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Inspection on 26/02/08 for Willowbank Residential Home

Also see our care home review for Willowbank Residential Home for more information

This inspection was carried out on 26th February 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

What has improved since the last inspection?

The home has continued to work on developing a more person centred approach in their care plans. This means that residents` care needs are known and staff members are able to provide consistent care that reflects the wishes, dignity and aspirations of residents. All staff files now contain a record of all training the individual member of staff has completed. There has been a significant improvement in the training events staff have attended during the past twelve months. This improvement means that the management of the home are safeguarding the wellbeing of the residents by employing suitably skilled workers.

What the care home could do better:

Although care plans had been improved, there were still areas that could be further developed. These included making sure that directions to staff about how support is to be offered/given is clear and statements such as `one member of staff to assist with bath` is further expanded to say exactly what the assistance required is. Again, risk assessments for things such as helping to maintain individuals mobility need more information about how the risk is to be appropriately managed. The way in which medication is administered needs to be improved to make sure that residents receive their medication when they should and that staff do not sign for medication that has not been administered. Such errors could place residents health at risk. Facilities that should be available for use by residents such as bathrooms must not be used for storage. This can place the health and safety of residents at risk.

CARE HOMES FOR OLDER PEOPLE Willowbank Residential Home 134/136 Seymour Road South Clayton Manchester M11 4PS Lead Inspector John Oliver Unannounced Inspection 10:00 26 February 2008 th 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 Willowbank Residential Home DS0000061407.V348835.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. Willowbank Residential Home DS0000061407.V348835.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Willowbank Residential Home Address 134/136 Seymour Road South Clayton Manchester M11 4PS 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) 0161 370 9080 Nageeb Aubdool Nazmah Aubdool Nageeb Aubdool Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Willowbank Residential Home DS0000061407.V348835.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The numbers of service users accommodated must not exceed thirteen (13) service users who require personal care only by reason of old age (OP). Staffing arrangements at the home must be maintained in line with minimum levels specified in the Residential Forum guidance ` Care Staffing in Care Homes for Older People`. The home must employ, at all times, a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 27th February 2007 Date of last inspection Brief Description of the Service: Willowbank is a residential care home offering accommodation and personal care for up to 13 elderly persons. At the time of the inspection there were 9 residents accommodated with 4 vacant places. The home is situated in Clayton in the north of the city in a quiet residential area close to local amenities. The home was previously two semi-detached houses, which have been adapted to form one property with ramp access to the front of the building. The home has small well-maintained gardens and a patio area accessed by patio doors from the lounge. Parking is available on the road and at the side of the building. The home offers accommodation in 3 double and 7 single bedrooms. There are two lounges with combined dining space. The fees charged for the home are £374:52 per week. Willowbank Residential Home DS0000061407.V348835.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. We came to this quality rating at the last key inspection. The inspection was undertaken as part of a key inspection, which includes an analysis of any information received by us (the Commission for Social Care Inspection) in relation to the home prior to the site visit. This visit, which the home did not know was going to happen, took place over the course of 6 hours on Tuesday 26th February 2008. During the course of the site visit we spent time talking to the residents, the registered manager (owner) and staff on duty to find out their view of the home. Before the site visit we sent the manager of the home an Annual Quality Assurance Assessment (AQAA) document for them to complete and return to us with information about the service they provide. This was returned before the visit took place and contained a lot of good information that helped us to assess the service being offered by the home. We also spent time examining various files and written information and spent some time look around the building. What the service does well: We found that residents were treated with dignity and respect and were treated as individuals. When speaking with the management and care staff team it was clear that they understood the importance of ensuring that residents knew the house was their home and as such had choices about how they wanted to spend their day. The atmosphere in the home was warm, welcoming and friendly. People living the home said that they enjoyed living there and that they were well looked after and staff were very good. One resident told us, “I am very happy living here – I am looked after well”. One relative told us, “Staff are good, willing to care – the care is extremely good – goes far beyond the call of duty”. Residents can furnish their individual bedrooms to reflect their character and personal choices. This respected residents’ diverse needs. Willowbank Residential Home DS0000061407.V348835.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Willowbank Residential Home DS0000061407.V348835.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 Willowbank Residential Home DS0000061407.V348835.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. Prospective residents are provided with information regarding the service prior to admission and receive a full assessment of their needs. EVIDENCE: The manager told us that all prospective residents are assessed prior to being admitted into the home and we looked at the file of one recently admitted person. We saw that a member of the nursing staff team from the Primary Care Trust (PCT) had carried out an assessment of need. We also saw that the manager of the home had visited the resident prior to moving into Willowbank in order to carry out his own assessment of need and that this assessment included comments made by the resident during that assessment process. We spoke to this resident who was able to tell us that she had lived in Willowbank for about five weeks and that she was happy with how her admission into the home took place. She said that ‘everybody is very kind’ Willowbank Residential Home DS0000061407.V348835.R01.S.doc Version 5.2 Page 9 and that she knew who to speak to if she was concerned or unhappy about anything. The information gathered from both assessments was then used to develop an initial care plan for the resident. Evidence was also available to demonstrate that the manager had recently visited another prospective resident in Tameside General Hospital in order to carry out an assessment of need. The manager told us that the home did not provide an Intermediate Care service. Willowbank Residential Home DS0000061407.V348835.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. Care plans were in place that detailed the needs of the individual resident. Current medication practice does not ensure the safe handling and administration of medication in the home. EVIDENCE: Each resident at the home had a care plan that detailed their individual needs and how those needs should be met. These plans have been developed from the initial assessments carried out prior to moving into the home and then further developed on an ongoing basis. Those care plans we looked at included information relating to health and personal care needs, mobility, social interests and risk assessments, and were reviewed by the manager on a monthly basis. Information was mainly person centred, but in some instances, lacked enough information for staff to be clear about what they needed to do. For example, one care plan stated ‘one member of staff to assist with bath’. More information is required to ensure Willowbank Residential Home DS0000061407.V348835.R01.S.doc Version 5.2 Page 11 that the needs of the resident are fully met and the member of staff knows exactly what assistance is required from what is stated in the care plan. Wherever possible, these had been signed and dated by the resident and or their relative, for example ‘I have read and agree with everything in this care plan’. We saw evidence that the manager had reviewed care plans on a monthly basis. Risk assessments were in place for things such as mobility, but again, needed more information to direct staff about how the risk was to be appropriately managed. We saw written evidence that other healthcare professionals such as the district nursing service, General Practitioners and Chiropodist regularly visited the home to meet resident’s needs. During our visit to the home we had the opportunity to speak on the telephone with the relative of one resident. This relative told us ‘Care is extremely good; I am kept informed about…care plan and my relatives’ health has improved 200 since Mr & Mrs Aubdool have owned the home’. The manager told us that since the last inspection visit he has purchased a set of sit-on weighing scales in order to monitor the weight of each resident. Residents spoken to told us ‘”Staff are good” and “Staff are really helpful”. Management of medication is via a monitored dosage system provided by a local pharmacy and medication was stored in a lockable medication trolley that was secured to the wall. The manager confirmed that all staff with the responsibility for administering medication had received relevant training and those staff training records we examined indicated that appropriate training had been received. There is a Medication Administration Record (MAR) for each resident that details what medication they are currently taking. A photograph of the resident is also displayed on the front of this sheet to ease identification. The manager confirmed that he collects monthly prescriptions directly from the surgery and checks them for accuracy before sending them to the pharmacy for dispensing. We looked at the MAR for one particular resident, which indicated that a previously prescribed medication had been discontinued. Although none of this medication had been administered, staff were still signing the MAR as if they had been. This demonstrated that staff are not following relevant procedures when administering medication, which could place residents at potential risk from errors occurring. Also, Tramadol Capsules 50mg had been prescribed one to be taken four times daily. 112 capsules had been supplied for the month and signatures indicated that 100 had been administered, leaving 12 capsules Willowbank Residential Home DS0000061407.V348835.R01.S.doc Version 5.2 Page 12 still to be dispensed. We found that 28 capsules were still left, demonstrating that staff had been signing for but not dispensing medication. This indicated that this particular resident did not receive their medication as prescribed and could be placed at risk. Details of discontinued medication were also still appearing on some individual MARs. This can be confusing and the manager should request that such details be removed from MARs as soon as the General Practitioner discontinues the medication. Controlled medication was stored in a lockable cabinet away from the medication trolley. This lockable cabinet does not meet the requirements of the Misuse of Drugs (Safe Custody) Regulations 1973. One resident was on a controlled medication and the controlled drugs book was checked and was found to be correct. The managers and member of staff spoken to during the visit had a good understanding of the physical and emotional needs of people in respect of maintaining their privacy and dignity. We saw that staff knocked on doors, that residents were sensitively assisted to the toilet and during meal times were supported on a one to one basis. Residents are offered a key to their bedrooms unless a risk assessment states otherwise and keys to a lockable space are given to all new people on admission. Willowbank Residential Home DS0000061407.V348835.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 good. This judgement has been made using available evidence including a visit to this service. Daily routines in the home demonstrated that residents were encouraged to maintain control over their lives, maintain contact with their family and friends and to participate in leisure activities. EVIDENCE: The home provided a range of activities for the residents on both an informal and formal basis and records were kept of such events and those residents involved. Residents told us that each morning they have a session of gentle exercise with the manager where they move their arms and legs ‘to get the circulation going’. Other activities include bingo, current affair discussions, reminiscence sessions, and board games, watching movies and, when the weather is fine, trips out. Residents said that they could choose whether they wanted to be involved in the activities on offer. The deputy manager is a qualified beautician and carries out regular ‘pampering’ sessions. Meals in the home were planned using a four-week menu, which was regularly discussed with the residents. The manager told us that should the residents not want any of the available choices on the menu then something else would Willowbank Residential Home DS0000061407.V348835.R01.S.doc Version 5.2 Page 14 be prepared. On the day of the inspection visit all the residents had chosen to have potato hash. Although this was served hot and tasted fine the appearance was bland and lacked any additional colour from things such as vegetables. Residents told us ‘Food is good – I like a good dinner’ and ‘I usually enjoy the meals here – you can have something different if you want’. No record was kept on a daily basis of the food prepared and this was discussed with the manager. It would be good if such a record were kept so that nutritional intake for each resident could be monitored and appropriate diets maintained if necessary. We saw that relatives and friends were encouraged to visit at any time and the residents we spoke to confirmed this. Residents also told us that they could follow their own routines and make choices about their daily lifestyle such as what time to get up and what time to go to bed. Willowbank Residential Home DS0000061407.V348835.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 good. This judgement has been made using available evidence including a visit to this service. Policies, procedures and training measures were in place for staff to support residents to raise any issues of concern and to protect residents from neglect and abuse. EVIDENCE: The home had a complaint procedure that was detailed in both the Statement of Purpose and the Service Users’ Guide. It was also displayed in prominent places throughout the home. Information in this procedure needed to be reviewed and updated to reflect the new contact details for the Commission for Social Care Inspection. The manager told us that since the last inspection visit all staff had participated in adult safeguarding training with Manchester City Council. We examined a number of staff files and the training records confirmed this. Residents told us that they knew who to talk to if they had any concerns or worries and one resident said ‘I would go straight to the manager’. Further discussion with the manager and a member of staff on duty confirmed that they had a clear understanding of the policy and procedures relating to the safeguarding of vulnerable adults. Willowbank Residential Home DS0000061407.V348835.R01.S.doc Version 5.2 Page 16 We have had no complaints about the home since the last inspection visit and there have been no safeguarding investigations undertaken. Willowbank Residential Home DS0000061407.V348835.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 adequate. This judgement has been made using available evidence including a visit to this service. The environment was generally clean, tidy and comfortable but some areas of the home could place residents at risk. EVIDENCE: We had a look around the building and found the home to be reasonably clean, tidy and well kept. Rooms have been personalised to reflect the character of the person whose room it is and a number of rooms had new carpets fitted and new UPVC double glazed windows. New carpets had also been laid in the lounge, dining area and downstairs corridors and a number of new armchairs had also been purchased. Since the last inspection visit the bath in the downstairs bathroom had been removed and replaced with a ‘wet room’ after consultation with the residents. Willowbank Residential Home DS0000061407.V348835.R01.S.doc Version 5.2 Page 18 The manager told us that all the residents enjoy using this facility. During the tour of the premises it was noted that the upstairs bathroom is inaccessible as it is being used to store furniture, bedding and resident’s clothing. This not only looked unsightly and prevents residents from having a choice between taking a bath or a shower but is also a health and safety risk. The windowpane in this bathroom is cracked and needs replacing to minimise any risk to residents who may eventually use this bathroom. Paintwork is also flaking off the walls in parts and looks unsightly. Willowbank Residential Home DS0000061407.V348835.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 good. This judgement has been made using available evidence including a visit to this service. Sufficient numbers of staff are employed in the home with improved staff training and development helping to ensure staff are competent to carry out their jobs. Good recruitment and selection processes helps to protect residents from unsuitable people working in the home. EVIDENCE: The files of two members of staff were examined and both were found to contain relevant pre-employment documentation including references and enhanced Criminal Record Bureau (CRB) disclosures. Since the last inspection visit staff records indicated that much more training had taken place during the past 12 months and included Safe Handling of Medication, Moving and Handling, Health & Safety and Protection of Vulnerable Adults. The manager also told us that both he and the deputy manager had successfully completed the Registered Managers Award (RMA). We spoke with the carer on duty who confirmed the training she had done in the past six months and told us that the home was adequately staffed to meet the needs of the current residents living in the home. One relative spoken to told us “There are always enough staff on duty”. The management team were Willowbank Residential Home DS0000061407.V348835.R01.S.doc Version 5.2 Page 20 involved in delivering care to the residents due to the reduced number of residents currently living in the home but staffing levels should be monitored as part of the development of the service. It was confirmed by the manager that seven care staff are in the process of completing a National Vocational Qualification (NVQ) Level II in care. Willowbank Residential Home DS0000061407.V348835.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. Residents living in the home benefit from having the support of a management team with skills to provide a good quality service and procedures in place to promote their interests and well-being. EVIDENCE: When we spoke with the manager he was able to demonstrate a good understanding and knowledge of the residents’ needs. At the time of this inspection the home was not operating to full capacity and therefore the manager and his wife were taking a primary role in working with care staff in supporting the care of the residents. Willowbank Residential Home DS0000061407.V348835.R01.S.doc Version 5.2 Page 22 The manager has developed a questionnaire to survey both residents and relatives about the quality of the service the home and staff provides. The manager told us that the information gained from these questionnaires would be used to further develop the service and the results would be published in the Service User Guide. The manager did not deal with residents’ monies and only dealt with the personal allowance for one resident for which appropriate records were kept. Since the last inspection visit the manager has ensured that risk assessments had been put in place for those radiators not covered by a guard or guards had been fitted where found to be necessary. The manager told us within the information returned to us in the Annual Quality Assurance Assessment that all equipment used in the home was appropriately serviced and maintained and a random check of a number of servicing records confirmed this. Willowbank Residential Home DS0000061407.V348835.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 3 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 X 3 STAFFING Standard No Score 27 3 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 Willowbank Residential Home DS0000061407.V348835.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13 (2) Requirement Medication must be administered to people who use the service in accordance with the prescribers’ directions to ensure that the individuals’ health is not put at risk. To make sure Controlled Drugs are appropriately stored plans must be made to provide a Controlled Drugs cupboard which is compliant with current regulations Misuse of Drugs (Safe Custody) Regulations 1973. a) The upstairs bathroom must be cleared of all stored furniture, bedding and clothing. b) The cracked windowpane in this bathroom must be replaced. Timescale for action 26/02/08 2. OP9 13 (2) 27/06/08 3 OP19 13 (4) (a) (b) (c) 30/05/08 Willowbank Residential Home DS0000061407.V348835.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations a) Care plans should contain enough detail to support staff in meeting the residents’ needs in the most appropriate way. b) Risk assessments should contain enough detail to support staff in managing the identified risk in the most appropriate way. Food prepared on a daily basis should be recorded so that the nutritional intake for each resident can be monitored. Information relating to complaints should be updated to include the relevant details of how to contact the Commission for Social Care Inspection. The upstairs bathroom should be re-painted where paintwork has started to peel off the walls. Staffing hours/ratios should be kept under review to ensure that the needs of the residents are met at all times. 2 3 OP15 OP16 4 5 OP19 OP27 Willowbank Residential Home DS0000061407.V348835.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 Willowbank Residential Home DS0000061407.V348835.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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