Care Home: Spring Lodge

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What the care home does well Spring Lodge is a homely and comfortable environment. The facilities meet the needs of people living there and provide space for people to spend their time both communally and in private. People felt that the staff knew them well and provided support according to their knwoldege of them as individuals. The management of medication was good and staff understood the need to maintain records and carry out a robust approach to the administration of medication to people who live at the home. The quality of meals was felt to be good and people told us that they were able to make choices from a planned menu. People knew how to complain and believed that they would be listened to and action taken in response to their feedback. What has improved since the last inspection? The service has continued to develop and improvements had been made in the provision of snacks and drinks, the safeguarding processes and policy. The manager has attained her NVQ 4 Registered Managers Award since the last inspection. What the care home could do better: The documentation in care plans requires further consideration to ensure it reflects all the assessed needs of the individual. Staff`s understanding of the way in which they complete daily records should be reviewed to ensure that they reflect the care provided to the individuals and how this has progressed against their care plans. The service should continue to progress the development of activities and consider how staff offer opportunity for inclusion of people in their activities of daily life and if this is appropriately recorded. Staff training requires further development to ensure it reflects the assessed needs of people living at the home and equips staff with the skills to meet these needs. CARE HOMES FOR OLDER PEOPLE Spring Lodge 23 Vicarage Gardens Clacton On Sea Essex CO15 1BU Lead Inspector Sara Naylor-Wild Key Unannounced Inspection 23rd January 2009 10:00 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 Spring Lodge DS0000061194.V373962.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. Spring Lodge DS0000061194.V373962.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Spring Lodge Address 23 Vicarage Gardens Clacton On Sea Essex CO15 1BU 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) 01255 420045 headoffice@blackswan.co.uk www.blackswan.co.uk Black Swan International Limited Mrs Maria Teresa Cardwell Ms Margaret McKeen Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Spring Lodge DS0000061194.V373962.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 18 persons) Date of last inspection Brief Description of the Service: Spring Lodge is an established care home for older people offering accommodation for eighteen service users on the ground and first floor. Fees are £367. 00 per week. This is the cost of a contracted bed. Hairdressing, chiropody, opticians, toiletries and newspapers and magazines are all charged at cost. Communal areas consist of a main lounge and dining room on the ground floor, with a further small lounge on the first floor. Catering and laundry services are in house and are found to the rear of the property. Accommodation is in sixteen single rooms, eight with en suite facilities of wash hand basin and toilet and one double room with en suite facilities of wash hand basin and toilet. Access to the first floor is by a staircase or passenger lift. Toilets and assisted bathrooms are found on each floor. Communal areas consist of a main lounge and dining room on the ground floor, with a further small lounge on the first floor. Catering and laundry services are in house. Spring Lodge is a detached property, located in a tree-lined road in a residential area of Clacton on Sea. It is close to the town centre, which has the usual amenities of shops, post office, library and leisure facilities. The sea front and promenade are within walking distance. Spring Lodge DS0000061194.V373962.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 2 star. This means the people who use this service experience good quality outcomes. This unannounced key inspection was carried out on the 23rd January 2008. As part of the inspection we checked information received by Commission for Social Care Inspection (CSCI) since the last inspection on13th February 2007. looking at records and documents at the care home and talking to the manager, Ms Margaret Mckeen, care staff and the people living at the home. In addition the Annual Quality Assurance Assessment (AQAA) completed in September 2008 was considered as part of the inspection process and a tour of the premises was completed at the visit to the care home. The service sent us their Annual Quality Assurance Assessment (AQAA) when we asked for it. This contained information about what they felt they did well and how the service was seeking to improve the outcomes for people living at the service. The manager assisted the inspector at the site visit. Feedback on findings was given during the visit with the opportunity for discussion or clarification. We would like to thank the manager, the staff team, and people living at the service and their relatives for their help throughout the inspection process. What the service does well: Spring Lodge is a homely and comfortable environment. The facilities meet the needs of people living there and provide space for people to spend their time both communally and in private. People felt that the staff knew them well and provided support according to their knwoldege of them as individuals. The management of medication was good and staff understood the need to maintain records and carry out a robust approach to the administration of medication to people who live at the home. The quality of meals was felt to be good and people told us that they were able to make choices from a planned menu. People knew how to complain and believed that they would be listened to and action taken in response to their feedback. Spring Lodge DS0000061194.V373962.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Spring Lodge DS0000061194.V373962.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Spring Lodge DS0000061194.V373962.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People considering moving to the home can be assured that the service will understand their needs and be prepared to meet these. This would be further strengthened by the additional information gathered during the assessment process. The service does not provide intermediate care. EVIDENCE: The documents relating to the admission of one of the people who had most recently moved into the home Spring Lodge DS0000061194.V373962.R01.S.doc Version 5.2 Page 9 The assessment form contained information about the person, their family details, their medication, any allergies and indications of support they required from mobility to personal care. These assessments were accompanied by risk assessments for selfmedicating, prevention of falls, scalding, diabetes, moving and handling and challenging behaviour. The format is brief but provides an overall understanding of the person and their needs. They would benefit from a greater depth of detail about how the person requires support. For example the areas relating to mobility and personal care are in the main tick boxes that identify a need but not the degree of support they require. This would help the service to ensure that they were prepared for the person’s admission. The service does not provide intermediate care. Spring Lodge DS0000061194.V373962.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the service can be confident that the staff will support them in a way that meets their needs and expectations. However this should be better documented in care planning records. EVIDENCE: Care planning on files for four service users were case tracked during the inspection visit. The care plan is made up of double-sided format with sections relating to subjects identified during the person’s initial assessment. These included medical care, personal needs, mobility, moving and handling and transfers, behavioural and emotional care, activities and financial management. Each section contained a few lines of description of the task under consideration and the level of support the person would require. This was in sufficient detail for staff to understand how they would provide support to the person and included reference to risk assessments completed for some areas of support. Spring Lodge DS0000061194.V373962.R01.S.doc Version 5.2 Page 11 Although some if the completed risk assessments held on peoples’ files did not match the information recorded in their daily records or accident records. In one example seen it stated that the person had no history of falls in previous 3 months, whilst accident records relating to them demonstrated that they had suffered falls. Other assessments for risks did not provide a full understanding of how the service is responding to the risks present. This applied to the assessment of bedrails that stated when rails not suitable but did not detail how the risk had been addressed. In another assessment there was an indication that a person suffered from the risk of repeated pressure sores, although there is not action plan in place either in the risk assessment or care plan to reduce these. Overall the risk assessments were present but did not always support the service in determining the most appropriate action to take to reduce the risk. All the care plans were regularly reviewed and these documents contained a higher level of information about the details of a person’s support and how successfully this was being carried out with measurable outcomes recorded in the goal plan, although there were still some issues raised in the initial assessment documents that were not dealt with in the document. Overall the documents contained in the care plan that included assessments, care planning notes, risk assessments and reviews would provide some indication of how to meet a person’s needs but require a review of their quality to ensure they give a summary of clear instructions to staff in how to best meet the persons needs. This is particularly important in supporting people with dementia People who lived at the home said that they were aware of their plan of care and discussed how they understood staff were meant to support them. They felt that the service was tailored to meet their individual needs and preferences and that staff understood them. It was evident from these discussions and observation of staff that they knew more about how people should best be supported than the care plans had documented. There were records of medical attention and visits by health care professionals that were maintained separately in the care plans. This gave a good indication of the reasons for the visit and their outcomes and would support staff in following the instructions to manage individual’s health needs. People spoken with during the inspection said they had regular access to their GP and the district nurse where required. They said the staff were supportive in this. Staff competes the daily records for each person and these contained references to how people have spent their day, but also have statements lifted from care planning documents such as ‘xxx is independently funded and their Spring Lodge DS0000061194.V373962.R01.S.doc Version 5.2 Page 12 family will sort out their affairs’. This has no relevance to the care plan or how the person was supported during that day. The way records are completed and staffs understanding of the reasons for daily recording requires some attention. Health care records were present on care plans and included details of the health professional’s visits and their outcomes. The information from these was translated into people’s care plans for staff to monitor. The overall management of care plans and how the documentation was used to support staff in meeting people’s needs was discussed with the manager and their line manager during the inspection. It was clear that there had already been a review of these records and developments were planned by the service to address these issues. The observation of the lunchtime medication round and the management of medication generally within the service were considered again at this visit. There were no issues found in the management and safekeeping of medication at this visit. Staff administering medications checked prescription records before dispensing the medication and handled medication appropriately when giving them to people. They completed the records appropriately and ensured that medication was secure at all times. A Controlled drugs cabinet was located separately from other drug storage in the main office. Spring Lodge DS0000061194.V373962.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home benefit from a range of opportunities for occupation and activity. These are supported by their care plans and known to staff. EVIDENCE: Activities had developed since last inspection with a programme of trips, events and occupational opportunities posted in the main lounge. This included crocheting, outings to zoos and garden centres as well as entertainment attending the home. There were records maintained of who attended and how much they enjoyed the pursuit. One person told us in a survey that they enjoyed the Zoo outing and likes to play bingo. Another person’s relative told us that they liked to be in the garden as much as possible and that they are encouraged and supported to do so. Spring Lodge DS0000061194.V373962.R01.S.doc Version 5.2 Page 14 The service has a number of people living there with cognitive impairments and for this group of people large scale organised activities may not always be appropriate. The service attempts to engage people in the programme but there needs to be consideration of how the staff involve people in activities of daily life. Staff tended to report on the tasks undertaken rather than how much people took part in the activity themselves. This requires a more holistic approach to this aspect of care support. People also appreciated the opportunity to spend time alone or with their companions and not join activities they did not wish to. Three people spoken with spend time in their rooms and adjoining rooms. They enjoyed being able to read their papers or magazines and not be part of the crowd and appreciated that staff respected their choices. Surveys returned to the Commission by people living at the home and their relatives indicated that the services visiting policy is open and welcoming. One person told us “I am always welcome to see my (relative) at any time I wish…the staff are kind and friendly” The lunchtime meal were observed during the inspection visit and the choice of meals was discussed with people living at the home. Meals were served in an unhurried manner and presented well. In one case where the meal was not quite to the liking of the person this was immediately changed without fuss by staff. People told us that the meals were of a good standard and that they were able to chose from a menu that provided them with more than one option. Meals were taken where people preferred either in dining areas, bedrooms or day rooms. Spring Lodge DS0000061194.V373962.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the service can be confident that they will be listened to and their concerns acted upon. They can be sure that staff have been trained to recognise abuse and will act to protect them. EVIDENCE: The service has a complaints procedure, this sets out the way in which complaints can be made and the timescale that complainants can expect to receive a response to be made. The process meets the guidance set out in the National Minimum Standards for Older People. A complaint log is maintained by the service, although they had not received any complaints since the last inspection. The Commission has not been notified of any complaints in relation to the service. People we spoke with during the inspection told us they knew how to make a complaint and were confident that if they needed to their comments would be followed up and action would be taken. The service has a safeguarding policy and procedures are in place for the reporting of allegations of abuse and staffs whistles blowing procedures. Spring Lodge DS0000061194.V373962.R01.S.doc Version 5.2 Page 16 The policy reflects the guidance provided by the Local Authority safeguarding procedures. All the staff have undertaken training in protecting vulnerable adults from abuse and were able to recognise and understand how to report any concerns of abuse. One report of an allegation of abuse had been made by the service in relation to the behaviour of a staff member. Appropriate action was taken by the home to ensure that people who live at the service were protected. This demonstrated a robust approach to the safeguarding of people living at the home and that the service understands the importance of its actions. The matter had been managed by the local authorities safeguarding unit. Spring Lodge DS0000061194.V373962.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During a tour of the home it was noted that the premises were in good order, clean and well maintained. There were no detectable odours present. Bedrooms were all furnished in a homely way and people had the opportunity to personalize their rooms with their own possessions. Spring Lodge DS0000061194.V373962.R01.S.doc Version 5.2 Page 18 As well as the main lounge downstairs there was also seating areas on the first floor, and people were seen using these facilities as they preferred. There are a number of bathing facilities around the home to suit different people’s needs. The manager reported that there were plans for the bath on the first floor being replaced, as the style required the person to remain seated in the bath whilst it was filling and emptying and this was not popular with people living at the home. The service has a fire safety system in place that is maintained regularly and has annual safety checks carried out by an external company. During the inspection conversations with people living at the service highlighted issues with a Dorgaurd mechanism in place on some rooms. This equipment is a means of fixing open doors. It is not linked to the main fire system but is responsive to the sound of alarms and will retract to allow the door closure mechanism to activate on the sounding of fire alarms. Unfortunately they can be sensitive to other noise and in this case a person complained that they closed at night in response to the nurse call system operating. The person suffered from a high anxiety of closed in spaces and became very agitated if the doors were closed. To overcome this problem they had wedged open the door. Other people were also found to have wedged open doors, and as this presents a fire safety hazard this was discussed with the manager and responsible individual for the company. They were aware of the issue and gave details of steps taken and how further exploration was being made to rectify the issue. Spring Lodge DS0000061194.V373962.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the service benefit from being supported by an experienced and dedicated staff team. They are protected by the home’s recruitment practices and training programme. EVIDENCE: Four staff records were examined at the inspection visit to demonstrate the services approach to recruitment, supervision and training of staff. The recruitment records held for each staff member included completed application forms, two written references from previous employers and checks made against data held by the Criminal Records Bureau and Department of Health’s Protection of Vulnerable Adults list. These checks would provide an understanding of the individual’s previous employment and their suitability to work with vulnerable adults. New staff are inducted into the service using the Skills for Care induction programme. This provides new starters with a sound basis of understanding of Spring Lodge DS0000061194.V373962.R01.S.doc Version 5.2 Page 20 the services ethos and the expected levels of good practice required to meet the needs of people living at the home. Training is organised by the company’s central training unit but each service is able to set up or request training as appropriate. The manager has a training Matrix organised with training for each staff member. This demonstrated that staff had completed training required by health and safety legislation such as moving and handling, first aid, fire safety, safe food handling and health and safety subjects. There was further training planned for infection control in the coming year. The staff files seen contained evidence of them completing other subjects such as dementia and safeguarding adults. Other training linked to identified needs of people living at the home were not included on the matrix and this was discussed with the manager as a point of development. Spring Lodge DS0000061194.V373962.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home can be confident that the service is lead by a competent and able manager. EVIDENCE: Mrs McKeen has been registered manager for some time and has attained her NVQ Registered Managers Award. People we spoke with during the inspection said that they were confident in approaching Mrs Mckeen and felt that the service was operated in the best interest of people living at the home. Spring Lodge DS0000061194.V373962.R01.S.doc Version 5.2 Page 22 The service operates a Quality Assurance programme that includes surveys to stakeholders, meetings with staff and people living at the home, audits by the company. Outcomes of these efforts are recorded and incorporated into the service plans, which are published for people to understand how their comments have been received. Further efforts in quality monitoring are being made to look at specific areas such as admissions and discharges. The management of money held on behalf of people living at the service was considered. The records of money belonging to the three people whose records were case tracked during this inspection were examined. There were clear and auditable accounts held for each person that contained information about income and expenditure along with receipts. The accounts are audited by the company’s main office at regular intervals. Staff supervision is carried out at regular intervals; this was supported by evidence of records maintained of supervision. The recording of supervision has been revised and greater detail is maintained of the discussions and how these feedback into the training programme. Records of maintenance of equipment and annual safety checks were seen during the inspection. These included certificates for the five-year electrical safety, Gas Safety certificate, Records of passenger lift and moving and handling equipment maintenance checks and fire safety checks. These demonstrate that the service is operating safely with the appropriate monitoring measures. Spring Lodge DS0000061194.V373962.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 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 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 Spring Lodge DS0000061194.V373962.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 15 Requirement Timescale for action 30/06/09 2 OP7 13 3. OP7 15 4. OP12 17 (2)(n) People living at the service must be supported by detailed care plans that inform staff about how to support the indiviudal’s assessed needs People must be supported in 31/07/09 taking risks in their daily lives by risk assessments that detail how the risk has been considered and steps taken to reduce the impact on the individual. The way in which the plan of 30/06/09 care is being implemented and how well this is succeeding in responding to the person’s assessed needs must be documented by staff. The registered person must 06/05/09 consult service users about the programme of activities arranged by or on behalf of the care home, providing facilities for recreation having regard for service users’ needs. Spring Lodge DS0000061194.V373962.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP30 Good Practice Recommendations Staff training should reflect the assessed needs of people living at the service. Spring Lodge DS0000061194.V373962.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Spring Lodge DS0000061194.V373962.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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