Care Home: Castle Mount

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What the care home does well What has improved since the last inspection? Cumbria Care has improved the format for writing care plans for residents and once this is established, this will give a better picture of what is needed by each individual person. We were pleased to see that the management of medication had become much more efficient and staff were taking extra care when dealing with people`s medicines. Residents told us that the laundry was working more efficiently, as they had felt that there were delays and items getting mixed up. They thought the manager had improved this. A number of bedrooms and corridors had been decorated and re-carpeted to a good standard. New furniture had been purchased for lounges and the home now has more specialist beds that help people who have poor mobility. We judged that the staff team has now become more stable and that there is less turnover of staff. Several residents said that it was good to have an established senior staff team who worked well together. What the care home could do better: We judged that the care of people with dementia is done in a sensitive and caring way but we would like to see Cumbria Care give the manager support to improve this specialist unit so that people who live there may have an even better quality of life. CARE HOMES FOR OLDER PEOPLE Castle Mount Bookwell Egremont Cumbria CA22 2JP Lead Inspector Nancy Saich Unannounced Inspection 09:00a 21 October 2008 st 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 Castle Mount DS0000036522.V371516.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. Castle Mount DS0000036522.V371516.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Castle Mount Address Bookwell Egremont Cumbria CA22 2JP 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) 01946 820454 01946 825513 castle.mount@cumbriacc.gov.uk www.cumbriacare.org.uk Cumbria Care Mrs Amanda Jane Taylor Care Home 34 Category(ies) of Dementia - over 65 years of age (11), Learning registration, with number disability (1), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (2), Old age, not falling within any other category (34) Castle Mount DS0000036522.V371516.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 34 service users to include: up to 34 service users in the category OP (Old age, not falling within any other category); up to 11 service users in the category DE(E) (Dementia over 65 years of age); 2 named service users in the category of MD(E) (Mental disorder excluding learning disability or dementia over 65 years of age); 1 named service user in the category of LD (Learning disability). Date of last inspection Brief Description of the Service: Castle Mount is a purpose built home for older people that was refurbished to a good standard in 1999. Cumbria Care, the in-house Cumbria County Council provider, operates the home. Mandy Taylor manages the home. The home caters for older people within the limits of the registered categories listed above. The home is divided into group-living areas and one of these is especially for people with dementia and this part of the home also has a secure garden. Charges range from £337 to £449 per week, depending on the level of care needs. Information about the home can be obtained from the manager at the home on the number above or from the Cumbria Care website. Castle Mount DS0000036522.V371516.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 two star. This means the people who use this service experience good quality outcomes. This was the main or key inspection for the year. The lead inspector, Nancy Saich, asked the manager to fill out a form called the Annual Quality Assurance Audit (the AQAA) earlier in the year. This asks for details of what has improved in the home since the last inspection and for the plans for the coming year. This was completed at the time promptly, with plenty of detail and the manager was in the process of completing this years AQAA. We (the Commission for Social Care Inspection) visited the home, and met with the resident representative who gave out postal surveys to people who live in the home and their relatives and friends, and to the staff group. We had a good response to these surveys and we quote from them in the report. The responses were fairly positive and gave us a good picture of what its like to live and work in the home. We completed an unannounced inspection on the above date where we spoke to residents, the manager and to staff, toured the building, sat in lounges and shared a meal with residents. We also looked at files and documents that backed up what was said and what was seen. What the service does well: This home is good at only taking on new service users who they know will fit in with existing residents and who the staff team know they can care for properly. We judged that residents were generally receiving good levels of care and the surveys confirmed that, for most people, the care they received met their needs. • • “Things are the way I want them to be. Dont let anyone spoil them …” “I think that Castle Mount is a clean, well-run home staffed by personnel that treat residents with care and respect.” Castle Mount DS0000036522.V371516.R01.S.doc Version 5.2 Page 6 And one survey simply said: • “They are always there for me …” We had evidence to show that people in this home have the kind of lifestyle that they want and that they are satisfied with the activities and outings on offer. • “The staff are always obliging, the activities are a very good and outings are especially welcome. The meals are a very good and the home is always very clean. I am happy to stay here”. We had very positive comments about the food in the home and we judged that catering in this service is of a very high standard. We learnt that residents were confident that any complaints they had would be taken seriously and that there was nothing abusive happening in the home. Castle Mount is a comfortable home where residents feel relaxed and secure. On the day of the visit the home was clean, well decorated and furnished and we could see that staff were careful about hygiene and the control of infection. Some of our surveys, returned by both staff and residents, said that sometimes staffing levels were low. We checked on this and a found that there had been a problem due to ill-health but we were satisfied that both the manager and Cumbria Care had dealt with this. Staffing levels were good on the day of our visit. We saw plenty of evidence to show that new staff are only taken on after they have had suitable background checks. We were pleased to see that nearly 60 of the current staff group have National Vocational Qualifications in care at level 2 and that some people are now working on level 3. We were given a copy of the training plan and had evidence to show that staff got good levels of training. The manager of the service has a nursing qualification, the Registered Managers Award and is working on the National Vocational Qualification in care at level 4. We had plenty of evidence to show that she was a capable and confident manager who uses systems well to give residents the care and services they prefer. A number of people on the day and in surveys commented on how good she was: • “We are very lucky to have her as a manager, she is easy to talk to and very interested in all of us and is very caring ... but you can still have a laugh and joke with her.” DS0000036522.V371516.R01.S.doc Version 5.2 Page 7 Castle Mount Cumbria Care has a quality assurance system in place and this manager uses it to make sure that residents, staff and families are asked their opinions. She uses this to look at forward planning for the service. We checked on a number of systems: residents’ money, staff supervision, food hygiene, fire safety and general maintenance and health and safety matters, and we found that these were being managed in an efficient and organised way. What has improved since the last inspection? What they could do better: We judged that the care of people with dementia is done in a sensitive and caring way but we would like to see Cumbria Care give the manager support to improve this specialist unit so that people who live there may have an even better quality of life. Castle Mount DS0000036522.V371516.R01.S.doc Version 5.2 Page 8 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. Castle Mount DS0000036522.V371516.R01.S.doc Version 5.2 Page 9 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 Castle Mount DS0000036522.V371516.R01.S.doc Version 5.2 Page 10 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): 1, 3 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. New people to this service are given plenty of information and the staff team make sure that they can care properly for any new person. EVIDENCE: The manager had updated the information available for prospective new residents and for people who buy care on their behalf. We were given a copy of this at the inspection and we judged that this gave plenty of suitable information for people to make decisions about coming into the home. We spoke to some people who had only recently come to live in the home and they were happy with the support they were given about this important decision. One person spoke at length about how he was helped to settle. Castle Mount DS0000036522.V371516.R01.S.doc Version 5.2 Page 11 We also checked on residents’ files and found that people had social work assessments, medical information and that senior staff made sure that they had good levels of information about new people. Castle Mount DS0000036522.V371516.R01.S.doc Version 5.2 Page 12 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, 10 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People who live in this service receive good levels of health and personal care that allow them to be as well as possible. EVIDENCE: A new way of writing plans of care for residents has recently been introduced into this home. It is intended to give people who live in the home more of a voice and to allow them to ask for the things they want and need. We judged that this is a good system and we could see that staff had started to work on this. We read all of the plans and we looked at a number in depth. We spoke to people who owned these care plans. We judged that staff had completed a lot of work rewriting all of these plans and we could see that some of them were of a very high standard. Castle Mount DS0000036522.V371516.R01.S.doc Version 5.2 Page 13 We also found some instances where some details needed to be added to the plans. These related to nutritional planning and work with some people with dementia. We were aware that the change over to the new system might mean that there are some gaps. The manager and the staff team assured us that the system was still in progress and that care planning was being carefully monitored. Residents told us that they had been involved in this change and a number of people showed us their own copy. We also judged that people in this home receive good standards of care because we met people who were well, happy and settled. We can see that these changes show a lot of promise and we are prepared to give the home more time to establish this new system. We could see from care plans and daily notes that people got good support with health issues and that they could access not just the GP but specialist health professionals. We checked on the medication held on behalf of residents and we found good systems that are regularly monitored by senior staff. We saw people being given medication correctly and had evidence of people managing their own medication. In the past, there had been some errors with this but the senior staff now pay a lot of attention to medicines and there have been no errors from this staff team in the last two years. People who live in the home told us that the staff team are polite, caring and respectful. They also told us that, individually, they prefer some staff to others but they thought that this was normal for any group of people. The men in the home can now choose to have direct personal care from a male care assistant and a number of people commented on this as an improvement. During our visit we saw a lot of friendly interaction between residents and staff and we could see that staff knew their residents very well and respect them as individuals. Castle Mount DS0000036522.V371516.R01.S.doc Version 5.2 Page 14 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): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The people who live in the home were happy with the lifestyle provided and everyone was very positive about the high standard of catering in the home. EVIDENCE: The residents we spoke to told us that they could live their daily lives very much as they chose. Some people get up early, some a bit later; one or two people spend a lot of time in their own bedrooms and others prefer to socialise in the lounge for most of the day. This home has an activities co-ordinator who has, in the past, organised very good activities and outings. This person is currently not at work and the rest of the staff group try to do as many activities as possible. We were told that this is a temporary problem and residents look forward to things are getting back to normal. Castle Mount DS0000036522.V371516.R01.S.doc Version 5.2 Page 15 We had evidence to show that residents from the different units in the home are all given opportunities to go out or to participate in activities. Things like outings, church services and entertainments are open to everyone and most people told us that they were satisfied with how things were in the home. We spent some time in the specialist unit for people with dementia and we found that these people have a peaceful and relaxed place to live in. We thought that staff gave them good levels of care but we thought there were opportunities in this unit for improvements. We would like to see more activities that are specifically for people who may have problems with their memory and we would like to see some changes to the environment and perhaps to the daily routines that would give these people an even better lifestyle than they currently have. We shared a very well prepared and presented meal with residents. People in the home told us that they were given three good meals a day and plenty of snacks and home baking. In each of the units there are small kitchens and staff help residents to get hot drinks and snacks whenever they wish. Residents and relatives told us that they thought the food offered was varied, healthy and appetising. Several people told us they had put on weight and another person told us that they had lost weight because the catering staff were helping her to choose lower calorie options. We also had evidence to show that when people did not eat very well, the right kind of nutrition was in place. Staff agreed that they needed to show these nutritional plans in more detail in the general care plans. The local environmental health officer had inspected the kitchen recently and gave the catering operation a five star rating, which is the highest rating possible. Castle Mount DS0000036522.V371516.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People in this service were confident that they would be listened to and protected properly by the manager and the staff team. EVIDENCE: We had received no formal complaints about this home since our last inspection visit. The manager said that she dealt with routine matters as they came up but that there had been no formal complaints made to her. Cumbria Care, as part of the County Council, has a formal Complaints Procedure and copies of this were available around the home. There is also an anonymous suggestion box and the home has a residents’ representative who told us he would speak up for the others if he had to. Most residents were very confident about making complaints and told us that they would tell any staff member but that they could - and would - go to the manager with anything that troubled them and that she would deal with it. There had been one issue related to adult safeguarding made in the last two years. This potential problem had been dealt with very well after an initial error in the investigation. We had plenty of written and spoken evidence to show that any similar event would be handled correctly in the future. Castle Mount DS0000036522.V371516.R01.S.doc Version 5.2 Page 17 We spoke to staff and residents about abuse and they said that nothing of this sort was happening in the home. They could tell us how they would report anything like this and we judged that staff had good knowledge of what constituted abuse and they would report this straightaway to the manager, to Cumbria Care or to ourselves. The manager told us that she continues to work with the senior team to make sure that everyone feels confident about following the local arrangements for managing Adult Protection. Castle Mount DS0000036522.V371516.R01.S.doc Version 5.2 Page 18 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, 26 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People who live in this home are relaxed, safe and comfortable in this pleasant environment. EVIDENCE: Castle Mount is a purpose-built home that was updated in 1999. Cumbria Care continues to decorate and replace carpets and furniture on a regular basis. The manager shared the plans for future improvement with us and residents showed us their bedrooms that had been papered and carpeted. The decorators were working on the day of the visit. Staff in the home have helped residents to make their bedrooms their own and have added homely touches to shared areas. Castle Mount DS0000036522.V371516.R01.S.doc Version 5.2 Page 19 In the dementia care unit staff have helped people to put their names and photographs on their bedroom doors to help with any disorientation. We would like to see more of these touches in this specialist unit. Castle Mount is in a residential area and is a short drive from the centre of Egremont. There is good access and all around the home there is equipment and adaptations for people with poor mobility. The home has a call bell system and a number of security systems to make sure people can summon assistance and are kept as safe as possible. Our surveys told us that residents and visitors judged that the home was always clean and hygienic. On the day of the visit all areas were clean, orderly and fresh. Some of the women in the home spoke about the laundry and how the manager had worked to improve the proper return of clothing. These people were pleased with the way their personal laundry was done and told us that staff were happy to give people fresh clothing or bedding at any time. There had been an outbreak of sickness and diarrhoea in the home but this had been very well contained by careful management and good attention to infection control. Castle Mount DS0000036522.V371516.R01.S.doc Version 5.2 Page 20 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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. This home has a settled, experience and trained team who have residents’ best interest at heart. EVIDENCE: We looked at the original rosters for the months of August and September 2008 and we found that there were usually seven care staff in the mornings, six later in the day and two waking night staff. During the day there was always a supervisor and, as one resident put it, “… Mandy (the manager) is always here!” We could see that there are always two members of staff in the dementia care unit and that there were usually housekeeping and catering staff on duty. Some of the surveys said that things would be better with more staff but we judged that the staffing levels are appropriate for the levels of dependency in the home. We did see that sometimes a shift hadnt been covered due to illhealth but we did not think that there had been any times when staffing had fallen so low as to be unsafe. Castle Mount DS0000036522.V371516.R01.S.doc Version 5.2 Page 21 Around 60 of the staff have National Vocational Qualification in care at level 2 and the other staff are working towards this award. We were impressed that all the senior staff were registered for the level 3 award and were prepared to pay for this themselves. The manager gave us a copy of her training plan for the next year and we saw records in individual files and in the quality assurance system showing that everyone on the staff team had training that allowed them to do their job properly. Some individuals had gone on very specific training courses. For example, a number of people had attended training on care planning and one of the chefs in the home had attended a training course on nutritional needs. Most people on the team had also received training on dementia care. Again, we would like to see further training being made available for staff so that they would have knowledge of the very best practice in caring for people with dementia. We are aware that this may be an issue that can only be taken forward by Cumbria Care but we were pleased to note that the manager, senior staff and care staff were eager to learn as much as they could about this disorder and how to work with the distress it sometimes causes. We checked on recruitment files for new staff and discovered that the manager follows Cumbria County Council guidelines and that no-one starts to work in the home unless their identity and background have been checked. We were pleased to see that the manager follows good practice in equal opportunity recruitment and that she and senior staff had recently attended some training on this. Castle Mount DS0000036522.V371516.R01.S.doc Version 5.2 Page 22 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, 36, 38 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. This is a well managed home with good systems that allow residents to have high levels of care and services. EVIDENCE: Mandy Taylor has managed this home for around three years. She is suitably trained and experienced in looking after older people and in managing staff and resources. She has created a stable staff team and has worked on management systems so that things run very smoothly in this home. She gets good, regular support from senior management of Cumbria Care. More importantly, the people who live in the service rate her highly as a manager and we received lots of praise and respect for the work she does. Castle Mount DS0000036522.V371516.R01.S.doc Version 5.2 Page 23 This home has a simple and comprehensive system that everything from fire safety to staff supervision is dealt with in a straightforward and efficient way. The paper records are easy to find and available for staff use. Confidential records were stored securely and these were detailed and up to date. There is an electronic record system that is used mainly by the manager and she could access a concise record of everything we needed. We judged these systems to be of a high standard. We checked on residents’ money and found that this was being dealt with correctly. We saw that staff supervision was being recorded properly and in detail, and that personnel files were up-to-date. We looked at records of maintenance, health and safety, food hygiene and fire safety. We also discussed these matters with the manager and staff. We found that all the systems were working well to make sure that residents were kept as safe as possible and that the home was a comfortable place to live and work in. Together these things show that quality systems are maintained at all times. We also heard that the manager has regular staff meetings and meets with residents and their relatives at least four times per year. When all these strands are put together, we had enough evidence to show that there was a functioning system to make sure the quality standards were being met at all times. There has been a quality audit and a business plan prepared this year and we look forward to receiving any updates or changes do this. Castle Mount DS0000036522.V371516.R01.S.doc Version 5.2 Page 24 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 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 3 4 3 Castle Mount DS0000036522.V371516.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NA 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. Standard Regulation Requirement Timescale for action 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 OP12 Good Practice Recommendations It is recommended that the manager discuss with Cumbria Care ways to improve on activities, the environment and staff development so that people with dementia have care and services that meet their needs in a way that reflects new research into dementia care practice. Castle Mount DS0000036522.V371516.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection NW Regional Office Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ 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 Castle Mount DS0000036522.V371516.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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