Care Home: Heron Lodge

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What the care home does well Tudor Grange is a friendly and caring home, where people are looked after with dignity and consideration by a team of competent staff in sufficient numbers to meet their needs. The new manager is an experienced and caring person who is keen to bring a positive new direction to the home. Some excellent feedback was received about how caring staff are and also about the way that people are looked after at the end of their lives. One resident wrote, "The staff are always very pleasant and helpful" One relative wrote, "Mum was given such kindness and dignity at the last" The home is good at supporting people`s relatives and friends. One person said, "My visitors are always offered a cup of tea. They are welcome to have lunch with me if they wish" The home is good at consulting people about how they wish to live their lives, and the food is greatly enjoyed, being made from fresh ingredients by an experienced and caring team in the kitchen. Complaints are listened to and acted upon and the home itself is clean and tidy. What has improved since the last inspection? What the care home could do better: CARE HOMES FOR OLDER PEOPLE Tudor Grange Nursing & Residential Home 163 Norwich Road Wroxham Norwich Norfolk NR12 8RZ Lead Inspector Maggie Prettyman Unannounced Inspection 30th October 2007 09:30 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 Tudor Grange Nursing & Residential Home DS0000069849.V353856.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. Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tudor Grange Nursing & Residential Home Address 163 Norwich Road Wroxham Norwich Norfolk NR12 8RZ 01603 782194 01603 782194 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) Kingsley Care Homes Ltd Manager to be registered Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27), Physical disability (2) of places Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The total number of service users not to exceed twenty seven (27) To accommodate from time to time two service users under the age of 65 years. When considering the admission of a service user aged under 65 years of age the registered person and/or registered provider shall inform and discuss with the Commission the appropriateness of such a placement in line with the protocol drawn up by the registered manager dated 15/2/07. 21/11/06 Date of last inspection Brief Description of the Service: Tudor Grange is a period residence that has been adapted and extended to provide accommodation to a maximum of 27 older persons. The care home stands well back from the main road, within its own well maintained grounds and is surrounded by mature trees. It is located on the outskirts of the Broadland centre of Wroxham. The grounds are attractive and accessible to service users and the premises are maintained in good order and comfortably furnished. The registration is as a Care Home With Nursing and it is the policy of the care home to restrict future admissions to only service users in need of nursing care. All accommodation is in single rooms and the majority have en suite facilities. The current (October 2007) range of charges is £460 - £720 per week. Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out using information from previous inspections, information from the providers, the residents and their relatives as well as others who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the home and current judgements for each outcome group. This inspection took place over the course of 8 hours and included a full tour of the premises, discussion with people living at the home and their visitors, as well as discussion with the new manager, representatives of the new purchasers and conversations with staff on duty. Written documents were inspected which included care plans, staff files and safety records. Prior to the inspection a detailed Annual Quality Assurance Assessment was completed by the home, and confidential questionnaires were returned to the Commission from residents, staff and relatives. What the service does well: Tudor Grange is a friendly and caring home, where people are looked after with dignity and consideration by a team of competent staff in sufficient numbers to meet their needs. The new manager is an experienced and caring person who is keen to bring a positive new direction to the home. Some excellent feedback was received about how caring staff are and also about the way that people are looked after at the end of their lives. One resident wrote, “The staff are always very pleasant and helpful” One relative wrote, “Mum was given such kindness and dignity at the last” The home is good at supporting people’s relatives and friends. One person said, “My visitors are always offered a cup of tea. They are welcome to have lunch with me if they wish” The home is good at consulting people about how they wish to live their lives, and the food is greatly enjoyed, being made from fresh ingredients by an experienced and caring team in the kitchen. Complaints are listened to and acted upon and the home itself is clean and tidy. Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The home has had significant change in the past six months and many systems have been subject to change. As a result of this some shortfalls have developed or been identified during this inspection. The new manager and owner demonstrated concern about these matters and an active commitment to resolving them. We have no reason to believe that these requirements and recommendations will not be addressed and resolved by the time the home is next inspected. Requirements • • • • • Care plans must include details of peoples social and cultural interests and needs Information recorded in care plans must be kept consistently and acted upon A system of nutritional assessment must be fully implemented and people identified as at risk to be offered suitable nutritional supplement Personal toiletries must be individually marked as such All staff must be recruited according to the care standards requirements Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 7 Recommendations • • • • • • • • • • A more detailed needs assessment should be developed The system of medication should be subject to written audit Dividers in medication records should contain more personal detail about people including name of choice and photograph A planned schedule of activities that reflect the individual and group wishes of residents should be instituted The menu should be planned in advance in consultation with residents A list of individual likes and dislikes as well as dietary requirements should be available in the kitchen Bathroom areas should not be used to store surplus equipment The laundry door should be kept locked shut A written protocol should be given to the home’s manager to ensure consistent vetting of new staff An up to date list of staff training should be available in the home An audit of accidents and incidents in the home should be undertaken 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. Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 3 and 6 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have the information they need to decide whether the home can meet their needs. Everyone who comes to live at the home has their needs assessed before they are admitted. Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 10 EVIDENCE: The new owners have updated the Statement of Purpose and Service User guide. These were displayed on notice boards at the home and are given to people and their families during the admission process. These documents are fairly detailed and accurately describe the home and its services. They could be improved by the addition of photographs and inclusion of contact details of the local authority and healthcare services. Needs assessments of varying standards were seen in people’s individual files. The new owners have a form, which is now being used. The form has space for free text, but at times lacks detail that is specified in the standards. A recommendation has been made in this respect. The home does not provide intermediate care. Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9, 10 and 11 People who use the service experience good quality standards in this area. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on individual needs, but care planning does not currently include enough reference to people’s social and cultural needs. The principles of dignity and respect are put into practice and the home supports people and their families well during end of life care. Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 12 EVIDENCE: Care plans were found in place for all people whose files were inspected. These plans tend to focus on people’s health care needs and contained little evidence of social or cultural needs and expectations. In addition, whilst daily logs had been kept conscientiously, changes in the system seem to have led to some confusion about what other documents should be completed and who is responsible for this. This has been a very difficult time for the home and the new manager and owners demonstrated a consistent attitude of care and concern about these shortfalls. A new computerised care planning system is to be introduced in the near future, but care must be taken to ensure that records are kept consistently and action taken as necessary in the interim. A requirement has been made in this respect. Evidence of people’s health care needs being addressed was seen in care plan records, in accountability sheets in people’s individual rooms and by direct observation during the inspection. The home is not currently using the MUST nutritional screening tool, but has plans to do so. Evidence was seen of weight records being held, but action to investigate significant weight loss for two people had not been taken. A requirement has been made in this respect The home has adopted an MDS medication system since the last inspection. A professional and conscientious Nurse was observed administering the system with care. When interviewed he demonstrated thorough knowledge and consistent good standards. Fridge temperatures are kept and an appropriate secure controlled drugs register and storage are in place. The new MDS system has been audited by the manager, but a written record has not been kept. A recommendation has been made in this respect. The MAR chart dividers were not clearly labelled with people’s personal details and could be improved by doing so. A recommendation has been made in this respect. Observation of practice during the inspection as well as feedback from people and their families prior to the visit and discussion with people living at the home during the visit, demonstrated that people are treated with dignity and respect. Staff were observed being polite and cheerful. Records had people’s name of choice noted. People said that their clothes and personal possessions are well looked after and do not get lost. Prior to inspection a detailed comment sheet was received from the relative of somebody who received end of life care at the home. They described both their relative and themselves being fully supported by the home and how safe and well cared for they had felt. They said; Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 13 “We were so grateful that mum was given such kindness and dignity at the last. We were so glad that she did not have to go to hospital after her final stroke. She was kept clean and comfortable and free from pain. We were allowed to spend as much time at the home as we wished, and were treated with great kindness always.” Tudor Grange Nursing & Residential Home DS0000069849.V353856.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): Standards 12, 13, 14 and 15 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are able to make choices in their daily lives. The home does not currently have enough social or recreational activities, although this is planned for the future. EVIDENCE: Some activities are provided by the home, but an up to date list of what is going on is not available to residents, who rely on staff telling them. Detailed life histories recording people’s social interests and preferences are not currently in place. The new manager plans to allocate a worker to co-ordinate and plan activities. It is hoped that these activities will have more emphasis on normal life occupation as well as group entertainment. A recommendation has been made in this respect Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 15 Feedback from pre-inspection questionnaires as well as discussion with residents and visitors during the inspection demonstrated that visitors to the home are welcomed and supported. People are offered refreshment and meals if they wish. There is currently limited involvement with the local community in terms of people coming to the home, or people living at the home maintaining existing links; this is an area that will undoubtedly improve with the new emphasis on life history work and a more proactive management approach. People living at the home were seen exercising choice in their daily lives in terms of rising and retiring time, whether they choose to spend their time in their rooms and where they eat their meals. A list of luncheon choices was seen in the kitchen. Some people have chosen to have their medication at different times to the regular “round”. People’s rooms are filled with their own possessions and are individual in décor and furnishings. Excellent feedback was received prior to the inspection about the quality of food at the home. An experienced and competent cook was found preparing wholesome food from fresh ingredients in a clean, tidy and well-organised environment. The home does not currently have a planned menu that has been planned according to resident suggestion and choice. There is no doubt that the wealth of experience of the kitchen team ensures that people enjoy food to their taste, but planned menus need to be in place to ensure nutritional balance. A recommendation has been made in this respect No list of dietary preferences or requirements was available for the kitchen Life History work and consultation with people living at the home will easily resolve this. A recommendation has been made in this respect Tudor Grange Nursing & Residential Home DS0000069849.V353856.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): Standards 16 and 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns and are protected by a trained staff team. EVIDENCE: The home has recorded complaints and has reported them and responded to them appropriately. The past months have been a difficult time, but preinspection responses to questionnaires suggest that the home is now back on an even keel and that people feel that the home is much improved since the change of ownership and management. Evidence from staff records and from the homes manager demonstrated that staff are trained in adult protection and that this is updated regularly. Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The new owners of the home are investing significant resources into improving the home and its facilities and are to be commended for this. Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 18 EVIDENCE: The home is being extensively redecorated, refitted and refurbished. Work is still in progress, but many areas of the home are now completed. People living at the home confirmed that they have been consulted about the new layout and colour schemes and that they are happy with the decisions made. A sample of maintenance and safety records were examined and found to be up to date. The gardens are well maintained and pleasant. Most bathroom and shower areas were tidy. Unfortunately one had a number of unnecessary items stored in it and toiletries were found that were not labelled. A recommendation and a requirement have been made in respect of these issues. The home is clean, pleasant and hygienic throughout. The atmosphere is fresh and free from any odour. A new laundry has been installed and the worker responsible during the inspection confirmed that clothes and linens are appropriately sorted and that a good system of labelling peoples individual clothes is in place. The sluice was in working order in a well-organised and tidy room. The door to the laundry does not lock and detergents stored in the room could be a risk to residents. A recommendation has been made in this respect Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff at the home are trained, skilled and in sufficient numbers to meet the needs of people living there. EVIDENCE: There have been significant issues over recent months with several staff having left the home’s employment. This has caused some disruption and upheaval for people living and working at the home. However, feedback from people at the home and observation during the inspection demonstrated that these problems are resolved and that staffing levels are at an acceptable standard of hours and consistency. Because of staff turnover, NVQ levels are not as good as they have been. However, several staff are booked to start this training and the home demonstrated a commitment to ensuring that people are supported to gain these qualifications. Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 20 Examination of staff files demonstrated that the home has not always fully verified people’s work history and references. This matter was discussed in detail and the Commission’s publication on safe recruitment practice was left with the new manager. A requirement and a recommendation have been made in respect of these matters. Evidence in staff files demonstrated that staff receive training in all aspects of their work. These records were a bit patchy and it was difficult to tell who is in need of update and when. The new owners have a training co-ordinator who monitors training, but it would be helpful for the manager to have up to date information at the home. A recommendation has been made in this respect Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 and 38 People who use the service experience good quality standards in this area. This judgement has been made using available evidence including a visit to this service. The new manager and owners are working hard to improve the home and to develop and to implement quality assurance systems for the benefit of people living there. Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 22 EVIDENCE: The new manager is a qualified nurse who has good experience of managing and working in environments where care of frail and elderly people take place. During the inspection he demonstrated a caring and professional manner. He also showed great interest in developing quality of life services for residents and expressed commitment to the individuality of service delivery. He has yet to complete his registration with the Commission. The new owners have a director responsible for quality compliance. Some feedback questionnaires have been distributed, though a report is yet to be collated. Evidence of the company’s commitment to quality assurance was seen in leaflets and information given following the home’s acquisition as well as by the feedback during the inspection relating to improved service and satisfaction on the part of people living at the home. The manager stated that home does not handle money on behalf of residents. Observation of practice during the inspection demonstrated that the home operates safe working practices. Cleaning products are safely stored and servicing records were in place for equipment at the home. Window restrictors were in place in all occupied upstairs rooms. Risk assessments were in place and accidents and incidents are recorded and reported. The home may benefit from auditing accidents and incidents to identify any underling patterns and trends. A recommendation has been made in this respect. Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 24 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 2 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 3 15 3 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 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 3 N/A X X 3 Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 16 m Requirement Care plans must include all aspects of people’s care needs including social, recreational or cultural matters All aspects of care plans must be maintained consistently and action taken when records demonstrate a change in peoples care needs The system of nutritional assessment must be fully implemented, and action taken to protect people identified as being at risk of malnourishment. People’s individual toiletries should be labelled as such. All staff must be recruited to the standards required and all references and identity documents must be validated. Timescale for action 31/01/08 2 OP7 12 31/12/07 3 OP8 12. 1a 31/12/07 4 5 OP26 OP29 13.3 19 Schedule 2 31/12/07 31/12/07 Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 26 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 OP3 Good Practice Recommendations A more detailed needs assessment form should be developed to ensure that all aspects of peoples needs are considered prior to their admission to the home. A system to provide a written audit of the administration of medication should be implemented. Dividers in the MAR charts should be clearly marked with peoples personal details to ensure that people can be easily identified. A range of planned activities should be made available in consultation with people living at the home, or using their life histories if appropriate. The meals at the home should be provided according to a planned menu that is developed in consultation with people living at the home. A written record of individual likes, dislikes and dietary requirements should be available in the kitchen. Bathrooms should be kept free of unnecessary stored items. The laundry door should be kept locked shut so that detergents are safely stored. A protocol of requirements should be written for homes managers to ensure that staff are recruited and vetted to good standards. Up to date training records for staff should be kept at the home. 2 3 OP9 OP9 4 OP12 5 OP15 6 7 8 9 OP15 OP19 OP38 OP29 10 OP30 Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 27 11 OP38 An audit of accidents and incidents at the home should be undertaken to identify any possible underlying patterns and trends so that preventative action can be undertaken. Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Tudor Grange Nursing & Residential Home DS0000069849.V353856.R01.S.doc Version 5.2 Page 29 - 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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