Inspection on 30/09/05 for Wyndham House

This inspection was carried out on 30th September 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Wyndham House 15/01/09

Wyndham House 21/11/08

Wyndham House 30/09/08

Wyndham House 03/04/08

Wyndham House 28/11/07

Wyndham House 24/07/07

Wyndham House 07/06/07

Wyndham House 14/12/06

Wyndham House 04/05/06

Wyndham House 02/02/06

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

CARE HOMES FOR OLDER PEOPLE Wyndham House Manor Road North Wootton Kings Lynn PE30 3PZ Lead Inspector Lella Andrews Unannounced 30 September 2005 th 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 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. Wyndham House I55 s64103 Wyndham House v244849 UN 300905(4).doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Wyndham House Address Manor Road, North Wootton, Kings Lynn, Norfolk. PE30 3PZ. 01553 631386 01553 631105 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Eaglecrest Care Management Ltd Position vacant Care Home 35 Category(ies) of Older People with Dementia (35) registration, with number of places Wyndham House I55 s64103 Wyndham House v244849 UN 300905(4).doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Home is registered for up to 35 older people with dementia Date of last inspection 02/12/04 Brief Description of the Service: Wyndham House is a large detached building in North Wootton, close to the town of Kings Lynn. The Home was originally a Victorian house which has been extensively extended. The Home provides care for up to thirty five older people who have dementia. There are twenty six single rooms and five shared rooms on the ground and first floors. The majority of the bedrooms are ensuite. Wyndham House I55 s64103 Wyndham House v244849 UN 300905(4).doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Inspection was unannounced and took place between10.15am and 5.30pm on Friday 30th September 2005. A quick tour of the building was undertaken although not all of the bedrooms were seen. The Manager was present throughout the Inspection and the Inspector also spoke to two members of staff on an individual basis. Several of the residents have communication difficulties but the Inspector spoke to two of the residents and also spent time in the dining room observing residents and staff. The Inspector spoke to two relatives during the day. A selection of records were also seen. The Home was bought by Eaglecrest Care Management Ltd in June 2005. Mr Fanibi is the Responsible Individual for the company. A new Manager, Mandy Smith, was appointed in July 2005 and has recently completed the Registration process with the Commission. The Commission has also recently agreed to change the registration of the Home so that it can provide care for up to thirty six (36) older people with dementia. What the service does well: What has improved since the last inspection? The Proprietor has undertaken a great deal of improvements to the environment in the four months since the Home was bought. These include raising the floor in the conservatory to remove the need for the residents to use steps. New carpets have been fitted in the dining room and some corridors. The garden is being landscaped and ramps and handrails fitted to enable the residents to use it safely. Trees have been cut down to increase the natural light into some of the bedrooms. Wyndham House I55 s64103 Wyndham House v244849 UN 300905(4).doc Version 1.40 Page 6 A new Manager was appointed in July 2005 who is providing effective leadership and working with the staff team to help them to work in different ways with the aim of improving the service provided to the residents. An Activities Co-ordinator has been employed recently and is organising activities every afternoon during the week. The care plans are being reviewed to see what information still needs to be in included The majority of the staff have received training with regard to working with older people with dementia 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. Wyndham House I55 s64103 Wyndham House v244849 UN 300905(4).doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Wyndham House I55 s64103 Wyndham House v244849 UN 300905(4).doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 5 Prospective residents needs are assessed prior to them moving into the Home Prospective residents and their relatives have an opportunity to visit the Home prior to moving in EVIDENCE: The Inspector looked at the records relating to four of the residents. These all contain an initial assessment. The Manager advised that she currently undertakes the assessments but will be providing training to the Deputy Manager so that she is also able to carry these out. The assessment process involves meeting the prospective resident at the home/hospital and gathering information from the resident, relatives and any health professionals involved. The Manager provided an example of how the assessment process provides good information on which to base the decision about whether the Home can meet the individuals needs or not. Residents and relatives told the Inspector that they had been invited to visit the Home prior to making the decision to move there. Wyndham House I55 s64103 Wyndham House v244849 UN 300905(4).doc Version 1.40 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 10 The residents all have a care plan but these are not detailed enough to provide effective guidance to staff about how to meet individual needs The records are not accurate enough to confirm that all of the residents health care needs are being met Residents said that they feel that they are treated with respect EVIDENCE: The Inspector looked at four of the care plans. The format of these are very uniform and not individualised at all. The care plans need to be individualised with detailed guidance for staff of how to meet the residents needs. The care plans need to contain risk assessments which are individualised for each resident and shows that areas of risk have been adequately assessed and steps taken to reduce the risks. The staff complete daily notes and on occasions these are very brief. It is recommended that these are more detailed which will be easier to do once the care plans are more detailed as the areas highlighted in the care plans can be referred to. Wyndham House I55 s64103 Wyndham House v244849 UN 300905(4).doc Version 1.40 Page 10 The Manager has only been employed since July 2005 and has had to prioritise the areas of the Home which do not meet the National Minimum Standards. However, she has recognised that the care staff have not all previously been used to taking responsibility for completing daily notes and is providing support as necessary. Another area that the Manager has recognised as not working effectively is that of someone overseeing the care being provided on a daily basis and having a consistent approach to liasing with GP and other health care professionals. The Deputy Manager is now responsible for making health care appointments although Senior staff will do this if it is urgent and the Deputy Manager is not on duty. The daily notes show that there have been times when concerns about a residents health have been noted in the daily notes but that there is then no written evidence of any action taken to address the need. The care plans do contain individual moving and handling assessments, pressure area assessments and dependency assessments. There is some evidence of these having been reviewed recently also. However, when a need is identified there then needs to be a care plan available for the staff to follow so that the assessments are meaningful. Weight charts have recently been implemented. A recent situation affecting the health of several of the residents was dealt with appropriately. Residents said that the staff are kind and that they respect their privacy and dignity. Privacy is reduced for some residents due to the number of shared rooms but screens are provided in the shared rooms. It is required that risk assessments are carried out for residents who share a bedroom and that a record is kept of the discussions with the resident and their relatives about the situation. It is required that the Manager undertakes a review of whether the residents would like to have a lock on their bedroom door as currently these are not provided. A record of the outcome should be recorded in the individual care plans. Wyndham House I55 s64103 Wyndham House v244849 UN 300905(4).doc Version 1.40 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 There has previously been few, if any, organised activities but this is being addressed through the employment of an activities co-ordinator Residents are supported to maintain contact with family and friends A lot of the changes that have been made in the way in which the Home is run is with the intention of improving the opportunities that the residents have to make their own choices The menus have been improved over the last three months and now provide a better variety of meals EVIDENCE: The staff said that they try to offer choices to the residents about issues such as times to get up and to go to bed. Staff were heard to offer choice to the residents. However, the staffing levels can sometimes restrict the choices available to the residents as they may have to wait for assistance. The residents who are able to make their choices clear through verbal communication were seen to be offered choices but further work needs to be undertaken to provide opportunities for choice to those residents who find verbal communication difficult Wyndham House I55 s64103 Wyndham House v244849 UN 300905(4).doc Version 1.40 Page 12 An Activities Co-ordinator was employed three weeks ago and works for two hours each afternoon from Monday to Friday. Two of the residents told the Inspector that they have enjoyed the activities provided. Other residents said that they did not wish to join in with organised activities and that this choice is respected. The staff advised that they have little, if any, time to spend on an individual basis with residents. The care plans contain information about the residents family. Several visitors were seen in the Home on the day of the Inspection. Two relatives spoke to the Inspector and both said that they visit very regularly and are always made to feel welcome by the staff. They spoke highly of the care provided to their relatives and said that they are kept informed of any situations that arise concerning their relative. The Commission has recently received a complaint from a relative about the care that their relative had received at the Home and the lack of communication from care staff. The individual details of the complaint were mainly upheld but they relate to the first few weeks that the new Proprietor and Manager were at the Home and they had already identified the majority of the issues and had started to address them. The arrangements for looking after residents monies were not inspected on this occasion. The Manager advised that a new cook was appointed in July of this year and that the menus have recently been changed following discussions with the residents and their relatives. Residents told the Inspector that they enjoy the meals and one said that they prefer this new menu. The menus were seen and these show a variety of dishes. The area of choice with regard to mealtimes is one that needs further development and the Manager has plans for this. Currently there is only a choice of one meal on the menu but staff advised that if a resident doesn’t like it then they can have an alternative. Only one of the residents had a choice of drink during the lunchtime. One resident had a beer with lunch but the other residents all had the same type of fruit squash in their glass. It is recommended that the Manager develops effective ways for offering choice within the menus and that this includes drinks. The majority of the staff have recently received training with regard to working with older people with dementia and this should help them with developing new ways of offering choice to the residents. Two of the residents require assistance at mealtimes and they were each supported by a member of staff who sat with them and were not distracted by other tasks. The care plans show that weight charts have recently been introduced so that the residents weight can be monitored. Wyndham House I55 s64103 Wyndham House v244849 UN 300905(4).doc Version 1.40 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Residents and relatives who spoke to the Inspector were confident that their complaints would be dealt with appropriately EVIDENCE: The Home has a complaints procedure which is provided to residents when they move into the Home. The Manager said that she will ensure that the relatives of the current residents have a copy of the revised complaints procedure. Relatives who spoke to the Inspector said that they are confident that the Manager will deal with any problems that might arise and that they feel able to discuss issues with her. They said that they have met the new Proprietor. It is expected that as the Manager and staff team improve the ways in which they communicate with the residents who have dementia then this will lead to an increase in the residents ability to raise any issues that they might be concerned about. Wyndham House I55 s64103 Wyndham House v244849 UN 300905(4).doc Version 1.40 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 24 25 and 26 The Proprietor has undertaken a lot of work to improve the environment in the four months that he has owned the Home The decoration and furnishings in most of the bedrooms is satisfactory but there are some rooms which are in urgent need of redecoration and refurbishment. There are several bathrooms and toilets around the Home and all have appropriate aids to make them easier for the residents to use. The majority of the Home is clean, pleasant and hygienic but there are some areas which do not smell very pleasant EVIDENCE: The Inspector was shown around the communal areas of the Home and into most of the bedrooms. Not all of the bathrooms were seen. Wyndham House I55 s64103 Wyndham House v244849 UN 300905(4).doc Version 1.40 Page 15 The Proprietor has undertaken a lot of improvements to the environment in the short time that he has owned the Home. The improvements that have already been made were prioritised on the basis of situations that could cause a risk to the health and safety of residents and staff. Relatives, staff and residents commented on the positive improvements. It is required that the Commission is provided with a copy of the maintenance plan for the outstanding work. Some of the bedrooms on the ground floor open into a long conservatory. The floor in the conservatory has been raised with a new carpet laid. This means that the residents do not have to negotiate a step from their bedroom into the conservatory. New carpets have been laid throughout the large dining room and lounges. Doors have been fitted to one of the lounges so that the two rooms can be separated. A new lock has been fitted to the front door to improve the security of the building. The front drive has been cleaned and several large trees have been removed to improve the natural light into some of the bedrooms. The Managers office has been moved to the second floor and the room that was being used as an office has been converted back into a bedroom. This was seen during the Inspection and agreement given for it to be used which will increase the registered numbers to thirty six (36). This room is a single room with an ensuite shower and toilet. The Manager is aware of the need to undertake a risk assessment prior to a resident being given this room as there is a small step to the ensuite toilet. It is required that a curtain is fitted to the glass panel in the door prior to any residents using this room. A small room on the ground floor which was previously used as a treatment room has now been changed into a staff office where the records are kept and where handovers can take place. The garden is in the process of being redesigned. Ramps have been built, with handrails, so that residents can have safe access to the garden. The residents spoke particularly highly of the work being carried out in the garden. The Home has a large dining room with nice views over the garden. This room is also used for activities. There are two lounges which seem as though they are one room with a central corridor through to the stairs. However, doors have been fitted to one of the rooms so that they can be divided. It was noted during the Inspection that there was a television on in one room and the radio on in the other room without the doors being closed. This resulted in a confusion of noise with no-one able to either watch the television or listen to the music effectively. It is required that this situation is addressed. The bathrooms have hoists to provide assistance to the residents. There are bathrooms on the first and ground floors. It is recommended that the Wyndham House I55 s64103 Wyndham House v244849 UN 300905(4).doc Version 1.40 Page 16 bathrooms are made more homely as they currently look very functional. It is also required that toiletries and razors are not left in the bathrooms as there is a risk to those residents who are confused. The Home has five shared rooms and twenty six single rooms. All of the bedrooms, except for one, have an ensuite toilet. Privacy screens are provided in the shared rooms. The bedrooms all show signs of personalisation with evidence that residents are encouraged to bring in photos, pictures, ornaments and small items of furniture. The standard of decoration and furnishings of the bedrooms is variable with the majority of bedrooms in the older part of the Home in need of urgent redecoration and refurbishment. The Proprietor has already started this process and it is expected that the maintenance plan will provide suitable dates for when this will be completed. There is an unpleasant smell in some areas of the Home, particularly in the area by the original front door to the building. The Home employs adequate numbers of domestic staff and it is thought that the carpets/flooring will need to be replaced to remove the smell in one particular area. It is required that the unpleasant smells are eradicated. It is required that those carpets which are creased or have come loose are refitted or replaced. It is required that maintenance work is carried out to those door frames in the older part of the Home which are very marked and damaged. It is required that the strip lighting which is in place in one of the bedrooms on the first floor is cleaned and it is recommended that consideration is given to replacing this with more domestic style lighting. Wyndham House I55 s64103 Wyndham House v244849 UN 300905(4).doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 The numbers of staff on duty, particularly in the mornings, needs to be increased to ensure that the staff are able to meet the needs of the residents in an unhurried, relaxed manner EVIDENCE: The usual staffing arrangements in the Home are for four care staff to be on duty during the morning, three during the early part of the afternoon and four during the evening. In addition to the care staff there is a cook on duty every day (including weekends) and then a kitchen assistant on duty every evening to prepare and clear up after the teatime meal. Domestic staff are also on duty every morning including weekends. The Manager works mainly Monday to Fridays in addition to the care staffing rota. The Home also has an administrator. There are two waking night staff on duty each night. Discussions with the staff, Manager and residents as well as observations during the Inspection highlight the need for additional staff on duty, particularly in the mornings. Additional staff should ensure that the staff are then able to assist the residents in a more relaxed, unhurried manner. The staff are being expected to take on additional responsibilities with regard to the completion of care records and the monitoring of the health needs of the residents and these tasks all take time to do effectively which they currently do not have. The newly appointed Deputy Manager also has additional Wyndham House I55 s64103 Wyndham House v244849 UN 300905(4).doc Version 1.40 Page 18 responsibilities which means that she has less time to undertake personal care tasks with the residents. It is required that the staffing levels are increased in the mornings and that a review of the staffing needs is undertaken. Wyndham House I55 s64103 Wyndham House v244849 UN 300905(4).doc Version 1.40 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 and 32 The residents are benefiting from the ethos and management approach of the new Manager and Proprietor EVIDENCE: The Manager was appointed to the Home in July 2005 and has worked hard to implement some of the changes that the new Proprietor is aware need to be put into place to improve the care provided to the residents. The Manager has recently completed the registration process with the Commission. She plans to commence the Registered Managers Award shortly. The Manager has high standards and is in the process of working with the staff team to look at different ways of working than they may have been used to in the past. The Manager is clear in her intentions that any changes need to be for the benefit of the residents. The Manager advised that she receives good Wyndham House I55 s64103 Wyndham House v244849 UN 300905(4).doc Version 1.40 Page 20 support from the Operational Manager of the organisation and from the Proprietor. Wyndham House I55 s64103 Wyndham House v244849 UN 300905(4).doc Version 1.40 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 x x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION 2 3 3 x x 2 2 2 STAFFING Standard No Score 27 1 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 2 x 3 x x x x x Wyndham House I55 s64103 Wyndham House v244849 UN 300905(4).doc Version 1.40 Page 22 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. Standard 7 Regulation 15 Requirement The registered person must ensure that the care plans contain detailed guidance for the staff about how to meet the residents needs The registered person must ensure that risk assessments are undertaken and that these are recorded within the care plans The registered person must ensure that a risk assessment is undertaken for all residents who share a bedroom The registered person must ensure that a review is undertaken with regard to the provision of a lock on bedroom doors the registered person must provide the Commission with an updated plan for the future maintenance and redecoration of the Home The registered person must ensure that a curtain is provided at the glass panel in the new bedroom door The registered person must ensure that arrangements are in place to prevent the television and radio being on in the same Timescale for action 30th Nov 2005 2. 7 13 (4c) 30th Nov 2005 30th Nov 2005 31st Dec 2005 3. 10 13 (4c) 4. 10 12 (4a) 5. 19 23 30th Nov 2005 6. 19 12 (4a) 31st oct 2005 31st Oct 2005 7. 20 23 Wyndham House I55 s64103 Wyndham House v244849 UN 300905(4).doc Version 1.40 Page 23 area 8. 9. 10. 11. 21 19 26 24 13 (4a) 23 (2b) 16 (2k) 16 (2c) The registered person must ensure that toiletries and razors are not left in the bathrooms The registered person must ensure that the damaged doorframes are replaced The registered person must ensure that the Home is free from offensive odours The registered person must ensure that those carpets which are creased or loose are repaired or replaced The registered person must ensure that the strip lighting in one of the bedrooms is cleaned The registered person must ensure that the staffing levels are increased in the mornings The registered person must undertake a review of staffing and provide a copy to the Commission Immediate and ongoing 31st Dec 2005 30th Nov 2005 31st oct 2005 31st Oct 2005 15th Nov 2005 30th Nov 2005 12. 13. 14. 25 27 27 23 (2p) 18 (1a) 18 (1a) 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. 5. Refer to Standard 15 16 7 21 25 Good Practice Recommendations It is recommended that the Manager progresses her plans to provide choice at mealtimes It is recommended that the Manager ensures that relatives all have a copy of the complaints procedures It is recommended that the daily notes are more detailed It is recommended that the bathrooms are made more homely It is recommended that the use of strip lighting in one fo the bedrooms is reviewed Wyndham House I55 s64103 Wyndham House v244849 UN 300905(4).doc Version 1.40 Page 24 Commission for Social Care Inspection 3rd Floor Cavell House St Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 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. 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