CARE HOMES FOR OLDER PEOPLE
Aliwal Manor Turners Lane Whittlesey Cambridgeshire PE7 1EH Lead Inspector
Nicky Hone Key Unannounced Inspection 02 August 2006 1:00 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 Aliwal Manor DS0000015291.V293528.R01.S.doc Version 5.1 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. Aliwal Manor DS0000015291.V293528.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Aliwal Manor Address Turners Lane Whittlesey Cambridgeshire PE7 1EH 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) 01733 203347 01733 203566 Aliwal Healthcare Ltd Care Home 30 Category(ies) of Dementia - over 65 years of age (9), Old age, registration, with number not falling within any other category (30) of places Aliwal Manor DS0000015291.V293528.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 20th December 2005 Brief Description of the Service: Aliwal Manor is a care home providing residential accommodation for up to thirty service users, including nine places for people with a formal diagnosis of dementia. The home is situated in the town of Whittlesey, Cambridgeshire with good access to local facilities. The home is divided up into four separate units: Wordsworth, Shelley, Byron, and Tennyson and includes a unit designated for service users with dementia. Each unit has a separate lounge, a dining room and a kitchen where snacks and drinks are prepared. The main meals are prepared in a central kitchen and there is a main laundry room. There are an adequate number of toilets and the home has five large bathrooms, which have assisted bathing equipment. There is a separate shower room. The home employs an activities coordinator who works at the home for four hours a day. There is a separate day centre, which is accessed by people in the local community on two days a week and can be used by service users living in the home. The fees for accommodation and care at Aliwal Manor start at £340 for residential care and £415 for dementia care. Twenty four of the places are block-booked by Cambridgeshire County Council, with the other six available to service users who fund their own care. The Commission for Social Care Inspection (CSCI) produces a published report following each inspection. These reports are available in the foyer of the home. Aliwal Manor DS0000015291.V293528.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. At the time of this inspection, there was no manager in post at Aliwal Manor, and the team leader who was acting manager was on holiday. The Regional Operations Manager (ROM), Donna Samujh, attended the inspection. There were twenty-eight service users in residence. This inspection was unannounced and was carried out over 4.5 hours. The inspector made a tour of the building, spoke to service users and staff, checked some records and spent time in discussion with the ROM, the team leader on duty and the administrator. What the service does well: What has improved since the last inspection? Aliwal Manor DS0000015291.V293528.R01.S.doc Version 5.1 Page 6 It was disappointing that none of the six requirements made following the inspection in December 2005 had been fully met, and that today’s inspection has resulted in eighteen requirements. 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. Aliwal Manor DS0000015291.V293528.R01.S.doc Version 5.1 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 Aliwal Manor DS0000015291.V293528.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home carries out an assessment of the needs of each new service user before the person is admitted, so that service users can be confident that their needs can be met. EVIDENCE: The file of a service user who was staying at the home for a respite stay was checked. There was a detailed assessment on the file. On the morning of the inspection one of the staff had been out to carry out an assessment with a person who was due to have a respite stay at the home. The assessment was seen and contained good information. Intermediate care is not offered at this home. Aliwal Manor DS0000015291.V293528.R01.S.doc Version 5.1 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Care plans do not contain enough information nor give clear enough guidance to make sure service users’ needs can be met by the staff. Not enough attention is paid to ensuring health issues are recorded. EVIDENCE: The files of two service users were checked. One of these service users was visiting the home for a short stay. It was difficult to find the information that would be needed to offer care to this person as the file was very muddled. The care plan was not signed or dated, and contained little guidance as to how this service user wanted her needs to be met. Two ‘daily diary record’ sheets had been started, with notes from different days on each sheet: some dates were missing altogether. Some good assessments, for example a risk assessment for moving and handling, a nutrition assessment, and an assessment of the risk of pressure sores had been completed, but were not linked to care plans nor to daily notes.
Aliwal Manor DS0000015291.V293528.R01.S.doc Version 5.1 Page 10 A second file, of a service user who spends the majority of time in bed, was looked at. There was a care plan on the file which had been reviewed and updated in June 2006, and risk assessments had been carried out. However, charts to monitor aspects of this person’s care had been started but not completed consistently. For example, according to the fluid chart, on one day the service user had not been offered a drink between 15:00 and 20:30; the service user had only been turned twice in one twenty-four hour period; and the diet chart only listed food available, not whether any had been eaten nor the quantity eaten. Two service users spoken to said they have been shown their care plans regularly and signed them: it was not clear whether the service users had any part in deciding what was written on the plan. Service users spoke about regular visits from the chiropodist, and said they have their own doctor. Sometimes they are taken to the surgery (which is next door to the home), or the doctor visits them at home. Medication Administration Record (MAR) charts were seen in two of the units. There was some evidence that the requirement made at the previous inspection, that reasons for medicines not being administered must be recorded on the reverse of the charts, had been complied with for a short while, but this had not been maintained. Changes to MAR sheets were not signed and dated, and there was no list of staff members’ initials to link them with their full names. The CSCI pharmacist will be asked to visit the home to carry out a full inspection of medication issues. Service users said they are quite happy for the staff to look after their medicines for them and that they are given their medication at the right time. Two service users spoken to said their privacy is respected, and staff were observed to knock on doors before entering service users’ rooms, toilets and so on. The two service users both said they have a lock on their bedroom door which they can lock if they want to. Staff were seen assisting service users with their food at lunchtime: this was done in a very relaxed way and the interaction between the staff and the service users was friendly and respectful. Aliwal Manor DS0000015291.V293528.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users said that they can make choices about the way they live their lives. EVIDENCE: Two service users spoken to said they have an active social life, as there is plenty going on if service users want to join in. They spoke about being taken to the shops when they want to go, birthday parties, music entertainment brought in to the home, bingo, games and more. They can go to the day centre if they want to, on Tuesdays and Thursdays, and join in what goes on there. They said the hairdresser is in the home every week, and the chiropodist visits regularly. These two people were happy that they are able to make choices about how they live their lives, and that these choices are respected by the staff team. The home employs an activities coordinator who works four hours a day in the mornings. At the start of the inspection she was helping service users in the dementia unit with their meal. Care staff said they also try to do activities with the service users in the afternoons. Records of activities are kept in service users’ files, with an assessment of each person’s social care needs. The
Aliwal Manor DS0000015291.V293528.R01.S.doc Version 5.1 Page 12 records seen indicated that still more could be done to improve the range and frequency of activities offered to the service users. Service users said their families and friends can visit at any time. They can go out with their visitors if they want to, or they can pay for their visitors to join them for a meal. Every birthday, service users choose whether they want a private party with family and friends, or with other service users: the cook provides buffet food and a birthday cake. All service users spoken to were very pleased with the quality of the food. One service user showed me the menu on the board in the unit kitchen, which lists two choices for the main course every day except Wednesdays and Sundays, when a roast lunch is offered. This service user said that the care staff come round every morning and ask them to make a choice from the menu. If they want something different, the cook will make it for them. On speaking to the cook I was impressed with the range of alternative meals that are available, including a wide choice of vegetarian food, if service users want something other than the two main choices. The menu showed a cooked breakfast being available on Sundays, but two service users said they hadn’t been offered this for some time: breakfast consists of cereal and toast. Service users upstairs said that they and their visitors are able to make drinks, hot or cold, at any time. The menu on the day of the inspection stated that there was roast pork for lunch: the cook explained that this had not been delivered so she had cooked roast turkey breast roll which she had in the freezer. Service users said they had enjoyed the meal: it looked appetizing and nutritious. The cook keeps a record of what food is provided: more detail of the alternatives provided must be recorded. The cook was assisting one of the service users with their lunch in the dementia unit. She explained that five people need assistance with their food, so all staff help out with this so that all the service users can have their meal at the same time. The cook goes round the home every lunchtime to make sure that the service users are enjoying the meal. She writes the menus based on what the service users tell her they like to eat. Aliwal Manor DS0000015291.V293528.R01.S.doc Version 5.1 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users know how to complain and feel confident any complaints will be addressed. Staff training in the Protection of Vulnerable Adults is not adequate to ensure that service users are protected from abuse. EVIDENCE: Two service users spoken to said they would be happy to talk to Diane (acting manager) in the office if anything was wrong, and that she would sort out their problems, but neither had ever needed to complain. One of the service users showed me where the complaints procedure was pinned to the notice board, and read out that she could also complain to the CSCI if she wanted to. A complaints log and record of all action taken following a complaint is kept. Not all staff have received adequate training in the Protection of Vulnerable Adults. Aliwal Manor DS0000015291.V293528.R01.S.doc Version 5.1 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The maintenance of this home, both inside and outside, is not good enough to make sure service users have a clean, well-maintained and comfortable place to live. EVIDENCE: It was disappointing to note that the physical environment is not as well maintained as it used to be. For example, several corridor and lounge carpets throughout the home were stained; walls in one unit were dirty; toilets were not clean; there was a damaged chair in one lounge; wallpaper was peeling off the walls in several places; and tiles in one of the toilets were coming off the walls. There was a strong smell of stale urine in one of the bedrooms seen and in a corridor. Some of the outside areas have also been allowed to become messy and poorly maintained. The garden areas at each side of the glass corridor were full of rubbish: broken coat hangers, old dishcloths, discarded pegs, and
Aliwal Manor DS0000015291.V293528.R01.S.doc Version 5.1 Page 15 general rubbish. The patio garden outside one of the lounges was overgrown and unkempt and the tubs were full of dead plants and weeds. This patio had a very deep drop to one side of the path, with no protection for service users. The ROM said that a maintenance team had been booked to visit the home the following week to deal with external maintenance. Aliwal Manor DS0000015291.V293528.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff team is committed to offering a quality service, but training offered to them is not adequate to ensure that they are properly trained to carry out their jobs well. EVIDENCE: It was very clear during the inspection that the staff team at this home is a dedicated group of people, committed to ensuring they do their very best for the service users in their care. I spoke to three staff at some length during the course of the inspection. Two had been at the home for several years and both said how much they enjoy working at the home. They said “it’s a lovely home to work in”; “the staff are really nice; and “it’s a good staff team”. I observed some staff, especially in the dementia care unit, interacting well with service users. According to the staff roster, there are usually four care staff plus the team leader in the home during the day, and three staff at night. Staff who spoke to me said there are not always enough staff to meet the needs of the service users. They said the team works well together and try hard to cover each other’s shifts if there are gaps, but it is not always possible. These staff said they had undertaken a range of training courses in the past, including one of them doing her NVQ level 2 in care, but there had not been so
Aliwal Manor DS0000015291.V293528.R01.S.doc Version 5.1 Page 17 much available recently since there had been no permanent manager in post. Both said they had not had training in infection control, or in care of people with dementia. Training records seen were disappointing: I was told they were not up to date. However, these were the records that were available for inspection and from these records, none of the staff have received adequate, up-to-date training. For example, only three staff have had any training in fire safety awareness in 2006: all other staff have not had this training since 2004. The ROM agreed that several staff have not had dementia care training, nor training in the Protection of Vulnerable Adults. One person’s record showed she had not had a refresher course in moving and handling, and no staff have had training in infection control. A new workbook for induction training was shown to me: this now includes an introduction to Protection of Vulnerable Adults. However, there were no completed induction workbooks available for inspection, so no evidence that any staff have undergone this induction training. Personnel files for two staff members were checked. Neither of these files contained all the records required by the regulations. For example, there was no evidence on either file that a Criminal Records Bureau (CRB) disclosure had been received. On one of the files, of a member of staff from overseas recruited through an agency, there were no references. The ROM said that recruitment is dealt with by head office: staff would not be allowed to start work if the full information had not been received. Nevertheless, this information was not available for inspection, as required. Aliwal Manor DS0000015291.V293528.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 37, 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The issues identified during this inspection show that the home has suffered because there has been no permanent manager in post, resulting in a general deterioration in the standard of the service. EVIDENCE: Several of the staff who spoke to me were concerned about the number of changes of manager at the home, especially in the last 3-4 years, and said it has been “a bit tough recently” with no manager in post, even though the team leader who is acting manager has done her best. The ROM said this has been addressed by the company and a new permanent manager has been appointed: she is due to start at the home in mid-August. Aliwal Manor DS0000015291.V293528.R01.S.doc Version 5.1 Page 19 The company has a quality assurance system in place which is organised from their London office. Questionnaires are sent each year to all interested parties (service users, relatives, other professionals and so on), and the results collated into a report. This was available in the front entrance hall and a copy has been sent to the CSCI. The home only holds a small amount of cash for one service user. Records were seen and the recorded balance and cash total were accurate. Records of supervision of staff showed little evidence that supervision takes place regularly as required by the regulations and standards. There were only two records seen for supervision in 2006, one session with two staff in early May 2006, and one session for one staff member in mid May 2006. Monthly visits by a representative of the registered provider are carried out as required. A copy of the report written following the visit is kept in the home and a copy sent to the CSCI. It is disappointing that the issues identified during this inspection have not been identified and addressed as a result of the provider’s visits. Records in the kitchen showed that temperatures of fridges, freezers, heated trolleys and the hot food are recorded daily. Records of tests of the fire alarm system showed that tests had been carried out almost every week as required. The emergency lighting system had been tested monthly as required. Two issues discussed in other sections of the report above relate to health and safety issues and these were raised with the ROM: the patio area outside one of the unit lounges had a very deep drop to one side of the path, with no protection for service users; staff have not received adequate training in matters relating to health and safety, for example, moving and handling, infection control and fire safety. Aliwal Manor DS0000015291.V293528.R01.S.doc Version 5.1 Page 20 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 2 9 2 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 2 1 X X X X X X 2 STAFFING Standard No Score 27 2 28 2 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 3 X 3 1 2 2 Aliwal Manor DS0000015291.V293528.R01.S.doc Version 5.1 Page 21 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 OP7 Regulation 15 Requirement The registered person must prepare a written plan of care for each service user, detailing how the service user’s needs are to be met. The registered person must ensure that the healthcare needs of service users are met. Accurate records of the administration of medication must be maintained. The opportunities for service users to engage in leisure activities must continue to be improved. All staff must receive training in the Protection of Vulnerable Adults. The registered person must ensure that the home is kept reasonably decorated. A programme for the refurbishment of the home must be produced and submitted to
DS0000015291.V293528.R01.S.doc Timescale for action 30/09/06 2 OP8 12(1)(a) 31/08/06 3 OP9 13(2) 02/08/06 4 OP12 16(2)(n) 30/09/06 5 OP18 13(6) 30/09/06 6 OP19 23(2)(d) 30/09/06 Aliwal Manor Version 5.1 Page 22 the CSCI within the timescale. 7 OP19 23(2)(b) The registered person must ensure that the home is kept well-maintained. Defects identified on the day of the inspection must be rectified. Carpets identified as stained must be cleaned or replaced. External grounds must be appropriately maintained. All parts of the home must be kept clean. The premises must be kept free from offensive odours. The registered person must ensure that at all times adequate numbers of staff to meet the needs of service users are working in the home. Full information as detailed in Schedule 2 must be obtained before a person commences employment at the home. The registered person must ensure that staff receive training appropriate to the work they are to perform. Dementia care training must be arranged for all staff. This was a requirement following the inspection on 20/12/05: the timescale has not been met. All new staff must undergo an induction programme and a written record must be kept. Induction learning topics must show evidence of achievement. This was a requirement
DS0000015291.V293528.R01.S.doc 30/09/06 8 9 10 11 12 OP19 OP19 OP26 OP26 OP27 16(2)(c) 23(2)(o) 23(2)(d) 16(2)(k) 18(1)(a) 31/12/06 31/08/06 30/08/06 30/08/06 30/08/06 13 OP29 14 OP30 19(1), schedule 2& schedule 4 18 (1)(c) 02/08/06 31/12/06 15 OP30 13(6) 31/08/06 Aliwal Manor Version 5.1 Page 23 following the inspection on 20/12/05: the timescale has not been met. 16 OP31 9(2)(b) The registered person must ensure that the person employed to manage the home has the qualifications, skills and experience necessary for managing the care home. Arrangements must be made for all care staff to receive supervision at least six times a year. All staff must receive at least one session within the timescale. The registered person must ensure that staff receive training appropriate to the work they are to perform. Evidence must be available to show that all care staff have received training in moving and handling; infection control; first aid; safe food handling; and fire safety awareness. 30/09/06 17 OP36 18(2) 31/10/06 18 OP38 13 and 18(1)(c) 31/12/06 Aliwal Manor DS0000015291.V293528.R01.S.doc Version 5.1 Page 24 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 OP37 Good Practice Recommendations Training records should identify who has provided training, and what quality or level of training is being provided. Generally the training records should be informed by some analysis of the quality and appropriateness of the training and not just the title. More emphasis on providing details of the training should be available for future inspections. This recommendation was made following the inspection on 20/12/05 and had not been addressed. Aliwal Manor DS0000015291.V293528.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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