Inspection on 09/12/05 for Weatherdale Unit

This inspection was carried out on 9th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Weatherdale Unit 12/07/07

Weatherdale Unit 16/06/06

Weatherdale Unit 05/07/05

Weatherdale Unit 20/10/04

Weatherdale Unit 07/04/04

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

CARE HOMES FOR OLDER PEOPLE Weatherdale Unit Weatherdale Unit 31 Weather Oak Harborne Birmingham B17 9DD Lead Inspector Ann Farrell Unannounced Inspection 9th December 2005 08:45 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 Weatherdale Unit DS0000035597.V271445.R01.S.doc Version 5.0 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. Weatherdale Unit DS0000035597.V271445.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Weatherdale Unit Address Weatherdale Unit 31 Weather Oak Harborne Birmingham B17 9DD 0121 427 1607 0121 678 3745 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) Birmingham City Council (S) Vacant Care Home 10 Category(ies) of Dementia - over 65 years of age (10) registration, with number of places Weatherdale Unit DS0000035597.V271445.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. The unit is registered to accommodate 10 adults over 65 who are in need of care for reasons of dementia and associated challenging behaviours. Levels of staffing must be increased appropriately to reflect the numbers of day care service users Registration category will be 10 DE(E) That minimum staffing levels for the residential unit are maintained at 2 care plus a senior member of staff throughout the waking day of 14.5 hours Care/shift manager hours and ancillary staff should be provided in addition to care staff Additionally to the above minimum staffing levels, there must be 1 waking night care a senior on waking or sleeping-in duty for respite care users 5/7/05 Date of last inspection Brief Description of the Service: Weatherdale is a ten bedded respite and day care unit that is situated within a purpose built, local authority residential home. The unit is staffed and managed separately from the rest of the home and is registered with the Commission. It is funded and run jointly by the Health Service and Social Services and is designed to offer a variety of support services for carers/relatives looking after older people who have dementia and associated challenging behaviours. Support can be in the form of day care, overnight stays, weekend breaks or short stays. Weatherdale is located in a quiet, residential cul-de-sac off a main road in Harborne. The unit is within easy reach of public transport routes as well as all local facilities including shops, churches, library and swimming baths. It is a single storey unit with its own entrance with a coded lock. The unit comprises of lounge/dining area with a small kitchenette, quiet lounge, office space, laundry, fully equipped bathroom, two toilets and 10 single bedrooms. Lawns surround the building and there is a small, secure paved area with seating and flowerpots that residents have access to. There is limited parking to the front of the building. At the time of the inspection there were no minimum standards available for day care therefore only the residential provision was inspected. Weatherdale Unit DS0000035597.V271445.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was conducted over a half day commencing at 8.45am on 13th December 2005. This was the second statutory inspection for 2005/2006. Currently there is no manager in place and the deputy manager was not on duty. This resulted in a senior carer from the main home taking responsibility for the home from approximately 9.15am. At the time of arriving there were three care staff and a part time administrator on duty. During the inspection process the inspector undertook a partial tour of the home, sampled residents files and other documentation. What the service does well: What has improved since the last inspection? What they could do better: There are some areas that require redecoration. The medication system needs to be more robust and accurate records need to be maintained in order to demonstrate residents receive the medication prescribed. Management systems need to be reviewed and areas such as consistency, team working and communication addressed to ensure there is a cohesive workforce in order to meet residents needs. Weatherdale Unit DS0000035597.V271445.R01.S.doc Version 5.0 Page 6 The arrangements for staffing need to be reviewed to ensure there is a suitable skill mix and number of staff on duty at all times to ensure residents needs are met. The arrangements for activity and stimulation of the residents needs to be reviewed and suitable plans put in place to meet residents needs. The assessment and care planning system needs to be reviewed to ensure that all residents needs are identified and met whilst the resident is in the home. Robust systems must be implemented for dealing with residents money and valuables. Records must be countersigned by two people, be up to date and clearly demonstrate all transactions. The comforts fund must be reviewed and should only be used for the benefit of residents Records in relation to staff recruitment and staff training should be available in the home for inspection. Regular staff supervision must be undertaken to ensure staff receive the appropriate support. 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. Weatherdale Unit DS0000035597.V271445.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Weatherdale Unit DS0000035597.V271445.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,5,6 The assessment process described could not guarantee that all residents needs were identified and met. EVIDENCE: Weatherdale provides care to residents with dementia on a respite, overnight or day care basis in order to provide support to relatives or carers. Referrals to the unit are usually taken from health or social care professionals. At the time of this inspection it was stated that assessments are now undertaken when prospective residents visit the unit as staff are unable to undertake home assessments. This may have an impact as relatives or carers may not be present to give relevant information about the needs of prospective residents. Inspection of such assessments were not undertaken as a senior member of staff was not available who was fully conversant with the unit and residents attending the unit. The unit is able to meet a variety of needs. On arrival two care staff were sitting in the lounge with residents, the television was switched on and there was a lack of interaction between staff and residents. A similar incident was noted later when three staff were sat in the lounge talking to each other and residents were sat around the room apparently sleeping. Staff responded when there was some physical aspect to address such as welcoming new residents or day care clients into the unit or providing a dink and food. Weatherdale Unit DS0000035597.V271445.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,9 There are systems in place to meet resident’s health needs, but the lack of comprehensive records cannot guarantee all needs are met and consistency of care given to residents. The medication system is not sufficiently robust to ensure residents receive medication prescribed by the G.P. EVIDENCE: Since the time of the last inspection the unit has introduced core care plans, which appear to be focused on medical conditions and physical care. They are not personalised to residents. In addition, there is a record of activities of daily living, which covers physical aspects of care mainly. On examination of one residents file it was noted that the core care plans related to monitoring mental health and behaviour yet the activities of daily living did not indicate there were any problems with behaviour, which was rather confusing. The core care plan had been drawn up in June and had been reviewed once. The senior staff will need to review the assessment and care planning process to ensure all resident’s needs are identified and met appropriately. Staff receive medication when residents enter the home and any medication remaining is returned with them when they leave. Records are kept of these Weatherdale Unit DS0000035597.V271445.R01.S.doc Version 5.0 Page 10 and on inspection it was noted that it was not consistently completed when residents returned home. On one occasion a student nurse had recorded the medication into the home and it had not been countersigned by a member of permanent staff. It also became apparent during inspection the staff retain medication in the unit for some residents who spend long periods there and only return home for short periods. It was not possible to audit the medication for these residents. Also there were some gaps in the recording and codes had been used and not explained. Controlled drugs were not stored appropriately and there was no evidence of a controlled drug book at the time of inspection. There were five bottles of cream for one resident, one of which had been opened and they were dated as dispensed February 05. The cream that was in use had not been dated to indicate when it had been opened. When creams are opened they should be discarded after one month due to the risk of bacterial contamination. Weatherdale Unit DS0000035597.V271445.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 There is a lack of variety and range of activities for residents and there was noted to be poor stimulation and interaction with residents by staff. A full review of this area is required. EVIDENCE: At the time of arriving staff sat in the lounge with some residents and the television was switched on and there was not interaction. At a later time the television was switched off and staff were noted to be talking amongst themselves whilst residents sat around the lounge apparently sleeping. On discussion with staff they stated the occupational therapist visited weekly, “pat a pet” service visited monthly and they occasional played bingo with residents. This would appear to support what was found on the day of inspection. The home receives the main meals from the residential home. On discussion it was stated that the meals were variable. It is recommended that this area be reviewed. Weatherdale Unit DS0000035597.V271445.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These area were not assessed. Weatherdale Unit DS0000035597.V271445.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 The unit is generally well maintained. It could be enhanced further by some re-decoration. EVIDENCE: Weatherdale Unit DS0000035597.V271445.R01.S.doc Version 5.0 Page 14 The building is a ten bedded unit, which is attached to a large residential unit. The unit was clean, warm and generally well maintained. Parking is available in the main home and there is a small garden area for residents with potted plants and seating for when the weather permits. There is one combined lounge dining room and a small quite room, which were pleasantly decorated. Furnishings had been replaced in the lounge since the last inspection. The quiet room was rather cluttered and would not be suitable for residents to use. There are ten single bedrooms with wash hand basin, call bells and locks to doors. All rooms are adequately furnished and the home has ordered some new commodes, which were noted to be in need of replacement. In addition, some of the bedrooms inspected required re-decoration and lockable facilities. There is one large assisted bathroom, which is equipped with a parker bath. Residents would benefit from an additional bathroom with a shower facility to provide a choice. However, the inspector is aware that due to the size and layout of the unit this would be difficult to accommodate. There are two toilets with hand grab rails, but they are not partitioned from floor to ceiling. If the maximum number of residents (12) were on the unit this number of toilets could prove inadequate and it is recommended that consideration be given to the addition of an extra toilet. The inspector is aware of the difficulty of accommodating this. Rooms are individually and naturally ventilated and windows are provided with restrainers. All areas are centrally heated, but controls to the radiators cannot be accessed by residents to adjust the heating in individual rooms. Hot water outlets have thermostatic valves fitted to control the temperature of hot water to reduce risks from scalding. There is a separate laundry, which is adequately equipped and a separate room is used for the storage of cleaning materials. The home has a small kitchen and the doors to kitchen units had been replaced, but some of the carcasses and worktops were damaged and will need replacement. Also the ventilation requires attention and it is need of redecoration. Weatherdale Unit DS0000035597.V271445.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,30 There was a lack of motivation and poor staff morale, which may impact on residents. The arrangements for staffing were not satisfactory at the time of inspection. EVIDENCE: Staff in the home are made up of staff from the Primary Care Trust and Social Care and Health. At the time of arriving there was no senior member of staff on duty. Staff consisted of three care staff and the administration assistant. A senior carer who usually works in the main home arrived at approximately 9.15 am. Apparently these arrangements had been made with her as there was no senior member of staff who worked on the unit permanently to cover the morning shift. It was rather concerning that three care staff had been left responsible for the unit for a number of hours and there were insufficient senior staff or effective arrangements in place to cover periods of absence. This area will need to be reviewed and arrangements put in place to address staffing shortfalls to ensure there is adequate staff on duty at all times. At the last inspection it was stated that over 50 of care staff had completed NVQ level 2. During this visit it was stated that no new staff had been recruited to the unit. Weatherdale Unit DS0000035597.V271445.R01.S.doc Version 5.0 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35 There is a lack of staff support, team working and inconsistencies in the home, which need to be addressed in order to provide a suitable service for residents. EVIDENCE: Weatherdale Unit DS0000035597.V271445.R01.S.doc Version 5.0 Page 17 Currently there is no manager in post and the deputy manager is taking charge. The Commission has requested information in writing regarding the management arrangements for the unit. On discussion with staff there appears to be a lack of communication, support and team working. Some stated that they were concerned as to the future of the unit. This is currently under discussion as the Health Care Trust are in the process of drawing up a new strategy. Regular staff supervision is not occurring and the inspector felt there was generally a lack of motivation. All these issues may impinge on the care of the residents attending the unit. All residents/day care clients are only on the unit for short periods and at the time of inspection records were inspected in respect of moneys/valuables held on their behalf. It was noted that there were records for residents who no longer attended the unit or were deceased. Records indicated that sums of money had been deposited on the unit and there was only one signature in respect of transactions. It was stated by the administration assistant that the money had been returned to residents, but there was no evidence to confirm this. Also some valuable items were held in the safe facility and there was no records or evidence as to whom they belonged. On inspection of the comforts fund, which is used for the benefit of residents, it was noted that purchases had been made for items such as gloves, dishwasher tablets and other items for the running of the unit. This is not appropriate and the matter has been passed on to the senior managers to investigate fully. On discussion it was stated that there is no quality assurance system in place. Records indicated that the team manager undertook regular visits each month and no issues of concern had been raised. Weatherdale Unit DS0000035597.V271445.R01.S.doc Version 5.0 Page 18 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 2 x 2 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 1 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 3 2 X 3 2 2 3 STAFFING Standard No Score 27 1 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 1 1 X 1 X X X Weatherdale Unit DS0000035597.V271445.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP2 Regulation 5(1)(b) Requirement Timescale for action 30/03/06 2. OP3 14 3. OP7 17(1)(a) All residents should be provided with a statement of terms and conditions at the point of admission to the unit. This area was not assessed and is carried forward from 30/12/03. The registered person must 30/01/06 undertake a review of the arrangements in respect of admission ensuring that information is sought from relatives etc. and a comprehensive assessment drawn up. The registered person must 30/01/06 undertake a review of the daily recording processes for residents and implement systems that are easy to follow, enable retrieval of information that meets data protection guidelines. This area was not assessed and has been carried forward from 30/8/05 . The registered person must review the care planning process to ensure that records are personalised to residents, outline in detail the action to be taken by staff and cover all needs in a DS0000035597.V271445.R01.S.doc 4. OP7 15 30/03/06 Weatherdale Unit Version 5.0 Page 20 5. OP9 13(2) 6. OP12 16(2)(m) (n) 7. OP16 22 8. OP19 23(2)(b) (d) holistic manner. The registered person must ensure a robust system in respect of medication and ensure all audits are accurate to include; • A record of all medication entering the home must be checked and countersigned by two members of staff. • A record of all medication returned to residents must be maintained consistently. • Staff must ensure the accurate administration and recording of medication. • All codes must be explained and gaps must not be left on the MAR chart. • All controlled drugs must be stored appropriately and recorded in the controlled drug book. • Creams must be dated when opened and discarded after one month. The registered person must undertake an assessment in respect of residents interests/hobbies and draw up a suitable plan (group or individual) and ensure that the plan of activities is implemented. The registered person must ensure that details of all complaints to the home are available for inspection. They should indicate complaint, investigation, findings, outcome and resolution. This area was not assessed and has been carried forward from 30/7/05. The registered person must ensure the kitchen is redecorated and damaged unit replaces. Timescale of 1/7/04 DS0000035597.V271445.R01.S.doc 30/12/05 30/01/06 30/12/05 30/03/06 Weatherdale Unit Version 5.0 Page 21 9. OP19 23(5) 10. OP19 23(2)(g) 11. OP24 23(2)(d) 12. OP24 16(2)(k) 13. OP21 12(4)(a) 14. OP25 23(2)(p) 15. OP25 23(2)(m) 16. OP27 18(1) 17. OP29 19(1)Sch 2 18. OP30 18(1)(a) not met The registered person must ensure there is adequate ventilation in the kitchen. Timescale of 1/2/05 not met. The registered person must ensure the quiet room is accessible to residents at all times. The registered person must audit all bedrooms and draw up a plan of re-decoration. Forward the plan to the Commission Timescale of 5/3/04 not met. The registered person must undertake a review of carpets and draw up a plan of replacement where required. Timescale of 30/8/05 not met. The registered person must ensure toilets are partitioned from floor to ceiling. Timescale of 30/1/04 not met. The registered person must ensure heating controls are accessible to residents. Timescale of 30/4/04 not met. The registered person must ensure a lockable facility is available in all bedrooms for residents use. The registered person must ensure there is adequate numbers of suitably qualified staff on the unit at all times to meet residents needs. The manager must ensure that all records as required in schedule 2 of the Care Homes Regulations are available on the unit for inspection. Timescale of 30/12/03 not met. All care staff must receive induction and foundation training to the specifications detailed by TOPSS. This has been carried forward from 1/1/05. DS0000035597.V271445.R01.S.doc 30/01/06 30/12/05 30/01/06 30/03/06 30/03/06 30/03/06 30/03/06 15/12/05 30/01/06 30/03/06 Weatherdale Unit Version 5.0 Page 22 19. OP31 8(1)(a) 20. OP32 10(1) 12(1) 21. OP33 24 22. OP35 17(2) 23 OP36 18(2) 24. OP38 23(2) 25. OP38 18(1) 26. OP38 23(4) The senior managers responsible for the unit must submit to the CSCI their proposals to register a manager. Timescale of 5/2/04 not met. The registered person must address the issues in respect of communication, team working and staff morale to provide a cohesive workforce that is meeting resident’s needs. The registered person must introduce an effective quality assurance and monitoring system seeking views of resident and other stakeholders to measure the success in meeting the aims and objectives of the unit. The registered person must ensure a robust system is in place for handling residents monies and valuables that is fully auditable and includes two signatures for all transactions. The registered person must ensure that all staff receive formal supervision at least six times a year and records are retained in the home. The registered person must ensure there is evidence on site that the emergency call system has been serviced at least annually. Timescale of 1/12/04 not met. The registered person must ensure there is evidence on site to indicate the training that staff have undertaken. Timescale of 30/8/05 not met. The registered person must ensure the key pad on the entrance door is linked into the fire alarm system. This area was not assessed and has been carried forward from 30/8/05. DS0000035597.V271445.R01.S.doc 30/01/06 30/12/05 30/04/06 30/12/05 30/01/06 30/01/06 30/01/06 30/12/05 Weatherdale Unit Version 5.0 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2. 3. 4. Refer to Standard OP15 OP21 OP21 OP37 Good Practice Recommendations It is recommended that a review of meals is undertaken. It is recommended that to offer further choice a shower room be installed on the unit. To enhance the facilities for residents it is recommended that an additional toilet be installed. It is strongly recommended that both departments address the duplication of paper work carried out by staff. Weatherdale Unit DS0000035597.V271445.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Weatherdale Unit DS0000035597.V271445.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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