Inspection on 10/06/08 for Westwood Lodge

This inspection was carried out on 10th June 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Westwood Lodge 08/06/09

Westwood Lodge 24/09/07

Westwood Lodge 22/11/06

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Westwood Lodge Brookview Helmsman Way Off Poolstock Lane Wigan Lancashire WN3 5DJ Lead Inspector Mike Murphy Unannounced Inspection 10th June 2008 09:00 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 Westwood Lodge DS0000067836.V365986.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. Westwood Lodge DS0000067836.V365986.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westwood Lodge Address Brookview Helmsman Way Off Poolstock Lane Wigan Lancashire WN3 5DJ 01942 829999 01942 826357 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) Meridian Healthcare Ltd Mrs M J Mather Care Home 76 Category(ies) of Old age, not falling within any other category registration, with number (76), Physical disability (7) of places Westwood Lodge DS0000067836.V365986.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 76 services users to include: up to 76 service users in the category of OP (Older People); up to 7 service users in the category of PD (Physical Disability under 65 years of age). The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 24th September 2007 2. Date of last inspection Brief Description of the Service: Westwood Lodge Care Home is a purpose built home with 3 units, which offers general nursing and personal care for up to 76 residents. The home is situated in a residential area of Wigan and is approximately 5 minutes drive from Wigan town centre and local amenities. It is pleasantly situated in its own grounds and has attractive gardens with ample car parking space available at the front of the home. Accommodation for residents is provided on two levels and in the annex, The House. All rooms are single and 76 rooms have en suite facilities: two of these rooms have a shower facility. Level access to the home is provided and a passenger lift ensures access is provided to both floors. There are communal lounge/dining and quiet areas on both floors and within The House. The fees for the home are £360.51 - £580.00 per week. (Information supplied by the home at the time of this inspection) Westwood Lodge DS0000067836.V365986.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection (conducted by a CSCI inspector and Regulation manager) which included a site visit that the home did not know was going to take place was carried out over an eight hour period on the 10th June 2008. The process of inspection included observing what went on in the home, talking to residents, relatives, staff, and the home manager, looking round the home, and examining some important records. Before the inspection, we also asked the manager of the home to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This helps us to determine if the management of the home sees the service they provide the same way that we see the service. We felt this form was completed in well. What the service does well: What has improved since the last inspection? An ongoing programme of redecoration and refurbishment has continued since the last inspection. This has improved the quality of the home environment for resident’s living at the home. Westwood Lodge is currently working in compliance with the ‘Gold Standard Framework’. This involves discussing with residents, families, General Practitioners and other health care professionals the palliative care needs of the service user and how these can best be met. Most of the staff at the home have now had updated safeguarding training which is important in protecting vulnerable people as much as possible. Westwood Lodge DS0000067836.V365986.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Westwood Lodge DS0000067836.V365986.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 Westwood Lodge DS0000067836.V365986.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All people admitted to the home are suitably assessed beforehand to make sure their care and support needs can be appropriately met. EVIDENCE: The pre-admission assessment records of 7 residents admitted to the home since the last inspection were looked at. Before people are admitted to the home an assessment of their care and support needs is carried out with the involvement of the prospective resident, their relatives and health and social care professionals for example doctors and social workers. The reason for this assessment to help the prospective resident (and their relatives) in their decision how suitable the home would be and enable the nurse conducting the assessment to determine if the home will be able to meet the prospective resident’s needs appropriately. Westwood Lodge DS0000067836.V365986.R01.S.doc Version 5.2 Page 9 The initial assessment helps to form the basis of the plan of care to be followed following admission to the home. The 7 residents care records inspected contained detailed pre and post admission assessments. Westwood Lodge DS0000067836.V365986.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. The health and personal care provided for residents appears to be generally suitable. However the experience reported by residents and relatives reveals that there are still times when this does not meet their expectations. EVIDENCE: The care records of 8 residents were inspected. These contained care plans that were initially based on the pre-admission assessment. Care plans in the main addressed the health and personal care needs of residents adequately and were, again in the main, evaluated at least monthly. Risk assessments, that seek to protect resident’s health and welfare are also recorded in respect of residents skin integrity (assessing the risk of pressure sores), mobility (including the risk of potential falls and fractures), nutrition, (including regular weight monitoring) and other areas of potential risk for individual residents were also, in the main evaluated at least monthly. Westwood Lodge DS0000067836.V365986.R01.S.doc Version 5.2 Page 11 However 1 residents care records referred to weight loss. Whilst a referral had been made to the dieticians a specific care plan had not been developed to manage/monitor this problem and their care plans/risk assessments had not been formally evaluated since April 2008. Also care plans and the risk assessments of 2 other resident’s had not been formally evaluated since April 2008. All residents are registered with a local GP and it was evident that all were enabled to access opticians, chiropodists, dentists, district nurses, tissue viability nurses, control of infection nurses, dieticians and other specialist services as individual residents needed. A daily record is maintained that details resident’s progress. The practices for the receipt, recording, storage, handling, administration and disposal of resident’s medicines was inspected on all three units and was found to be adequate. However it is recommended that all handwritten entries on resident’s medication administration records are witnessed and signed by 2 staff. The qualified nurses are responsible for all aspects of managing medication in the home. Discussion with residents, relatives and staff revealed that residents were treated with respect and that their right to privacy was upheld. Comments made included; ‘the girls are great and work very hard’, ‘the staff are kind and decent with us all’, ‘my mum says the staff treat her well and are nice’. On the day of inspection staff communicated well with residents and showed them respect and protected their dignity. The majority of residents living at the home have been assessed as requiring ‘general nursing’ care and consequently have quite complex care and support needs. Whilst it was acknowledged that the situation has improved since the last inspection concerns were still being expressed by residents and relatives (and staff) to both inspectors that when there is a shortage of care staff (on the ground floor unit but more commonly on the top floor unit there is a significant impact on the quality of the care/support provided to residents – some residents continue to report having to wait for long periods when they use the nurse call bell for help and said that their care is rushed and at times incomplete, and are of the view that this is unacceptable although those staff on duty do their best to cope. The provision of staff at the home should be determined not merely by the numbers of residents living at the home but by their levels of dependency and other factors such as the layout of the building. The issue of staff provision is further addressed in the ‘staffing’ and ‘requirements’ sections of this report. Westwood Lodge DS0000067836.V365986.R01.S.doc Version 5.2 Page 12 Westwood Lodge DS0000067836.V365986.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. Residents are being supported by staff to participate in social activities and are in the main able to retain the ability to make personal choices. There was a general satisfaction with meals provision at the home. EVIDENCE: The home employs a social/leisure activities organiser who works 20 hours a week. Time is divided between the 3 units of the home where residents live. A planned programme of activities is in place and a written record of resident’s involvement in the activities provided is kept. Activities available include reminiscence sessions, games and trips out. Individual one to one activities with the co-ordinator are popular, especially for those with high dependency nursing needs. Westwood Lodge DS0000067836.V365986.R01.S.doc Version 5.2 Page 14 Residents and relatives again spoke favourably about the activities available but there is still a general view that more time should be devoted to individual and group activities – a number of residents spoke about being bored and in need of more social stimulation. As at the last inspection it was recommended that the time allocated for this provision should be reviewed as the nursing and care staff working on the individual units have to prioritise residents care and support needs. Discussion with residents and relatives (and observations made on the day of inspection) revealed that the routines of daily life in the home are generally as flexible as possible in a care home setting. However as at the last inspection how flexible depends on how many staff are on duty. Residents were encouraged to choose what time they get up and go to bed, what activities to engage in and staff inform and consult them (as far as possible) about the care and support they need. Clearly this is very important in enabling residents to retain as much independence and choice in their daily lives as possible. Residents wishing to retain religious links are enabled to do so. The home has an open visiting policy. There are no unreasonable restrictions on the time people visit. The only time restrictions would be imposed is when requested by residents. Relatives spoken to during the inspection said they continue to be made welcome at the home and were able to see their relatives in the privacy of their own room or in a quieter communal area. Meals are cooked on site in the home’s kitchen. Menus are varied, balanced and provide choice. Meals are served in designated dining areas (that were clean, comfortable and appropriately furnished) or the resident’s own room if desired. Residents’ meal times are as reasonable and as flexible as they can be in a communal setting. Lunch was observed on one unit on the day of inspection. This was a hot and substantial meal and staff assisted and served residents their meals appropriately. Discussion with residents revealed a general satisfaction with the meals provided. Westwood Lodge DS0000067836.V365986.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. Residents and relatives knew how to make a complaint if they felt it necessary. Written guidance and training arrangements ensure that all staff members have knowledge of abuse and protection arrangements and safeguards were in place to protect the welfare of residents. EVIDENCE: The complaints procedure was prominently displayed and is also available in the ‘Service users guide’ that is provided for resident’s and their relative’s information. A complaints log is maintained that details the nature of the complaint, how it has been investigated and the outcome. The home operates safeguarding and whistle-blowing policies that seek to protect residents. In addition, a copy of Wigan’s Inter agency protection procedure is held on site. All staff spoken to confirmed that they had safeguarding training (this was reflected in training records maintained by the home) and were aware of the whistle-blowing policy (the home also confirmed that safeguarding training had been provided to all staff have received safeguarding training. Appropriate pre-employment checks are conducted on all staff to ensure suitable people look after the resident’s. There have been complaint issues since the last key inspection. These have been managed appropriately within the complaints and safeguarding procedures operated at the home and by the local authority. Whilst all staff Westwood Lodge DS0000067836.V365986.R01.S.doc Version 5.2 Page 16 have been provided with safeguarding training it is recommended that all senior nursing/care staff at the home access local training in safeguarding to ensure senior staff are fully aware of local authority safeguarding processes. The company who own the home have appointed a safeguarding manager who deals with protection issues relating to residents. Westwood Lodge DS0000067836.V365986.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): 19,21,22,24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home appeared to be structurally well maintained throughout and provides a suitable and comfortable environment for the care of residents. EVIDENCE: A tour of the three units at the home was made during this inspection. All communal lounges and dining rooms were inspected and between four and six resident’s bedrooms on each unit. All areas were clean and warm and suitably ventilated. It was evident from inspection and discussion with the manager that a large number of environmental improvements have been made since the last inspection. These improvements include programmes of re-decoration and refurbishment in the Westwood Lodge DS0000067836.V365986.R01.S.doc Version 5.2 Page 18 ground floor units. The inspectors were also informed that a programme has been planned to refurbish ‘the house’ unit at the home. Lounge and dining areas on each unit were clean adequately decorated and suitably/comfortably furnished. Bedrooms inspected on each unit were clean, suitably furnished and equipped and in a number of cases very personalised. All bedrooms are provided with en-suite WC and washbasin. Aids and adaptations have been made generally to the environment to assist and enable residents and appropriate hoisting equipment is available. Specialist beds are provided for those residents whose nursing needs require such provision. Garden areas were well maintained and accessible to residents. The laundry area is separate from resident areas. The laundry was adequately equipped and staffed and the arrangements to provide residents with a laundry service were suitable and appropriate (residents and relatives report an improvement to the quality of the laundry service since the last inspection). Measures were in place to prevent the spread of infection such as suitable protective clothing for staff, cleaning programmes and hand washing arrangements. The advice of local infection control professionals is obtained when necessary. Malodour was being managed well. All residents have their continence needs assessed and are provided with aids and support to appropriately deal with those needs. Westwood Lodge DS0000067836.V365986.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 adequate. This judgement has been made using available evidence including a visit to this service. Whilst staffing provision has improved since the last inspection there are still issues in this area. The recruitment and training of staff employed at the home are managed appropriately. EVIDENCE: Whilst generally there has been improvement (since the last inspection) about the numbers of staff provided to care for and support residents a significant number of residents, relatives and staff voiced their view that at times this was still a concern. Although not an issue on ‘the house’ unit it was an issue on the ground and top floor units of the home. Residents and relatives (and staff) informed the visiting inspectors that when there is a shortage of care staff (on the ground floor unit but more commonly on the top floor unit there is a significant impact on the quality of the care/support provided to residents – some residents continue to report having to wait for long periods when they use the nurse call bell for help and said that their care is rushed and at times incomplete, and are of the view that this is unacceptable although those staff on duty do their best to cope. Westwood Lodge DS0000067836.V365986.R01.S.doc Version 5.2 Page 20 The provision of staff at the home should be determined not merely by the numbers of residents living at the home but by their levels of dependency and other factors such as the layout of the building. The home continues to make progress in the provision of NVQ 2 and 3 training. 3 staff recruitment files were inspected on this occasion. They contained evidence of CRB checks (including POVA first checks), 2 written references, criminal convictions declarations, proof of identity (including a photograph) and completed application forms – these included a detailed work history and a declaration relating to the prospective employees health status. Checks are made and recorded in respect of the status of registered nurses with their registered body. Training records and discussion with staff indicated that they were provided with induction training on commencing employment. There was also documentary evidence that staff had been provided training in moving and handling, safeguarding, fire safety and basic food hygiene and other relevant topics. Westwood Lodge DS0000067836.V365986.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 good. This judgement has been made using available evidence including a visit to this service. Management of the home is generally well organised. However there are still issues regarding staffing levels that are in need of addressing by the registered provider and registered manager. EVIDENCE: The registered manager is a registered nurse who has the required qualifications and experience and manages the home in such a way that seeks to meet the aims and objectives of the home. A deputy manager, senior nurses and an administrator support the manager in her role. Westwood Lodge DS0000067836.V365986.R01.S.doc Version 5.2 Page 22 Discussion with residents, their relatives, and staff revealed that the manager adopts an approach that enables issues to be easily discussed with her and that emphasis is placed on operating the home in the best interests of the residents. However although some aspects of staffing provision has improved issues regarding staffing levels on the ground floor and more often the top floor units of the home are rightly perceived by residents, their relatives and staff as being a management issue (for the registered provider and registered manager) that need to be regularly reviewed/addressed. Management policies are in place. The manager operates company procedures that seek to ensure the quality of the service provided is good. The manager and her team regularly conduct formal audits of various aspects of systems and procedures operated by the home. For example residents care records are periodically checked to ensure they properly reflect the care and support needed by residents and also demonstrate care and support is delivered (however issues with care records identified in the health and personal care section of this report suggests that this aspect of quality monitoring should be reviewed). Questionnaires are sent (by the company that operates the home) to seek the views of residents, relatives and staff, about the home. It is recommended that these groups are informed about the results of these surveys – possibly through the 3 monthly meetings the manager holds for relatives and the regular newsletter produced by the home. The manager’s area manager also visits the home regularly to support the manager. Measures were in place to ensure that residents’ financial interests are safeguarded. Residents are encouraged to control their own money. However where they are unable (or choose not to) personal allowances are managed by the home. The health, safety and welfare of residents and others are promoted and protected. For example staff are provided with regular training and appropriate equipment to ensure resident’s moving and handling needs are met – an example of this would be for a resident who needs to be safely moved with the aid of a hoist. Fire safety training is regularly provided. The premises were secure at the time of this unannounced inspection. The passenger lifts that enable residents and others to access all areas of the home have been serviced as has all hoisting equipment used in the home. Significant events in the home including accidents and illness are recorded and reported (as required legally) to the CSCI. Westwood Lodge DS0000067836.V365986.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 2 9 3 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 3 17 X 18 3 3 3 3 3 X 3 X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Westwood Lodge DS0000067836.V365986.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15(1) Requirement Timescale for action 31/07/08 2 OP27 18(1)(a) It is confirmed in writing that residents Care plans detail how their health and care needs are to be met That the CSCI is informed in 31/07/08 writing that staffing provision at the home has been reviewed and that adequate/appropriate staff are being provided to meet the care and support needs of service users 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. Refer to Standard OP7 OP9 OP12 Good Practice Recommendations That care plans/risk assessments should be formally evaluated at least monthly. That all handwritten entries on resident’s medication administration records are witnessed and signed by 2 staff. That the time allocated to providing leisure/social activities for residents is increased. DS0000067836.V365986.R01.S.doc Version 5.2 Page 25 Westwood Lodge 4. 5. OP18 OP33 That all senior nursing/care staff at the home access local training in safeguarding to ensure senior staff are aware of local safeguarding processes. That methods of communicating the outcome of quality assurance questionnaires to residents, relatives and staff are developed Westwood Lodge DS0000067836.V365986.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Westwood Lodge DS0000067836.V365986.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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