE 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) 01491 613400 01491 615115 abdulo@sanctuary-housing.co.uk Sanctuary Care Mr Abdul Okoro Care Home 60 Category(ies) of Dementia (30), Old age, not falling within any registration, with number other category (20) of places Watlington and District Care Home DS0000056018.V320489.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of 10 beds may be used for intermediate care (N). Service users may be aged between 18 and 65 years of age. Service users with dementia (DE) may not be accommodated in places allocated for intermediate care. The age/age range of the persons to be accommodated will be 60 years and over. 24th November 2005 2. Date of last inspection Brief Description of the Service: The Watlington & District Care Home is a purpose-built 60-bed care facility, providing nursing care to older people who are physically or mentally frail. The ground floor has 30 single rooms, a dining room and a sitting room overlooking the front of the home, and a quiet sitting room and a sun lounge to the rear of the home with access to an enclosed courtyard garden with a large raised centre flower/herb bed and paved pathways to a further large garden area. The first floor, with a further 30 single rooms, includes a designated area for the care of a maximum of ten service users requiring intensive short-term rehabilitative intermediate care. The local primary care trust works in partnership with the home to provide physiotherapy and occupational therapy for service users receiving intermediate care. Service users admitted for intermediate care may be in a younger age range (from age 18 years and over). There is a large sitting room/activities lounge and dining room. A third floor is used for staff accommodation. There are passenger lifts and stairs accessing residents accommodation. The home has a range of assisted bath and shower facilities and two treatment rooms. All residents rooms have an en-suite toilet and washbasin. The homes kitchen and laundry facilities are in refurbished and refitted former outbuildings across the approach drive to the homes main front entrance. The home has its own minibus for taking residents on outings. The fees for this service range from £625 to £1045 per week. Watlington and District Care Home DS0000056018.V320489.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 09:15 hours and was in the service for 6 hours, 45 minutes. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the services and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. There were only two questionnaires returned to the commission. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. The Inspector examined a sample of the residents records and care plans and followed this through by meeting with the individual resident to see if the care plan matched their needs. The medication system was examined and accompanying documentation. A tour of the premises was undertaken and records required by regulation were examined. The inspector observed lunch being served and the staff giving assistance to the residents. Staff rosters, recruitment procedures, and training and development plans were examined and discussed with the manager. The quality assurance and financial administration systems, were also examined. The inspector would like to thank all who contributed to the inspection in any way. What the service does well: The home offers a comfortable, homely, well-maintained environment, which is set in a delightful rural location and has attractive gardens and grounds. All areas of the home are cleaned to a high standard, and the furnishings and décor are of a high quality. Resident’s relatives and visitors spoken to all expressed great satisfaction with the service provided, and in particular the kindness of the staff. The commissions “have your say about Watlington & District Care home” document had a number of comments that supported this, such as “When I have been upset or worried I have been listened to and supported.” Watlington and District Care Home DS0000056018.V320489.R01.S.doc Version 5.2 Page 6 The home is well managed and there are clear lines of accountability, and evidence of good teamwork amongst all the staff. The administrative systems are well managed. The Manager is well supported by the company Sanctuary Care, and the Trustees of Watlington Hospital Charitable Trust, and the Primary Care Trust. The training and development programme in place is good and the monitoring of training undertaken by individual staff ensures that all staff are competent to carry out their work. Meals and mealtimes are of a good standard, and the dining rooms are attractively laid out to provide a comfortable, pleasant, environment for the residents to enjoy their meals. What has improved since the last inspection? What they could do better: Following the pre-admission assessment and decision for admission to the home being made, a letter confirming that the home is able to meet the needs of the individual must be sent to the prospective resident. The new care planning documentation needs to be introduced to improve the quality and clarity so that the best care is provided. Wound care needs to be reviewed and a protocol developed to ensure a scientific approach, and good outcomes for the residents. More attention needs to be made into finding out about residents preferences with regard to social and recreational activities and their preferred life styles before admission to the home. A review of the procedure for carrying out residents wishes at the time of their death needs to be carried out. The complaints procedure needs to be amended to reflect that people can approach the Commission at any stage of a complaint or concern. Watlington and District Care Home DS0000056018.V320489.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Watlington and District Care Home DS0000056018.V320489.R01.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 Watlington and District Care Home DS0000056018.V320489.R01.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Every resident has a pre-admission assessment of his or her care needs. The Intermediate Care service is working effectively and providing good outcomes for the residents. EVIDENCE: The inspector examined a sample of care plans and in each case the residents had a comprehensive pre-admission assessment of their care needs. This included information from care management, and other health care professionals. The Inspector discussed with the Manager the procedure for admission to the home. At the present time no letter of confirmation is sent following the assessment to confirm that the home will be able to meet those needs. It is a requirement that the home must confirm in writing to the prospective resident that the home is suitable for meeting their assessed needs. Watlington and District Care Home DS0000056018.V320489.R01.S.doc Version 5.2 Page 10 Intermediate care is provided in the home and is in a discrete unit that was purpose built. The inspector met with the senior nurse in charge of the unit and the GP who provides the medical care. The service is running well with positive outcomes for the residents in that they are being given maximum support to achieve independence and are able to go home. There are a number of people whose recovery is delayed for various reasons but on the whole the length of stay in the unit is short. The therapeutic team, work very well together and there are clear lines of communication to ensure continuity of care. Watlington and District Care Home DS0000056018.V320489.R01.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): 5, 7, 8, 9, 10 & 11. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Every resident has a care plan in which their assessed care needs are identified and the action required to meet them. Wound care and risk assessments need to be improved. EVIDENCE: The inspector examined a sample of care plans and records and followed this by meeting with the individual Resident to see if they’re identified care needs were being met. The forms that make up the care plans are very poor photocopies and it is difficult to read the headings on the pages and the handwritten parts are not clear due to the background being mottled. The home is about to implement new documentation for care planning that according to the manager will be in a clearer format than the present system and will be printed and not photocopied. The care plans examined gave a good “picture “ of the residents care needs and how these are met. The inspector observed appropriate interaction between residents and staff when dealing with behavioural difficulties, and it was clear that staff understood their care needs and how to deal with issues. Watlington and District Care Home DS0000056018.V320489.R01.S.doc Version 5.2 Page 12 Each of the care plans examined was very much about the resident’s physical needs and the documentation to record information about the resident’s social/recreational needs and preferred lifestyle was not completed. It is recommended that this documentation should be sent out prior to admission so that family and friends can help to complete this. Regular reviews are carried out and care plan audits with accompanying action plans were seen in the care plans. One care plan examined identified in the pre-admission assessment that the person had a history of falling and used a walking frame to assist them when walking. The inspector noted that there was no risk assessment in place for this aspect of care. It is recommended that when the care plans are developed they should be based on the information in the preadmission assessment to ensure all appropriate risk assessments are in place. The evaluation of wound care is not very scientific in that no measurements or photographs of the wound were available in order to ensure that healing or deterioration in the wound was taking place. It is recommended that the Registered Nurse’s involved in wound care should seek the advice of the specialist tissue viability nurse in order to develop a wound care protocol for the home. The home has very good access to GP services, community specialist nurses, dieticians, and other health care professionals. In the intermediate care unit there is evidence of good inter disciplinary care, and the resident’s are proud of their improvement and looking forward to returning home. The medication systems was examined and found to be in good order with up to date and complete records kept. The inspector observed staff assisting the residents in a kindly and respectful manner, calling them by their preferred term of address and always knocking on doors before entering. One of the relatives visiting said that the staff are wonderful and so very kind both to her and her husband. She also said that she always had a very warm welcome whenever she visits the home. There was little or no information in the care plans about the resident’s wishes at the time of their death. It is recommended that the registered nurses should review the whole care provision in regard to resident’s wishes at the time of their death. Watlington and District Care Home DS0000056018.V320489.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. 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. Every resident is given the opportunity to take part in activities appropriate to their needs and lifestyles, however more information about their previous interest would greatly enhance this aspect of care. From the evidence seen by the inspector and comments received, the inspector considers that this home would be able to provide a service to meet the needs of individuals of various religions, race and culture. EVIDENCE: The activities co-ordinator was not available on the day of the inspection to discuss the programme of activities. The Manager described to the Inspector what was available and a copy of the programme was seen. As the documentation in the care plans “Getting to know you” is seldom completed the activities co-ordinator is trying to complete these as well as provide the activities for a large number of people. The home is recruiting a number of volunteers to support the activities programme in the home. In response to the resident’s individual needs a lot of 1-1 sessions are provided and records are kept of each interaction. A new development is the creation of a “nostalgia” lounge, with a fireplace, and memorabilia of the 1930’s and 1940’s. This is proving to be popular with the resident’s, and helpful in managing their Watlington and District Care Home DS0000056018.V320489.R01.S.doc Version 5.2 Page 14 care needs. One of the residents had a birthday on the day of inspection and a party was provided in one of the lounges with singing, dancing and the cutting of a birthday cake that had been made by the cook. Religious services are provided in the home on a regular basis by the locals Churches in Watlington. The home has a minibus and outings to various places such as garden centres and the library are regularly undertaken. One of the relatives spoken to had trouble with her car and the driver of the minibus had arranged to transport her to and from the home so that she did not miss her visit to her husband. The inspector joined the residents for lunch in the ground floor dining room, and observed staff assisting the residents in a kindly and appropriate manner. The dining room was attractively laid out with colourful tablecloths and napkins, and the food was served individually from a heated trolley by the kitchen staff. The food served at this meal was nutritious, wholesome, and appealing. One of the residents spoken to said that the standard of meals provided was very good and that additional snacks were always available should they be needed. Watlington and District Care Home DS0000056018.V320489.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. 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. There is a complaints system in place that is accessible to all resident’s, relatives and visitors. The home makes every best endeavour to ensure that the residents are protected from all forms of abuse. EVIDENCE: The home has a complaints procedure in place that is contained in the service users guide, and a copy’s are available in leaflets form in the front entrance hall. The inspector examined a copy of this and the information about being able to contact the Commission at any stage was not explicit. It is recommended that the information in the complaints procedure about being able to contact the Commission for Social Care Inspection should be amended to reflect that people could contact the commission at any stage of a complaint. The home keeps a record of any complaints and how they were dealt with and the file was made available to the Inspector. No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. All staff receive training in the protection of vulnerable adults and the company provides this in house. Watlington and District Care Home DS0000056018.V320489.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable, homely, and well-maintained environment for the resident’s. EVIDENCE: The inspector toured all areas of the home and found it to be cleaned and maintained to a high standard. The furnishings and fittings in the home are of a good quality and afford a comfortable homely environment for the residents, relatives and visitors. One of the bathrooms had a waste bin that did not have a lid. It is recommended that all waste bins in bathrooms and toilets should have lids to ensure the rooms are hygienic and free from unpleasant odours. The inspector noted that the doors to the nurse’s stations in all three areas were propped open by chairs and other items of furniture. These doors are fire doors and the rooms are very small and poorly ventilated, and there is a need to hold them open in order to get the medication trolley through at least 4 times a day. This issue has been raised at many inspections since the opening Watlington and District Care Home DS0000056018.V320489.R01.S.doc Version 5.2 Page 17 of the home and no further action has yet been taken. It is a requirement that following discussion with the fire authority appropriate action must be taken to avoid using chairs and other obstacles to prop open the doors in all three of the nurses stations. Watlington and District Care Home DS0000056018.V320489.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is staffed with sufficient numbers and skill mix of staff at all times. The recruitment process for all staff is robust. The staff are all trained and competent to care for this group of people. EVIDENCE: The inspector examined staff rosters and observed that sufficient numbers and skill mix of staff are on duty at all times. The number of care assistants with NVQ 2 in care is still below the target of 50 , but progress is being made towards achieving this. The home also employ a number of staff who are trained nurses in their country of origin, and are working towards achieving registration with the Nursing and Midwifery Council in this country. Until they have attained this registration status they work as care assistants in the home. The inspector examined staff files and found that the homes recruitment procedure has been followed and all necessary checks and documentation was in place. Training and development is considered by the Manager to be of great importance and the Inspector was shown evidence of training undertaken by staff. A training matrix has been developed to track each training event and who attended to ensure that all staff receive the necessary mandatory training. It also contains any additional training for their individual personal development. The induction training package meets the Skills For Care guidelines. Watlington and District Care Home DS0000056018.V320489.R01.S.doc Version 5.2 Page 19 Watlington and District Care Home DS0000056018.V320489.R01.S.doc Version 5.2 Page 20 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed, and the quality assurance systems in place support this. EVIDENCE: The Manager has applied for registration with the Commission and is undergoing the necessary checks before interview. The Manager was appointed from Deputy Manager to Manager in December 2006, she is experienced in managing care homes, and is currently undertaking the Registered Managers Award. There is very good support from the Senior Management Team of the company. There was good evidence of team work and clear lines of accountability amongst the staff, and those spoken to are very happy to be working at the home, and many of the staff have worked in the home since it opened. Watlington and District Care Home DS0000056018.V320489.R01.S.doc Version 5.2 Page 21 The company have good quality assurance systems in place with regular audits being undertaken in all aspects of running the home. The Operations Manager regularly visits the home on a monthly basis and carries out checks in all aspects of the home and produces a report. This is made available to the Manager and the Commission. A Service User Survey was carried out in 2006 and a summary of the outcome was given to the inspector. This included comments such, as “It is as good as any hotel bar none!” “Sometimes when I can’t sleep at night I would love a cup of tea”. An action plan has been drawn up and the survey will be repeated annually. The inspector met with the administrator and discussed how the resident’s individual money is managed. There is a good system in place with all transactions recorded and receipts kept. The inspector examined records required by regulation and found them to be in good order. The fire log was kept up to date, and mandatory training in Fire safety, Moving and Handling and Food Hygiene is provided. Training in first aid is also provided and there is one member of staff who has the first aid appointed person status. Watlington and District Care Home DS0000056018.V320489.R01.S.doc Version 5.2 Page 22 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 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Watlington and District Care Home DS0000056018.V320489.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 14(1)(d) Requirement It is a requirement that the home must confirm in writing to the prospective resident that the home is suitable for meeting their assessed needs. Timescale for action 12/02/07 2 OP38 23(4)(a) It is a requirement that following 26/02/07 discussion with the fire authority appropriate action must be taken to avoid using chairs and other obstacles to prop open the fire doors in all three of the nurses stations. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations • It is recommended that the homes “Getting to know you” documentation should be sent out prior to admission so that family and friends can help to complete this. DS0000056018.V320489.R01.S.doc Version 5.2 Page 24 Watlington and District Care Home • It is further recommended that when the care plans are developed they should be based on the information in the pre-admission assessment to ensure all appropriate risk assessments are in place. 2 OP8 It is recommended that the Registered Nurse’s involved in wound care should seek the advice of the specialist tissue viability nurse in order to develop a wound care protocol for the home. It is recommended that the registered nurses should review the whole care provision in regard to resident’s wishes at the time of their death. It is recommended that the information in the complaints procedure about being able to contact the Commission for Social Care Inspection should be amended to reflect that people could contact the commission at any stage of a complaint. It is recommended that all waste bins in bathrooms and toilets should have lids to ensure the rooms are hygienic and free from unpleasant odours. 3 OP11 4 OP16 5 OP26 Watlington and District Care Home DS0000056018.V320489.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 Watlington and District Care Home DS0000056018.V320489.R01.S.doc Version 5.2 Page 26 - 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!