Inspection on 07/07/08 for Willoughby House

This inspection was carried out on 7th July 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

Willoughby House 01/07/09

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Snydale Care Home

Larchfield Manor

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

CARE HOMES FOR OLDER PEOPLE Willoughby House St Johns Road Cudworth Barnsley South Yorkshire S72 8DE Lead Inspector Michael O`Neil Key Unannounced Inspection 7th July 2008 09:15 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Willoughby House DS0000071376.V367151.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. Willoughby House DS0000071376.V367151.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Willoughby House Address St Johns Road Cudworth Barnsley South Yorkshire S72 8DE 01226 717152 F/P 01226 717152 wendy.lovely.willoughby.house@googlemail.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Flagswan Two Ltd Manager post vacant Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Willoughby House DS0000071376.V367151.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 40 The maximum number of service users who can be accommodated is: 40 Random 04.06.08 2. Date of last inspection Brief Description of the Service: Willoughby House was formerly a vicarage that was adapted and extended to provide accommodation for up to forty service users. The property is in its own grounds and car parking is available. Accommodation is on two levels serviced by a passenger lift. It has 20 single bedrooms and 10 double bedrooms. The home is situated off the main Barnsley to Pontefract road in the village of Cudworth. It is within walking distance of all shops and local amenities in Cudworth. Barnsley town centre is approximately four miles away. Flagswan Two Ltd were registered with the CSCI as the new owners of Willoughby House in February 2008. The weekly fee is £351.50 per week. Hairdressing, chiropody, newspapers and toiletries are not included in the weekly fee and were charged separately. The manager supplied this information during the site visit on 7th July 2008. Willoughby House DS0000071376.V367151.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 that the people who use this service experience adequate quality outcomes. This was an unannounced key inspection carried out by Mike O’Neil, regulation inspector on 7th July 2008. Mike O’Neil and Jayne White, regulation inspectors, and Kevin Gouvier, South Yorkshire Fire and Rescue Service (SYFARS) also carried out a random inspection at the service on 4th June 2008. The random inspection was carried out because some anonymous concerns had been raised over some aspects of the environment at Willoughby House that may have affected people’s safety and welfare. Some findings from the visit On 4th June 2008 are also included in this report. Wendy Lovely is the manager and was present during both visits. Wendy is in the process of submitting an application to the CSCI to become the registered manager. Surveys, regarding the quality of the care and support provided, were sent to people staying in the home and their relatives. We received three questionnaires from people using the service and four from relatives. Comments and feedback from these surveys have been included in this report. On the day of the visits opportunity was taken to make a partial tour of the premises, inspect a sample of care records, check records relating to the running of the home, check the homes policies and procedures and talk to eight staff, five relatives and eleven people who live there. The CSCI inspectors visited Willoughby House for a total of 10.25 hours. We wish to thank the people living in the home, staff, and relatives for their time, friendliness and co-operation throughout the inspection process. What the service does well: People looked clean, well dressed and had received a good level of personal care. People said “The staff are very friendly” Willoughby House DS0000071376.V367151.R01.S.doc Version 5.2 Page 6 “I’m very happy here, I have a good standard of life” “The staff are marvellous.” Relatives said “Staff are very caring I can’t fault them” “The staff are brilliant” Relatives added that they always observed staff treat people in a “respectful and dignified way”. Relatives spoken to said they were able to visit at any time and were made to feel very welcome. We saw that everyone coming to the home was offered hospitality and staff took time to make sure friends and family were made to feel comfortable whilst visiting. People said that they felt very comfortable in going to the manager knowing that any concerns they may have would be addressed without delay. The home was clean and no unpleasant odours were noticeable. People spoke highly of the staff team and said staff always listened and acted on what they said. People said that staff were “always” available when needed. Staff interviewed said that they enjoyed working at the home and got a lot of job satisfaction. Staff were able to talk about the various training courses that they had attended. What has improved since the last inspection? This was the first inspection since registration. The following improvements have been noted in the last few months: New bedroom furniture has been purchased. Major works to repair the lift and electrical system have been, or are near to, completion. Some communal areas have been redecorated. Since the last visit in June 2008, some unpleasant smells found at that time have been eradicated. The manager is now informing the CSCI of any incidents that have occurred at the service. Willoughby House DS0000071376.V367151.R01.S.doc Version 5.2 Page 7 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. Willoughby House DS0000071376.V367151.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Willoughby House DS0000071376.V367151.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3. Standard 6 is not applicable to this home. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including random and key inspection visits to this service. People were individually assessed prior to admission to ensure their needs could and would be met. EVIDENCE: Care plans showed that people within the service had been assessed before moving into the home. Risk assessments and a detailed plan of care reflected any specialist interventions. The manager and staff liaised with professionals, the person and their families to find out about peoples needs. The manager visited people and undertook assessments, prior to admission. Willoughby House DS0000071376.V367151.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): Standards 7, 8, 9 and 10. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including random and key inspection visits to this service. Each person had a plan of care, however these did not include sufficient detail to ensure that all peoples needs were being met. People were however treated with respect and said they were very happy with the care they received. In the main medication procedures protected people’s health and welfare. EVIDENCE: Three peoples care plans were checked. The peoples care plans checked were good in that they contained some details about the person’s personality and their preferences and choices. Risk assessments were included within the documentation and included moving and handling, nutritional, skin integrity, and other risk factors. Willoughby House DS0000071376.V367151.R01.S.doc Version 5.2 Page 11 The care plans however were inadequate because: Staff failed to develop a care plan when the risk assessment, mentioned above, identified that the person was at risk of developing pressure sores. Staff, when writing peoples daily notes, were not being reflective of the information actually recorded in the persons care plan. Therefore, there were no records to evidence that staff had met certain care needs of people over several days. Documenting “fine today” is not sufficient when recorded, in isolation, in a person’s daily record. Staff had failed to date and record the time when writing peoples notes. Staff need to remember that peoples care plans and daily notes are a legal document. People looked clean, well dressed and had received a good level of personal care. People said “The staff are very friendly” “I’m very happy here, I have a good standard of life” “The staff are marvellous” Relatives said “Staff are very caring I can’t fault them” “The staff are brilliant” “I’m kept informed about what is going on and whenever I visit the staff are always the same friendly, kind and helpful” Medicines were securely stored in locked trolleys within a locked room. Medicine Administration Records (MAR) checked were completed with staffs’ signatures. Peoples health and welfare was not fully protected however because; Some handwritten MAR sheets checked did not contain General Practitioners or two members of staffs’ signatures alongside any directions regarding the dosage of the medication or the time the medication was to be given. Willoughby House DS0000071376.V367151.R01.S.doc Version 5.2 Page 12 A drug controlled under the Misuse of Drugs legislation was being incorrectly stored. The medicine needed to be stored in controlled drug cabinet but was actually being stored in the medicine trolley. After consultation with the local pharmacy, arrangements were made by the staff to store the medicine appropriately and safely. Staff said they had received medication training. We saw certificates of this training. Staff were aware of the need to treat people with dignity and respect and were observed interacting in a friendly and pleasant way. Relatives said they always observed staff treat people in a “respectful and dignified way”. Willoughby House DS0000071376.V367151.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): Standards 12, 13, 14 and 15. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including random and key inspection visits to this service. People had a choice of lifestyle within the home and were able to maintain contact with family and friends ensuring that they continued to be involved in community life. People were able to make choices about daily living and be involved in some social activities. Meals served at the home were of a good quality and offered choice to ensure people receive a balanced diet. EVIDENCE: People said they were able to get up and go to bed when they chose, and were seen to walk freely around the home, if able. Relatives spoken to said they were able to visit at any time and were made to feel very welcome. We saw that everyone coming to the home was offered hospitality and staff took time to make sure friends and family were made to feel comfortable whilst visiting. Willoughby House DS0000071376.V367151.R01.S.doc Version 5.2 Page 14 People and relatives said that there were activities planned including parties and entertainers visiting the home. We saw that some people welcomed the opportunity to undertake simple activities and talk to staff or other people in the home. A game of bingo was held in the morning. A good number of people joined in with the game, which they said, they had enjoyed. The mealtime experience for people in the home was positive. Tables were nicely set. Everyone was offered a drink as they arrived at the table. Staff were supporting people with their meal in a polite and discreet way. People said “The food is very good” “I’m enjoying my meal” The cook was aware of peoples special dietary needs and said that people were asked each morning what they wanted for lunch. Willoughby House DS0000071376.V367151.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): Standards 16 and 18. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including random and key inspection visits to this service. Complaints procedures were in place and people and their relatives felt confident that any concerns they voiced would be listened to. Staff had an understanding of the procedures to be followed should they suspect any abuse at the home, so helping to ensure that people were protected from abuse. EVIDENCE: People and their representatives had been provided with a copy of the homes complaints procedure, which was also on display in the entrance hall. This contained details of who to speak to at the home and who to contact outside of the home to make a complaint should they wish to do so. People said that they felt very comfortable in going to the manager knowing that any concerns they may have would be addressed without delay. Regarding safeguarding adults, the safeguarding policies and procedures were available to the staff. Staff had undertaken Safeguarding Adults training, and the manager was able to evidence this by producing the training records. Willoughby House DS0000071376.V367151.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19,25 and 26. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including random and key inspection visits to this service. Some of the homes environment was not well maintained which meant that some people did not live in a comfortable and safe environment. EVIDENCE: The home was clean and tidy and no unpleasant odours were noticeable. A member of staff said a new carpet cleaner had been purchased and this had helped to eradicate unpleasant odours that were noticeable at our visit in June 2008. Lounge and dining areas were domestically furnished to a good standard. In the last few months’ new bedroom furniture has been purchased and communal areas have been redecorated. Willoughby House DS0000071376.V367151.R01.S.doc Version 5.2 Page 17 People said they were very comfortable at the home. They had a variety of furniture and touches such as ornaments and pictures that gave their rooms a homely feel. Some areas of the home are in need of refurbishment and redecoration. The paintwork on large sections of the corridors is damaged and needs redecoration. Also the carpet in some areas of the corridor needs replacing and the lighting around several areas of the home is poor. The garden was accessible but in need of landscaping. A safe seating area also needs to be provided for people to use. It was confirmed by the manager, staff and people who live at the home that the heating and boilers in the home had not been providing heat or hot water to some areas of the home including people’s bedrooms. We made a requirement in June 2008 to rectify the problem by 01 August 2008. We spoke to people on both of our visits. People said they had been offered alternative rooms whilst the heating problem was fixed but they had declined. They all said they were warm enough. A Plumber was on site replacing a boiler on the day of this visit and he confirmed that he was due to meet with the provider the next day to plan a course of action to solve the heating problem. Willoughby House DS0000071376.V367151.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including random and key inspection visits to this service. Staff were employed in sufficient numbers. Recruitment procedures did not fully protect people. People receive care from a well-trained staff team. EVIDENCE: People spoke highly of the staff team and said staff always listened and acted on what they said. People said that staff were “always” available when needed. Staff and the manager confirmed that staffing levels were adequate. On examination of the staff training records there were records that indicated the staff had received moving and handling, fire training and other relevant clinical training. Staff interviewed said that they enjoyed working at the home and got a lot of job satisfaction. Staff were able to talk about the various training courses that they had attended. Staff were attending training on the day we visited the service. Willoughby House DS0000071376.V367151.R01.S.doc Version 5.2 Page 19 Three staff records of employment were checked. Recruitment procedures were not satisfactory because two files did not include a reference from the staff member’s last employer or a Criminal Records Bureau (CRB) check. One file did not provide proof of identity. The manager had to email head office to confirm that CRB checks had been obtained. We did see an email confirming the reference number of the CRB checks for the appropriate staff members. Full and relevant information in respect of each person employed must be kept together, be fully complete and made available or kept at the care home. Willoughby House DS0000071376.V367151.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,32, 33, 35, and 38. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including random and key inspection visits to this service. The procedures and ethos of the home ensure that in the main the home is run in the best interests of people who use the service. The services policies and procedures mean that the health, safety and welfare of people is not fully protected. EVIDENCE: A manager, Wendy Lovely, has been appointed to the service. Her position had been discussed with the CSCI.She is in the process of submitting an application Willoughby House DS0000071376.V367151.R01.S.doc Version 5.2 Page 21 for registration to become the registered manager. Wendy has several years experience within the caring profession and is currently working towards achieving her Registered Mangers Award. People staff and relatives said they were all happy to approach the manager at any time for advice, guidance or to look at any issues. Some staff did express concerns over the current management systems at the service. Staff said that repairs were taking too long and that senior management was not always returning calls when a crisis had occurred at the weekend or in the evenings. Staff gave examples where the home had been without electricity overnight and without hot water in the kitchen area because they were unable to request the services of plumbers or electricians. Staff also said equipment they had requested had not been delivered at the home and the whereabouts of the order was unknown. There appears to be issues and concerns surrounding procedures and communication in the management systems at Willoughby House. This management issue needs addressing urgently so that it does not affect the direct care that people view very highly. Meetings with management and staff need to happen frequently so that the communication channels are clear, and all staff are aware of the procedures to follow for the ordering of equipment and the maintenance of services. The home had a quality assurance system. There was evidence of internal auditing of the homes environment, services and records. Staff meetings were held and minutes of these meetings were seen. The responsible individual visited the home on a regular basis, a report was written following the visits. People who use the service and their families met with the manager of the home. These quality assurance systems will help to ensure that the service is operating in the best interest of the people who live there. A sample of monies that was looked after on behalf of people living at the home was checked. Records were kept and money tallied with the records. Kevin Gouvier, SYFARS and Mr M Hardy, Barnsley Regulatory Services, Barnsley Metropolitan Borough Council, have visited the service over the past month and made recommendations and requirements relating to the environment. We have liaised closely with these agencies. The agencies have informed us that the providers are cooperating with them and have given them assurances that works required will be completed. Willoughby House DS0000071376.V367151.R01.S.doc Version 5.2 Page 22 The major phase 3 electrical works have nearly been completed. The manager and maintenance man told us that the final connection and completion of the work would take place on 11th July 2008. The manager is notifying us without delay any event within the care home, which adversely affects the well-being or safety of any person. This was a requirement made at the inspection in June 2008. Staff said they had received recent fire safety and other health and safety training .A sample of records showed that staff were receiving this statutory training. At the time of the visit fire exits were clear and hazardous products were safely stored in the home. The fire risk assessment had been reviewed in April 2008. No issues requiring attention were highlighted in the review. This will promote the safety and welfare of the people. Willoughby House DS0000071376.V367151.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 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X 2 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 3 X 3 X X 2 Willoughby House DS0000071376.V367151.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 Requirement The care plan must set out in detail the action, which staff need to take to meet all aspects of the health and personal needs of the person. The persons daily notes must reflect the information actually recorded in the persons care plan. Staff must clearly record the date and time when entries are made in peoples daily notes. Controlled drugs must be stored safely according to the misuse of drugs legislation. Where handwritten entries are added to medication administration record charts, these must be signed and dated and all relevant information must be included. A programme of renewal of the fabric and decoration must be produced, and work started to implement the plan. Work to fix the heating must be commenced by the timescale for action date. People must be continually DS0000071376.V367151.R01.S.doc Timescale for action 01/10/08 2. OP7 15 01/10/08 3. 4. 5. OP7 OP9 OP9 15 13 13 01/10/08 01/08/08 01/08/08 6. OP19 23 01/12/08 7. OP25 16,23 01/08/08 Willoughby House Version 5.2 Page 25 8. OP29 17 19 9. OP32 12 10. OP38 23 consulted regarding their comfort. Additional safe heating systems must be provided in the effected rooms if required. This will ensure that people’s safety and comfort are maintained. Full and relevant information in 01/10/08 respect of each person employed must be kept together and made available or kept at the care home. The registered provider and 01/10/08 registered manager must maintain good personal and professional relationships with each other and staff. To maintain peoples safety major 01/08/08 phase 3 electrical works must be completed. 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. Refer to Standard OP19 OP32 Good Practice Recommendations A safe and suitable garden/seating area should be created for people. Regular meetings with the management and staff should be held to ensure that the processes for managing and running the home are open and transparent. Willoughby House DS0000071376.V367151.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Willoughby House DS0000071376.V367151.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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