Inspection on 29/01/07 for Wortley Lodge

This inspection was carried out on 29th January 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Wortley Lodge 27/11/07

Wortley Lodge 25/01/06

Wortley Lodge 15/08/05

Wortley Lodge 08/10/04

Wortley Lodge 28/06/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Wortley Lodge 26 Wortley Road East Ham London E6 1AY Lead Inspector Nurcan Culleton Unannounced Inspection 29th January 2007 10:00 Wortley Lodge DS0000022874.V326164.R01.S.doc Version 5.2 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 Wortley Lodge DS0000022874.V326164.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 Adults 18-65. 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. Wortley Lodge DS0000022874.V326164.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wortley Lodge Address 26 Wortley Road East Ham London E6 1AY 020 8472 9974 020 8472 9974 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) Mrs Pretim Singh Mrs Pretim Singh Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Wortley Lodge DS0000022874.V326164.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th January 2006 Brief Description of the Service: Wortley Road was registered in July 1995 as a 3 bedded home offering permanent accommodation for 3 adults with learning disabilities aged 18 to 65 years. The home comprises three single bedrooms, two bathrooms, large lounge, dining room fitted kitchen and has a paved garden. It is situated within the Upton Park area of East London, close to amenities and served by many bus routes to the area. The proprietor is also the manager of the establishment. The home excludes adults who have severe mobility problems, are doubly incontinent or who exhibit severe challenging behaviour. Wortley Lodge DS0000022874.V326164.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 29th January 2007. The Registered Manager was present to assist the inspector. At the time of inspection two service users were in the house. One service user had attended her day centre. The inspector spoke with the Support Worker on duty and both service users in the house. The inspector also toured the premises and examined a range of records and files, including staff and service users’ files. What the service does well: What has improved since the last inspection? What they could do better: The Statement of Purpose and Service Users’ Guide must be updated and the Service Users’ Guide must be available in a suitable pictorial format for the service users. Wortley Lodge DS0000022874.V326164.R01.S.doc Version 5.2 Page 6 The format of service users’ risk assessments needs to improve; the medication policy needs to include homely remedies; the recording practises of medication administration following service users’ overnight stays with family must improve; staff training records must be available and recorded staff supervision sessions are required on at least a bi-monthly basis. A financial and business plan is still outstanding from the previous inspection. A range of recommendations are given, including for the Manager to further expand the quality monitoring of the service as part of an ongoing system of finding ways to improve the service. 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. Wortley Lodge DS0000022874.V326164.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wortley Lodge DS0000022874.V326164.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is able to demonstrate that it is positively able to meet assessed service users’ needs. Prospective service users have the opportunity to visit prior to their admission and each service user is provided with a contract. EVIDENCE: The Statement of Purpose and Service Users’ Guide must be updated to reflect current staffing information. The Service User Guide must be available in pictorial form in a format suitable for the understanding of the service users. The Registered Manager informed that service users’ did not receive Local Authority assessments prior to their admission and the home’s completed preadmission assessments had been archived, though they had been seen and were satisfactory at previous inspections. It is recommended however that service users’ assessments are available for future inspections. The inspector was shown a policy stating that all service users require comprehensive assessments prior to their admission. Service users confirmed at previous inspections that they had visited the home before their placement. Satisfactory signed contracts are available in service users’ files. Wortley Lodge DS0000022874.V326164.R01.S.doc Version 5.2 Page 9 The home is able to demonstrate that it is able to meet service users’ needs through evidence seen in files, discussion with staff, service users and with the Registered Manager. The Manager informed, for example, that during the home’s summer holiday last year, one service user became uncomfortable in an unfamiliar environment to her. The possibility that she might become uncomfortable had been previously identified and measures were put in place to arrange for her supervised return to the home, whilst allowing the other two service users to continue to enjoy their holiday. The home also showed its ability to meet other individual service user needs, for example, one service user has a need to use a bath seat whilst bathing. Another service user who is Roman Catholic, is supported to attend church every Sunday. All three service users are from a white British background. Service users’ general daily routines and activities reflect their personal development needs and their individual choices. Wortley Lodge DS0000022874.V326164.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are consulted to take into account their needs and wishes. Service users are supported to take risks and participate in activities in the home and to develop independent living skills. Staff are familiar with and able to meet service users’ needs. EVIDENCE: The care plans (referred to as Support Plans in the home) were comprehensive, integrating the risk assessment, and identified needs including education/occupation, health, community participation, leisure, relationships, communication, personal care, finances emotional needs and religion. The service user or their representative signed each identified need. The risk assessments could be improved to identify a risk category, to indicate whether the risk is high, medium or low, the action to be taken, by whom and with a timescale. The Local Authority had reviewed one service user in August 2006, Wortley Lodge DS0000022874.V326164.R01.S.doc Version 5.2 Page 11 however the Local Authority reviews were outstanding for the other two service users and the Registered Manager informed of her efforts to engage the Local Authority. However all the care plans had been reviewed internally within the last six months. Staff support service users to manage their own finances. Their benefits are paid directly to their bank accounts and staff assist service users to access their money from their bank. Service users are enabled to take appropriate risks through being supported to engage in a variety of activities, inside and outside of the home, as outlined in below ‘Lifestyle’ section, to assist in their personal development and fulfilment. Wortley Lodge DS0000022874.V326164.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users continue to engage in consistent daily routines which enhance their opportunities for personal and social development and self-fulfilment. Service users’ rights are respected and their daily routines promote independence and choice. EVIDENCE: There continues to be a consistent routine of daily activities for the service users with no significant changes. Service users follow a full programme of activities to suit their individual needs and wishes both inside and outside of the home. One service user, who is non-verbal in communication, attends a day centre called Nu Life daily, where she engages in activities such as bowling, swimming, trips out, including going to a pub. Another service user also attends a day centre and two of the service users also attend college to take part in courses such as music, yoga, art and reading. Inside the home Wortley Lodge DS0000022874.V326164.R01.S.doc Version 5.2 Page 13 service users participate in arts and crafts, puzzle making, knitting, listening to music, cooking and watching DVDs borrowed from the library. In clement weather there are also trips out, including holidays. Service users are encouraged to undertake activities which promote their independence. One service user goes to the local shop independently. Staff support service service users to vote by taking them to the polling stations. One service user is able to prepare her own meals with support. Another prepares the dining table and is able to make tea for herself and others. Service users engage in domestic chores like cleaning. Service users have good opportunities to maintain contact with family members. One service users’ mother is closely involved with her daughter who has regular overnight stays at her mother’s house during the week. Her mother is consulted over all matters related to her daughter. The inspector observed on the pictorial menu board a choice of meals selected by service users, however a large proportion of the meals was observed to be convenient or processed meals in the records of meals consumed, such as chicken nuggets, quiche and fish cakes. It is recommended that these meals are kept to the minimum and more nutritious freshly cooked meals are provided instead. Wortley Lodge DS0000022874.V326164.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are offered personalised support tailored to meet their needs. Service users’ physical, mental and emotional needs are addressed and met in the home. Medication is appropriately administered. The medication policy could further improve. EVIDENCE: Records seen and observations made showed that the service users had medium to high level needs. Support workers offer full personal care support for one service user to varying levels as needed and prompt and offer supervision with personal care to the other two service users. Service users have good access to healthcare services, including their own GP and the Community Team where service users can access other facilities for their health care including mental health care needs. There are separate health files for all the service users. Staff guidelines were available from a psychologist for Wortley Lodge DS0000022874.V326164.R01.S.doc Version 5.2 Page 15 one service user, though none were presently seeing a psychologist. Medication records were appropriately maintained. The medication policy had been updated, however it also needs to include a policy on homely remedies. In addition, the home is advised to record the checks to confirm that medication has been administered, for example, through observation of the blister pack, following the return of one service user who regularly stays overnight with her mother and who has responsibility for ensuring that medication is given to her. The home must also ensure that any instances when medication has not been administered following overnight stays are also recorded and the reasons for this. Each service user has a signed statement concerning their death and dying personal wishes. Wortley Lodge DS0000022874.V326164.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ views are listened to and acted upon, leading to satisfied service users and a lack of complaints. Measures have been taken to protect service users from abuse, neglect and self-harm. EVIDENCE: There were no complaints logged in the complaints book. The lack of complaints and satisfaction felt by service users in the home was supported by interviews with the service users on the day of inspection and documents examined by the inspector. One service user firmly nodded her head and stated “yes” in answer to the inspector’s questions that staff in the home were nice, respectful to her and were supportive of her needs. The inspector examined service users’ views expressed in the minutes of the monthly residents’ meetings and quality assurance questionnaires. Positive views were noted. Statements included “I like living here”, “I feel well cared for”, “staff are supportive”, and areas such as respect for privacy, feeling safe were agreed with in the questionnaires. The complaints policy needs to be updated with the new CSCI contact details. Also the document must be revised to reflect that whilst service users may contact CSCI for advice or to discuss any concerns, the responsibility for investigating complaints remains with the home rather than with the CSCI. Staff have received adult protection training and there are no adult protection concerns. The adult protection policy was satisfactory. Wortley Lodge DS0000022874.V326164.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30 Quality in this outcome area is good.This judgement has been made using available evidence including a visit to this service. Service users environment is homely, comfortable and suitable for their needs. Rooms reflect the personal tastes and lifestyles of service users. EVIDENCE: The inspector toured the home. Bedrooms are sufficient to meet service users’ needs. Rooms were clean, tidy and personalised, reflecting individual tastes, including pictures on walls, photographs, other personal effects. The home was generally clean, tidy and homely. Service users are encouraged to maintain their own rooms. The inspector was satisfied that the home meets the needs of the service users. The home is generally in good order. The home has one bathroom on the first floor and one shower room on the ground floor. One service user has an electrically assisted bath seat to get in and out of the bath. There is a fitted kitchen with a comfortable dining area including sofas and a TV adjoining the kitchen and lounge with two sofas, television and a music system. Wortley Lodge DS0000022874.V326164.R01.S.doc Version 5.2 Page 18 There is also a paved garden at the back of the house. The home does not cater for any other specialist disability equipment. The paintwork on the lounge wall had been chipped which became exposed when the old sofas were replaced with new ones. The Registered Manager informed that the room was due to be repainted to match the new sofas. Wortley Lodge DS0000022874.V326164.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from having a stable and consistent staff team who are familiar with service users’ needs and clear about their roles and responsibilities. There are sufficient staff numbers and staff are supported to carry out their duties. The home operates a well functioning team with sound recruitment practices. EVIDENCE: There are currently three permanent staff members employed, one of whom is a senior support worker and one is a bank member of staff. Each shift consists of the manager and one support worker. One staff member is on sleep-in duty at night. The inspector examined all of the staff files. Staff files examined contained all required documentation , including CRBs and references and were in good order. Wortley Lodge DS0000022874.V326164.R01.S.doc Version 5.2 Page 20 The support worker interviewed had a good understanding of the needs of the service users. The service users have been resident for a long period and the staff team in the home have been stable enabling staff to develop intimate knowledge and skills of working with the service users. Service users spoken to had limited communication skills, however when interviewed indicated that staff respect them and respond to their needs. This was evident also in minutes of the residents’ meeting. Staff have completed NVQ Level 2 and 3 courses. The inspector saw a range of other relevant training certificates in staff files. However staff training records must be kept updated for inspection purposes. The inspector noted that supervision notes were not readily available as outlined by minimum standards, nor were annual appraisals available. Formal recorded supervision sessions are required on at least a bi monthly basis. However the support worker informed that staff received good support from the Manager and it was evident that there is close and regular contact with the Manager who is on site throughout the week and is on call when absent. The Manager advised there was a good team spirit among staff. This was reiterated by the support worker. The last team minute meetings dated back to November. The next team meeting is now due. The Registered Manager must ensure that team meetings do take place at least every two months. It is recommended that the agenda of team meetings is further expanded to include different topics of policy and procedure. This could contribute to staff development and the ongoing improvement of the service. Wortley Lodge DS0000022874.V326164.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42, 43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a positive approach to the management of the home. Most records are in place. Systems are in place to safeguard the best interests of service users. Previous health and safety requirements were achieved. EVIDENCE: The Registered Manager has qualifications including NVQ Level 4 to support her in her management position. She also has a relevant background and experience in social work. There is a positive management approach to the home, also evident in the outcome of views expressed by staff and in minutes of meetings where service users expressed satisfaction with the staff, the support received and their contentment of living in the home. This was reaffirmed in annual quality assurance questionnaires completed by staff and Wortley Lodge DS0000022874.V326164.R01.S.doc Version 5.2 Page 22 service users. It is recommended however that further effort is put into seeking out the views of interested parties not directly using the service, for example, family members and professionals, for quality assurance purposes. It is also recommended that the Registered Manager considers ways of continually improving the service in her management planning and to consider any quality assurance views obtained. Most records required by regulations were available and were generally in good order and systems are in place to ensure the efficient running of the care home. Health and safety practices are observed. Water temperatures and fridge/ freeze temperatures are taken daily. Windows restrictors are now appropriately in place meeting a further previous requirement. Certificates of gas and electrical wiring safety were seen, and a previous requirement for a water safety certificate was available. The Registered Manager informed that the Portable Appliance Test had been completed last week and was awaiting a certificate, however she was unable to evidence this. It is recommended that all contractors sign in a book to evidence their visit and work conducted, which is helpful to the inspection process particularly whilst certificates are pending. There remains an outstanding requirement for the Registered Manager to ensure that a business and financial plan is available for inspection and this requirement must met within the timescale stated. Wortley Lodge DS0000022874.V326164.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 Adults 18-65 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 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 3 3 3 3 3 3 1 Wortley Lodge DS0000022874.V326164.R01.S.doc Version 5.2 Page 24 yes 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. 2. Standard YA1 YA1 Regulation 4 5 Requirement The Statement of Purpose and must be updated to reflect current staffing information The Service User Guide must also be updated and to be available in pictorial form in a format suitable for the understanding of the service users. The medication policy needs also to include a policy on homely remedies. Timescale for action 10/04/07 10/04/07 3. YA20 13(2) 10/03/07 4. 5. 6. YA35 YA36 YA43 18 18(2) 25 The home also must make checks when service users return from overnight stays with family and sign records to confirm that medication has been administered. Staff training records must be 10/04/07 kept updated for inspection purposes. Formal recorded supervision 10/03/07 sessions are required on at least a bi monthly basis. The Registered Manager must 10/04/07 ensure that a financial and business plan is available in the home. Wortley Lodge DS0000022874.V326164.R01.S.doc Version 5.2 Page 25 The timescale of 30/04/06 was not met. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard YA2 YA9 YA17 YA22 Good Practice Recommendations It is recommended however that service users’ assessments are available for future inspections. The risk assessments could be improved to identify a risk category, to indicate whether the risk is high, medium or low, the action to be taken, by whom and with a timescale. It is recommended that processed foods are reduced and more nutritious freshly cooked meals are provided instead. The complaints policy needs to be updated with the new CSCI contact details. Also the document must be revised to reflect that whilst service users may contact CSCI for advice or to discuss any concerns, the responsibility for investigating complaints remains with the home rather than with the CSCI. To ensure that the walls in the lounge are repainted as advised by the Registered Manager. It is recommended that all staff have annual appraisals. It is recommended that the agenda of team meetings is further expanded to include different topics of policy and procedure. It is recommended that further effort is put into seeking out the views of interested parties not directly using the service, for example, family members and professionals for quality assurance purposes and for developing the service. It is recommended that the Registered Manager finds ways of continually improving the service in her management planning. It is recommended that all contractors sign in a book to evidence their visits and work conducted. 5 6 7 8 YA24 YA36 YA36 YA39 9 10 YA39 YA42 Wortley Lodge DS0000022874.V326164.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection East London Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU 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 Wortley Lodge DS0000022874.V326164.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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