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Inspection on 21/05/07 for West Lodge Residential Care Home

Also see our care home review for West Lodge Residential Care Home for more information

This inspection was carried out on 21st May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

Where the home looked after money on behalf of the people living there the monies were kept safe and documented clearly.

What has improved since the last inspection?

Unpleasant odours were not detected at any time, in any area of the home, during the site visit.

CARE HOMES FOR OLDER PEOPLE West Lodge Residential Care Home 32 Palmerston Road Buckhurst Hill Essex IG9 5LW Lead Inspector Jane Greaves Key Unannounced Inspection 21st May 2007 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 West Lodge Residential Care Home DS0000017995.V340708.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. West Lodge Residential Care Home DS0000017995.V340708.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service West Lodge Residential Care Home Address 32 Palmerston Road Buckhurst Hill Essex IG9 5LW 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) 020 8504 4542 02085 044542 sirdit.westlodge@tiscali.co.uk Dr S Seyan Mr J Kotecha Mrs C J Knight Care Home 19 Category(ies) of Dementia - over 65 years of age (19), Old age, registration, with number not falling within any other category (19) of places West Lodge Residential Care Home DS0000017995.V340708.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th April 2006 Brief Description of the Service: West lodge is a large detached property in Buckhurst Hill, which offers residential care to 19 people over the age of 65 years of age. The home is also registered to accommodate individuals who suffer from Dementia. There are 15 single rooms and 2 double rooms. There is a passenger lift to the first floor and a stair lift to a mezzanine floor. To the rear of the property there is a garden and a car park. The home is accessible by public transport and there are shops and amenities nearby. A copy of the most recent report by Commission for Social Care Inspection was displayed in the entrance hall and a copy of the home’s service user guide including a statement of purpose was present in service users’ rooms. Information from the registered provider on 21st May 2007 showed that the fees payable range from £443.00 to £475.00 per week. Additional charges are made for services as Chiropodist (£7.50), Hairdresser (£6.00 to £30.00) and daily papers. West Lodge Residential Care Home DS0000017995.V340708.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection. The inspection process included a site visit on 21st May 2007, which lasted 6 hours. The site visit involved: • • • • • Speaking with people living and working at the home Speaking with the manager and the registered provider Looking all round the home Observing how people were supported Sampling records. This inspection, covering the all key National Minimum Standards, took into account all the information CSCI had received about West Lodge Residential Home since the last inspection including information provided by the service and surveys of people living at the home, their families and some healthcare professionals. The overall care and well being of the residents was the focus of the inspection. What the service does well: What has improved since the last inspection? What they could do better: • The person in charge needs to continue efforts to make sure that the care plans belonging to the people living at the home clearly tell staff all the ways individuals need to be supported. Medication records need to be properly completed to be sure that the people living at the home safely receive their medicines. Personal care such as Chiropody treatment should be provided in private so that individuals living at the home have their dignity respected. DS0000017995.V340708.R01.S.doc Version 5.2 Page 6 • • West Lodge Residential Care Home • People living at the home would benefit from a programme of activities to provide stimulation and increased staffing levels to allow time for them to be accompanied outside the home. The person in charge needs to make sure that all recruitment checks are completed before new staff start to work at the home in order to ensure the safety of the people living there. The person in charge needs to give sufficient time to be a manager. • • 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. West Lodge Residential Care Home DS0000017995.V340708.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection West Lodge Residential Care Home DS0000017995.V340708.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People considering moving into west lodge have their needs assessed and a contract clearly detailing the service they will receive. EVIDENCE: The files of two people living at West Lodge were examined at this site visit. The registered manager had undertaken pre-admission assessments involving family members and healthcare professionals prior to the people moving into the home. These assessments contained minimal information however were supported by good detail contained within assessments provided by the Care Management Team. Family members reported that the home gave them plenty of information before the decision was made for their relatives to move in permanently. It was reported that families were shown around the home and given information about the food provided and the routines of daily living. Medication regimes were discussed and one family member said they felt reassured that the home could and would meet the needs of their relative. West Lodge Residential Care Home DS0000017995.V340708.R01.S.doc Version 5.2 Page 9 One person said, “ as soon as I saw the home I thought it was really good, it’s small and personal”. West Lodge did not accommodate residents referred solely for intermediate care. West Lodge Residential Care Home DS0000017995.V340708.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at west Lodge did not always have their dignity respected nor could they be confident that their health safety and welfare were protected by the medication administration practices in the home. EVIDENCE: The registered manager reported that the care plans of the people living at the home were being developed to provide a clear audit trail confirming the actions taken by care staff to meet individuals’ assessed needs. The care plans for 5 people living at the home had been completely re-written and developed since the previous visit and these were in a format that was clear and easy to follow. Discussion was held around the necessity to complete this task in a timely manner, as the remaining care plans did not provide a clear trail to confirm the actions to be taken or those actions that had been taken. The registered manager reported that the care staff had some understanding of these revised care plans. However, during discussion it was agreed that some training would be needed to ensure that care staff were able to use these West Lodge Residential Care Home DS0000017995.V340708.R01.S.doc Version 5.2 Page 11 documents effectively ensuring the people living at the home would benefit from a consistent care delivery that met their assessed and changing needs. The manager was able to demonstrate that relatives, social workers and GPs were invited to participate in care plan reviews however, letters from social workers and doctors were present declining invitations to attend. Two residents’ families spoken with reported that they had been invited, and had attended, reviews of their relatives’ care plans. Risk assessments associated with the routines of daily living were included in individual’s care plans. The manager did not demonstrate a good understanding of how the risk management framework could be used to support the people living at West Lodge to live a fuller life such as being able to access the garden of the home or make a cup of tea. The care plans provided evidence of external healthcare support being accessed for people living at the home. One healthcare professional spoken with as part of this inspection process reported: “They provide a good standard of care”, “They ring me if they have a problem” and “Care planning appears adequate to meet the needs of the people living there”. There were no people living at the home with pressure sores at the time of this visit. Medication administration records did not provide an accurate record of if, and when, people living at the home had received their medication. There were many gaps in recording. The reason given for some lapses in recording was staff shortages. It was not possible to get an accurate picture of the medication training provision on the day of this visit. The registered provider subsequently provided records, these did not identify when the last training had been delivered for medication administration only that some had been booked for May. During the course of this visit the people living at West Lodge appeared happy and cheerful and staff members appeared to interact with them in a wholly appropriate and respectful manner. However, some family members reported that they had observed instances of staff members becoming irritable with some residents at times and talking about individuals without consideration to confidentiality or respect of the person. One family member reported “ some of the staff seem to look at the residents as a nuisance to be dealt with rather than the frail and vulnerable human beings that they are” and another reported “Some carers get a little irritated with the residents and shout at them from time to time, I have seen this with my own eyes”. Other family members reported: ‘my relative finds all the care assistants very helpful and nice”, “Some staff are brilliant” and “Staff are very kind and patient” West Lodge Residential Care Home DS0000017995.V340708.R01.S.doc Version 5.2 Page 12 At a previous visit to this service a Chiropodist was treating people in the main lounge area. In the home’s response to the previous inspection report it was stated that this practice had ceased and that this treatment would be delivered in the small lounge to protect and respect the dignity of individuals. Family members reported that practice had not changed and Chiropody treatment was still taking place in the communal lounge. West Lodge Residential Care Home DS0000017995.V340708.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 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People using the service are not supported to be involved in meaningful daytime activities according to their individual interests and capabilities. EVIDENCE: West Lodge Residential Home did not have a formal programme of activities to provide stimulation for the residents. Entertainment and stimulation for residents has been an ongoing concern and has been raised in previous inspection visits. The amount of staff time for activities in the home is insufficient. Staff were able to report that service users have been involved in activities such as helping in the kitchen and helping in the laundry, it was reported that “some like to read a lot”, “some like to knit”, “they all love music” and quizzes often took place. Evidence was available in the daily recording to confirm that exercise sessions took place weekly and the occasional softball game and quiz. Comments received from family members included: “It would be better if more activities outside the home were provided”, “I am not sure how much stimulus is given to the residents. They appear just to sit in lines of chairs with TV on most of the time” and “There are no activities, everybody just sitting there”. West Lodge Residential Care Home DS0000017995.V340708.R01.S.doc Version 5.2 Page 14 The provider reported experiencing difficulty in finding activities that would stimulate the interests of the people living at the home and reported that they are all happy to sit and ‘be’. A discussion was held around how these people have become institutionalised due to prolonged periods of inactivity. Family members and staff reported that staffing levels prohibit carers spending quality time talking with residents and there is not the time to take people out for walks in wheelchairs or read to them. Visitors were encouraged at West Lodge and the people living there were able to meet with their relatives/friends in the privacy of their own rooms, in the small quiet lounge or in the communal lounge/diner. People living at West Lodge were encouraged to bring personal effects into the home to make their rooms feel more homely. Family members reported that routines in the home were not flexible around the wishes of individuals but were arranged around practicalities for the staff team. It was reported that many residents were ‘put’ to bed as early as 7pm so that all were in bed before the night staff came on duty. The people living at the home were not able to express an opinion, when asked, whether they were happy to go to bed this early. The food provided at the home was of satisfactory quality and met the dietary needs of the people living at the home. A menu book in the kitchen provided evidence that a daily choice was offered. One family member reported that the residents always opted for the first choice offered to them. The staff and manager were not able to demonstrate how people were supported to make effective and meaningful choices of activity/food/bedtime or any other aspects of daily life. Residents automatically responded without being aware of the choice they had made. West Lodge Residential Care Home DS0000017995.V340708.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 and 18 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Recruitment procedures did not promote the safety and well being of the people living at West Lodge EVIDENCE: The home has a complaints procedure that meets regulations. The procedure is up to date and is available for families and visitors on request. There had been one complaint logged since the last visit to the service. The complaints log did not provide full detail of all outcomes, actions taken and the timescales for these. Some of the people living at West Lodge had the cognitive awareness to be able to voice any concerns and reported they would be confident in approaching the manager or staff however, many individuals did not have the capacity to express their views. Family members reported that the staff and management team listened to their views and concerns and acted upon them however one person reported, “things slipped back again very quickly”. Policies and procedures for safeguarding the people using the service were in place. Protection of Vulnerable Adults training had been provided for the staff team in 2006, there was no system in place at the home to provide an West Lodge Residential Care Home DS0000017995.V340708.R01.S.doc Version 5.2 Page 16 overview of what training had been provided for the staff team and when refresher training was to be provided. One staff recruitment file sampled did not contain evidence of the pre employment checks necessary to promote and protect the safety and well being of the people living in the home. An immediate requirement notice was issued. Staff members demonstrated an awareness of issues around restraint. West Lodge Residential Care Home DS0000017995.V340708.R01.S.doc Version 5.2 Page 17 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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living at West Lodge live in a safe and clean environment EVIDENCE: West Lodge provides a physical environment that meets the needs of the people that live there. Maintenance and redecoration at the home tends to be reactive. The people living at the home are able to access all communal areas of the house however family members reported the residents were ‘not allowed’ to access the garden as there were insufficient staff on duty to supervise. Bathrooms were functional and fitted with the appropriate adaptations to meet the needs of the people living at the home. The home smelt fresh at this visit, a healthcare professional reported that the home always appeared fresh with no unpleasant aromas however family members reported occasions when unpleasant aromas were overpowering. West Lodge Residential Care Home DS0000017995.V340708.R01.S.doc Version 5.2 Page 18 Communal areas of the home appeared clean and tidy and individual bedrooms were fresh and clean. The kitchen floor was stained, cupboard fronts were ‘tired’ and in need of cleaning. The laundry area was clean tidy and organised, all family members reported being happy with this aspect of the service provision. Evidence was available to confirm that 14 of the 21 staff working at the home had received refresher training in the control of infection in April 2007. West Lodge Residential Care Home DS0000017995.V340708.R01.S.doc Version 5.2 Page 19 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 and 30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The service has poor recruitment procedures with shortfalls in recording and process being evident. The level of staffing restricts the ability of the service to deliver person centred support. EVIDENCE: The people using this service and their families/representatives were generally satisfied that the care provision met individuals’ needs however it was reported there were times where people had to wait for staff support due to limited staffing levels. The social and spiritual needs of the people living at the home were not adequately met; staff, residents and family members reported that staffing levels did not support this aspect of care. Comments received from family members included “Always short of staff”, “Sometimes the carers are busy and unable to attend straight away” and “some of the girls really do care, they work very hard but they don’t get the time to spend individual quality time with residents”. A healthcare professional reported “Higher staffing ratios is always a help”. The home had a ‘bank’ of casual employees who covered for sickness and other absences however this was not a reliable source of support as the manager covered for care staff and cooking duties regularly. West Lodge Residential Care Home DS0000017995.V340708.R01.S.doc Version 5.2 Page 20 Rotas showed there was one member of staff on night duty. The layout of the building and the changing needs of the confused and vulnerable people living at the home indicated that a review should be made of the night staffing hours to ensure they are an accurate reflection of the needs of the individuals. The recommended ratio of 50 of the care staff team trained to NVQ level 2 had not been achieved. It was reported that 5 of the 16 care staff members had achieved this qualification at the point of this visit and that 5 further staff members were working towards the NVQ3 qualification. One staff recruitment file was examined at this visit. There was no evidence to confirm that the pre employment checks necessary to promote the safety and well being of the residents living at the home had been undertaken. The staff member started to work at the home before references or a criminal Records Bureau disclosure (CRB) had been applied for. At the point of this inspection the CRB had not been completed and one reference had been received. This reference was from a private individual and had not been validated by a telephone call. No checks had been made against the protection of Vulnerable Adults (PoVA) register to confirm that this person was suitable to work with this client group. The home did not have an overview of the training provided for the staff team and not all certificates were available in the individual staff files. The registered provider reported that he was responsible for organising the training and as he was aware of the costing involved and was happy to provide any training that was identified by means of need, he did not see the necessity to provide a budgeted training plan for the home annually. West Lodge Residential Care Home DS0000017995.V340708.R01.S.doc Version 5.2 Page 21 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 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home was managed by a person who was fit to be in charge and of good character, however insufficient hours allocated to management responsibilities had a negative impact on overall outcomes for the people living there. EVIDENCE: At a previous visit to the home it was noted that the registered manager’s hours for management duties were just 2 x 6hr shifts per week provided there was no staff shortage due to sickness etc. This remained unchanged at this visit. West Lodge Residential Care Home DS0000017995.V340708.R01.S.doc Version 5.2 Page 22 The registered provider reported that 9 shifts per month were dedicated to managing the service and that this was sufficient. Rotas provided evidence that 6 shifts were ‘the norm’ in practice. These hours are insufficient to effectively manage a service such as this. Record keeping is not accurate and does not reflect what is happening in the service. Staff supervisions happen sporadically, staff training records are not complete, and staff recruitment is handled by head office however not monitored effectively by the registered manager to ensure the safety of the people living at the home. The development of care plans has not progressed at an acceptable pace and the people living at the home would benefit from having a stimulating activity program. These are just some of the areas that demonstrate the negative impact from insufficient management hours. On the day of this visit the manager had to ‘stand in’ for the cook and consequently another shift dedicated to managing the service was lost. The service undertakes an annual quality assurance survey of residents, their families and community stakeholders. The results have not been included within the home’s Statement of Purpose or Service User Guide. It was reported that the results of the annual quality assurance survey are used to drive the quality of service provision forward however there was no evidence available to confirm this. The service maintained some ‘pocket monies’ for individuals living at the home. These were kept in separate envelopes and written records were maintained of all monies spent. Certificates were available to provide evidence that health and safety checks were undertaken as routine at West Lodge. There were no outstanding health and safety issues observed or noted at this visit. West Lodge Residential Care Home DS0000017995.V340708.R01.S.doc Version 5.2 Page 23 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 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 West Lodge Residential Care Home DS0000017995.V340708.R01.S.doc Version 5.2 Page 24 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 OP9 Regulation 13(2) Requirement When medication is administered to people living at the home it must be clearly recorded, to ensure that people receive correct levels of medication. People living at the home must be provided with various activities to stimulate and enhance their lives. This is a repeat requirement that did not meet agreed timescales of 31/12/05 and 31/05/06 All recruitment checks necessary to promote and protect the safety and welfare of people living at the home must be made before new staff start to work at the care home. This is a repeat requirement that did not meet the agreed timescale of 10/04/06 The person in charge must ensure that the registered manager is supported to work sufficient ‘management’ hours to promote smooth and efficient DS0000017995.V340708.R01.S.doc Timescale for action 31/05/07 2. OP12 16(2)(n) 31/08/07 3. OP29 OP18 19(4) 21/05/07 4. OP31 18(1)(a) 31/05/07 West Lodge Residential Care Home Version 5.2 Page 25 running of the care home for the benefit of the people living there. This is a repeat requirement that did not meet the agreed timescale of 30/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations West Lodge Residential Care Home DS0000017995.V340708.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 West Lodge Residential Care Home DS0000017995.V340708.R01.S.doc Version 5.2 Page 27 - 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. 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