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Inspection on 10/05/05 for Alexander House Private Nursing Home

Also see our care home review for Alexander House Private Nursing Home for more information

This inspection was carried out on 10th May 2005.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Visitors to the home are always made welcome and offered refreshment. A visitor commented that the staff at the home were `very good and always friendly`. To care for the health needs of residents referrals are made to other professionals whenever needed.

What has improved since the last inspection?

Since the last inspection some improvements were noted at the home. Care plans were better completed and staff had a greater awareness of these. This meant that staff were more aware of residents care needs and better able to meet them. Staffing at the home is now stabilised and an acting manager has been appointed.An advocate said that she felt that the home was now much more welcoming, and that the staff now included residents more in things that affected their lives. They also commented that there was now `a lot of laughter at the home`. Although further work is needed to provide all residents with sufficient activity, residents` individual needs for stimulation and occupation is now more fully assessed and understood by staff. This should improve the outcomes for residents. The home now seems to be more open in the way that they are managing complaints and comments about the service.

CARE HOMES FOR OLDER PEOPLE Alexander House 25-27 First Avenue Westcliff On Sea Essex SS0 8HS Lead Inspector Vicky Dutton Gwen Buckley Unannounced 10th May 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Alexander House I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Alexander House Address 25-27 First Avenue Westcliff On Sea Essex SS0 8HS 01702 339635 01702 431096 asstav@aol.com Health and Home Limited Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Vacant CRH Care Home 25 Category(ies) of DE(E) Dementia-over 65 (12) registration, with number OP Old Age (25) of places Alexander House I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. To provide care and accommodation for one service user who is under 65 years of age and known to the Commission for Social Care Inspection. 2. Suitable private accommodation for all service users in line with the National Minimum Standards for Older People must be provided by April 2007. 3. Sufficient bathing faclilties for all service users in line with National Minimum Standards for Older People must be provided by April 2007. Date of last inspection 18th October 2004 Brief Description of the Service: Alexander House is a two storey private home situated in a quiet residential area of Westcliff on Sea, close to the seafront. The home is close to local bus routes. Alexander House is registered to provide personal care, nursing care and accommodation for 25 Older people. The home has 12 places for service users who have dementia. Accommodation is provided on three floors in nine single and eight double rooms. Two bedrooms benefit from en suite facilities. Other facilities include two communal lounges and a dining area on the ground floor. A passenger lift provides access to all levels within the home. Visitors parking is available at the front of the property. There is a well maintained garden to the rear for residents to use. Alexander House I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of five and a half hours. As an inspector and regulation manager undertook the inspection, this equated to eleven hours input. The inspection mainly focused on the progress the home had made since the last inspection. The home now has an acting manager in place and registration has been applied for. At this inspection a tour of the premises took place. Care and staffing records were selected at random and inspected. Medication processes and some health and safety records were also inspected. A number of residents and staff and one visitor were spoken with. After the inspection one of the resident’s advocates was spoken with on the telephone. Shortly after the inspectors’ arrival the company secretary for Health and Home arrived and took a lead role in the inspection process. The acting manager and other staff also assisted and took part in the inspection process. What the service does well: What has improved since the last inspection? Since the last inspection some improvements were noted at the home. Care plans were better completed and staff had a greater awareness of these. This meant that staff were more aware of residents care needs and better able to meet them. Staffing at the home is now stabilised and an acting manager has been appointed. Alexander House I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 Page 6 An advocate said that she felt that the home was now much more welcoming, and that the staff now included residents more in things that affected their lives. They also commented that there was now ‘a lot of laughter at the home’. Although further work is needed to provide all residents with sufficient activity, residents’ individual needs for stimulation and occupation is now more fully assessed and understood by staff. This should improve the outcomes for residents. The home now seems to be more open in the way that they are managing complaints and comments about the service. What they could do better: So that residents and their families can make informed choices about moving into care, the home must provide them with comprehensive information about the services that they offer. Although the home meet with prospective residents and assess their needs, they must be sure that they can meet these needs. The home must not admit service users that fall outside of the categories that they are registered to provide care and accommodation for. Most care plans sampled were well completed but some shortfalls were noted in the case of one resident. To help staff understand what is needed to properly care for residents the home must make sure that all individual plans of care always identify and include every aspect of care needs, and the choices and preferences of residents. To make sure that residents are kept safe medication must be managed in a way that follows all currently recommended procedures. Residents must have the opportunity to engage in social and individual activities. The home needs to continue to develop a range of suitable activities and opportunities for individual residents. The records held on staff induction and recruitment are not sufficiently well organised to ensue resident’s safety. The home must begin planning for the upgrade of the premises to meet the conditions on the home’s certificate. Plans and a schedule of works must be submitted to and agreed with the CSCI, the Fire Service, and the Health and Safety Executive before works begin. Residents welfare must be considered throughout the development. Please contact the provider for advice of actions taken in response to this Alexander House I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Alexander House I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Alexander House I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3, 4 Prospective residents and their families are not given comprehensive information about the home to enable them to make an informed choice about moving in. EVIDENCE: The home has not developed an adequate statement of purpose or service users guide. The acting manager confirmed that although she goes to meet and assess prospective residents, she can only tell them verbally about the home. There is no brochure or service users guide available to give people, so that they can be effectively informed about the service. Records viewed at this inspection showed that residents do have their needs assessed before moving into the home. However, two of the most recent admissions to the home have had complex needs with a clearly identified mental health diagnosis. The home is not registered to offer placement to residents in this category. Staff spoken with confirmed that they had not received training in the specific conditions identified. This does not ensure that residents will receive the best possible approach to meeting their needs. Alexander House I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 Page 10 In spite of the above, the home does seem to have made good progress in meeting the needs of recently admitted residents. An advocate for one resident said that the resident’s consultant had been ‘shocked at the change for the better’ in their condition. Staff training at the home is ongoing and should include training in the specific conditions relevant to residents’ needs. Residents at Alexander House mostly have a high level of care needs. Alexander House I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10 Care planning at the home is generally comprehensive and provides an adequate basis to ensure that residents’ health and care needs are met. This was not however true in all cases. EVIDENCE: Four care files were viewed at this inspection. Apart from one, they were well completed and provided staff with ample information and guidance to assist in meeting residents needs. Records showed that referrals were sought for input by other professionals such as speech therapist, dietician and physiotherapist. The home continues to experience difficulty in providing regular dental care for residents. Residents spoken with felt that the home met their care and health care needs. One resident was keen to particularly praise staff for the help and support they had received during a recent hospital procedure. One resident spoke of a specific health need, for which they took medication. This was not identified in the care plan and no guidance for staff nor risk Alexander House I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 Page 12 assessment in place for self administration. The acting manager did not feel that the condition had been formally diagnosed and agreed to look into this. As the home is registered to provide nursing care, registered nurses administer medication at the home. This inspection identified some shortfalls in best practice that would ensure residents are kept fully safeguarded. For example, medication was stored loose in the homes kitchen refrigerator, no labels on inhalers, no risk assessment in place for a resident who holds some of their own medication. (This was rectified during the inspection). During the inspection staff at the home were noted to treat residents with respect, and uphold their dignity. One shared room was noted not to have a dividing curtain in place to ensure that residents can maintain their privacy. Staff confirmed that this was on order. Alexander House I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15 There is currently little in the way of planned or other activity in the home to provide residents with adequate stimulation and occupation. The meals provided were adequate to meet residents’ needs. The home considers the religious and cultural needs of residents. EVIDENCE: During this inspection residents mostly sat passively in chairs in the lounge areas of the home. The television was on during the whole visit. When music was put on for service users the sound on the television was just turned down. A visitor said that there were no activities at the home, but that her relative would probably not want this anyway. A resident commented that ‘there is nothing to do’. This inspection noted an increase in staff/residents interaction. An advocate also said that they thought that the staff now involved residents much more. The acting manager said that activities appropriate to individual needs are now being developed. Musical entertainers regularly visit the home. Residents can access a mobile library, and some trips out are planned, with extra staff being provided to cover this. Some residents were noted to receive and enjoy a daily paper. One resident spoken with stated that the home arranged for her to have a visiting minister and they try to meet her cultural needs. Staff spoke of Alexander House I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 Page 14 appropriate arrangements on an individual basis to meet the needs of residents. Personal choices such as rising and retiring times were recorded in care files. At lunchtime during the inspection it was seen that residents were offered choice. Appropriate help and encouragement was given to residents to ensure that they had sufficient food and drink. Residents generally spoke well of the food offered by the home. Alexander House I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Residents and relatives can raise issues and feel that these will be dealt with. EVIDENCE: Since the previous inspection one complaint has been made directly to the CSCI about the home. Elements of the complaint related to care practices and environment were partly upheld. A visitor said that they would feel happy to raise any concerns with staff at the home. A resident spoken with felt confident she would be listened to as she had a member of staff that she would approach if there was a concern or complaint. The home now has a process in place dealing with complaints. It was an improvement to note that two recent complaints had been openly recorded and dealt with appropriately. Alexander House I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25, 26. The standard of the environment and furnishings is generally poor and does not provide residents with a well maintained, attractive and homely place in which to live. EVIDENCE: Alexander House has a condition on their registration that the premises and facilities must be brought up to current National Minimum standards by 2007. Work to achieve this has not yet begun. Specific shortfalls in relation to the premises have been fully itemised in previous inspection reports which can be viewed via the CSCI website on www.csci.org.uk. At this inspection service users who could express an opinion said that they were generally satisfied with the accommodation provided. As at the previous inspection one resident was noted to have the chair in her room pulled away Alexander House I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 Page 17 from the wall as there was a hole there with pealing paper and plaster. Furnishings in private and communal areas were often shabby. Some bedrooms were noted to be quite dusty. The premises posed a potential risk to residents. A particular concern at this inspection was that materials such as bleach and toilet cleaner had been left in toilet and bathroom areas accessible to residents. Alexander House I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29, 30. .Recruitment practice has improved although further development is needed. Record keeping is not up to date with regards to filing recruitment and training records. Recruitment and training records are not stored as required. EVIDENCE: On arrival at the home the inspectors found that the home was operating at below their minimum agreed staffing levels. Two care staff and a nurse in charge were on duty to care for fifteen dependent residents. Staffing levels must be maintained so that residents receive full care and attention. No new staff have been employed since the last inspection although two posts are about to be filled. Records of four staff were viewed and improvements in recruitment practice over the last 18 months was noted. However, further development is required to ensure service user safety. Gaps in employment noted in CVs should be explored and reasons why recorded: telephone confirmation of references should be made and outcomes recorded. It is also recommended that a risk assessment is undertaken when staff are planning to work long hours as tired staff can be a risk to themselves, other staff and residents. Records were not always up to date and the homes own policy not always followed in that: check lists on front of staff files were not always completed as expected; a large amount of training records were not filed in individual files Alexander House I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 Page 19 making it very difficult to evidence what training each member of staff has attended. TOPSS training has recently started to be implemented, although again due to the lack of up to date filing of training attended it was difficult to assess progress in this area for each member of staff. The home needs to ensure records are up to date to enable effective supervision and staff development. Thus providing a better system to meet the needs of residents. The provider stated supervision has not yet been implemented as other developments in practice had taken priority, but he sees the need for this to be in place now. The home does not intend that care staff undertake NVQ 2 or 3 as they are already nurses in their country of origin. However, this may mean they do not have a holistic view of care and services users needs may not all be understood outside of the medical model. Given that the home undertake a variety of training for staff it is recommended that they use the various training presently provided along with the nurse qualifications being assessed against NVQ towards the NVQ award. Gaps in training to meet the standard will be identified and many of the staff may already have the knowledge and competence to achieve the award. Alexander House I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 38 The acting manager has not yet had time to establish a strong presence in the home. Residents have not benefited from a consistent management approach at the home. EVIDENCE: Alexander house has been without a registered manager for over two years. An acting manager has now been appointed, and has applied to the CSCI to be registered. If successful this will improve the stability of the home and benefit residents. Health and safety records were sampled. To keep residents safe water temperatures must be fully monitored and remedial actions taken as appropriate. The home must be able to evidence that equipment is kept serviced and safe for residents. Alexander House I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 Page 21 Alexander House I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 1 x 1 2 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 1 1 2 2 2 3 1 STAFFING Standard No Score 27 x 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 2 x x x x x x 2 Alexander House I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 Page 23 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 4 Requirement Timescale for action 01/07/05 2. 1 5 3. 3 14 4. 4 18 The registered person must ensure that the Statement of purpose incorporates all elements as required by regulation. A copy must be provided to the Commission For Social Care Inspection, (CSCI). (Precious requirement date of 01/02/05 not met). The Service User Guide must 01/07/05 incorporate all elements as required by regulation. A copy must be provided to the CSCI and all service users. (Precious requirement date of 01/02/05 not met). The registered person must not 01/07/05 offer accommodation to a service user unless their needs have been fully assessed by a person competent to do so. Confirmation of the assessment and the ability of the home to meet their needs must be given to the service user in writing. This refers to the home admitting residents with specific mental health needs for which the home is not registered. Staff at the home must receive 01/08/05 training appropriate to the work I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 Alexander House Page 24 5. 7 15 6. 12 16 they are to perform. This refers to the need for staff to have specific training and knowledge relevant to residents assessed needs and conditions. A detailed service user plan of care must be drawn up in consultation with service users, families and significant multidisciplinary personnel. The care plan must reflect all aspects of service users assessed needs, include risk assessments for appropriate areas. This refers to the shortfals indentified at inspection. The registered Person must ensure that the routines of daily living and activities made available are flexible and varied to suit service user’s expectations, preferences and capacities. Activities and stimulation must be provided that meet individual assessed needs. (Previous requirement date of 14/01/05 not met.) A planned programme of maintenance and refurbishment must be developed for the home in order that systematic improvement of the environment takes place. Plans must be sent in to the CSCI as to how the home intends to meet their conditions of registration in relation to the home. (Previous requirement date of 01/02/05 not met.) The home must provide accommodation for each service user, which is furnished and equipped to assure comfort and privacy, and meets the assessed needs of the service user. This with reference to door locks. I56 S40206 Alexander House V225956 100505 Stage 4.doc 01/07/05 01/08/05 7. 19, 22, 23, 25 23 01/08/05 8. 24 12 01/12/05 Alexander House Version 1.30 Page 25 (Previous requirement date of 01/05/05 not met.) 9. 26 13 Hand washing facilities with hot water must be available in areas where infected material and or clinical waste are handled. This with particular reference to both the homes sluices and some communal toilet areas. (Previous requirement date of 01/02/05 not met.) The registered person must make arrangements to prevent the spread of infection at the home. This refers to the need for the home to be maintained in a clean and hygienic state. (Previous requirement of immediate not met.) The registered person must ensure that at all times suitably qualified and competent staff are on duty in sufficient numbers as are appropriate to meet the health and welfare needs of service users. Staffing ratios must ensure that the number of staff employed and on shift is sufficient to meet the assessed needs of service users in the home. Appropriate staffing levels must be maintained throughout the day. (This is a repeated requirement.) The registered person must ensure that robust recruitment processes are maintained and that records required by regulation are available at the home. (Previous requirement of immediate not met.) The registered person must ensure that there is a robust I56 S40206 Alexander House V225956 100505 Stage 4.doc 01/08/05 10. 26 13 01/06/05 11. 27 18 01/06/05 12. 29 19 01/06/05 13. 30 18 01/07/05 Version 1.30 Page 26 Alexander House staff induction, training and development programme, which ensures staff fulfil the aims of the home and meet the changing needs of service users. Suitable systems to record this information should be developed. (Previous requirement dare of 01/02/05 not met.) 14. 36 18 The registered person must ensure that staff at the home receive regular formal supervision to support them in the work they carry out and written evidence is available on future Inspection visits. (Previous requirement date of 01/02/05 not met.) Proper provision must be made for the health and safety of residents. This refers to the need to ensure the appropriate storage of COSHH materials. Proper provision must be made for the health and safety of residents. This refers to the need to ensure that the appropriate actions are taken and recorded when water temperatures are identified at over the reccommended temperatures. Equipment at the home must be appropriatly serviced and maintained. This refers to the homes hoist servicing records not being available. This information must be sent in to CSCI. 01/07/05 15. 38 12 01/06/05 16. 38 12 01/06/05 17. 18 23 01/06/05 Alexander House I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 9 28 36 Good Practice Recommendations The best practice issues identified in relation to the homes medication processes should be implimented. 50 of care staff to be trained to NVQ level 2 or above by 2005. Care staff should receive formal supervision at least six times a year. Alexander House I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 Page 28 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend On Sea Essex, SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Alexander House I56 S40206 Alexander House V225956 100505 Stage 4.doc Version 1.30 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. 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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