Inspection on 12/08/05 for Alver Bank

This inspection was carried out on 12th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Alver Bank 07/11/06

Alver Bank 10/01/06

Alver Bank 20/01/05

Alver Bank 16/06/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Alver Bank 17 West Road Clapham London SW4 7DH Lead Inspector Rehema Russell Unannounced 12 August 2005 th 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. Alver Bank G52-G02 S22717 Alver Bank V243837 120805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Alver Bank Address 17 West Road, Clapham, London SW4 7DH 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) 0207 627 8061 0207 720 2150 Lipnicka.Margaret@salvationarmy.org.uk The Salvation Army Ms Malgorzata Lipnicka CRH Care Home 27 Category(ies) of PC Care home only registration, with number of places Alver Bank G52-G02 S22717 Alver Bank V243837 120805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th January 2005 Alver Bank G52-G02 S22717 Alver Bank V243837 120805 Stage 4.doc Version 1.40 Page 5 Brief Description of the Service: Alver Bank is a home for older people owned by the Salvation Army Housing Association and managed by the Salvation Army Social Services. It is located in an historic listed building set in large, landscaped grounds. Within the same grounds and adjoining the home, there is a sheltered housing complex, as well as independent flat and a community centre. The home is situated between Brixton and Clapham and has good transport links. It offers some parking at the front of the home and on street parking. There is accommodation for 27 older people, all in single rooms. The ground floor has two lounges, the treatment room, two offices, the dining room, the kitchen, a few bedrooms, several toilets and bathrooms, and access to the gardens and grounds via stairs or a ramp. The first floor has the majority of bedrooms, several bathrooms and toilets, a shower room and a kitchenette. There is a passenger lift to the first floor which is shared by the sheltered housing block that adjoins the home. There are landscaped gardens to the front and rear of the property. The home and grounds are fully wheelchair accessible. Alver Bank G52-G02 S22717 Alver Bank V243837 120805 Stage 4.doc Version 1.40 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 12th August 2005. There were 25 residents in the home, with one resident in hospital and one vacancy. The inspector spoke with the manager, deputy, several support workers, several service users and one visiting relative. The inspector also perused documentation, ate lunch with residents and observed activities including a birthday party. What the service does well: 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. Alver Bank G52-G02 S22717 Alver Bank V243837 120805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Alver Bank G52-G02 S22717 Alver Bank V243837 120805 Stage 4.doc Version 1.40 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 standard(s) 1, 3 and 6 Prospective residents have the information they need to make an informed choice about the home and an assessment of need is undertaken prior to admission. EVIDENCE: There is a comprehensive and easily understood brochure, Statement of Purpose and Service Users’ Guide. They provide all of the information required by regulation, including residents’ views of the home. This information is regularly reviewed and updated, most recently in June 2005. Verbal and documentary evidence showed that all service users have a full assessment of needs before entering the home. Prior to admission, the home obtains the community care services assessment of need and any other relevant specialist reports and reviews. On this basis and information observed and obtained on internal assessment and trial visits, a dependency profile is compiled. This profile is the home’s internal assessment. The resident’s care plan is devised from this and the community care assessment. The dependency profile is updated monthly. The home does not admit residents for intermediate care. Alver Bank G52-G02 S22717 Alver Bank V243837 120805 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9,10 and 11 Residents’ individual health and personal care needs are laid out in care plans. The full range of healthcare specialists and facilities are employed to meet residents’ needs. Residents are safeguarded by the medication storage, administration and recording systems at the home. Residents feel they are treated with respect and their privacy is upheld. Funeral plans are in place to ensure residents’ wishes are met. EVIDENCE: Three care plans were seen. They were all signed by the resident plus the manager/senior care assistant/key worker as appropriate. One care plan was also signed by a relative of the resident. Each care plan had between 6 – 10 components which covered the mobility, health, communication, financial and behavioural needs of the resident. Each component clearly described the need and how it was to be met. There was no specific component for social needs as residents are given a full choice on whether to socialise and to join in with the activities at the home and this would only be listed if it presented as a mental, emotional or behavioural need. Monthly reviews are held via the updating of the dependency profile. Formal six monthly reviews are held and recorded, and evidence that relatives are invited to attend these was seen. Key workers spoken with were fully conversant with the care plans of the residents’ Alver Bank G52-G02 S22717 Alver Bank V243837 120805 Stage 4.doc Version 1.40 Page 10 they key worked. A second care file for each resident is kept in the treatment room. This has a detailed medical profile and records of doctor and other specialist appointments. These files showed that the full range of healthcare specialists is accessed for residents, either by the specialist visiting the home or by residents being escorted and transported to external appointments. A third care file is kept locked in the manager’s office. This file has information on financial matters, medical records and contract issues and other matters that it is not necessary for health or care workers to access. In this way, residents’ confidentiality is safeguarded. The storage, administration and recording of medication was checked and found to be satisfactory. The policy at the home is for only senior care assistants to administer medication and this was clearly understood by the care assistant with whom the inspector spoke. A requirement was made following the previous inspection that all visiting professionals and the home’s staff adhere to the appropriate practice for safeguarding residents’ privacy and dignity in regard to personal care given in the treatment room. The inspector observed throughout the day that this was being adhered to by visiting professionals and the home’s staff, both in the treatment room and in other areas of the home. Staff were observed to approach residents respectfully and discreetly in matters of personal care and hygiene, and residents spoken with confirmed that staff treated them with respect and safeguarded their privacy and dignity. Another requirement arising from the previous inspection was for all residents to have a form of care plan in place in regard to illness, dying and death. This had been done, with 10 responses received from the 27 families written to. From these responses, and discussion with the resident where feasible, comprehensive plans had been written to cover the events of illness, dying and death. Alver Bank G52-G02 S22717 Alver Bank V243837 120805 Stage 4.doc Version 1.40 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 standard(s) 12, 13 and 15 Residents’ social, cultural, religious and recreational needs are facilitated. Residents are encouraged and supported to maintain contact with family, friends and the local community. A varied, nutritious and wholesome diet is provided in pleasant surroundings and a convivial atmosphere. EVIDENCE: A large range of individual and group activities are on offer inside and outside the home. There are two large lounges. One is equipped with television, fish tank and objects of interest. The other is a quiet lounge, with no television but with books, music and a budgerigar. This lounge is used for the optional morning prayer meeting and for craft activities in the afternoon. On the afternoon of the inspection a party was being held for one resident, which the majority of other residents had freely chosen to attend. The party was celebrated with birthday cake, music and dancing in a happy and lively atmosphere. Residents are free to choose which lounge they wish to utilise, how often and when, and on the day of inspection residents were observed to move freely between the rooms as they wished. Inside the home, a range of activities such as darts, sing-a-long, arts and crafts, board games, quizzes and seasonal activities are offered. A list of daily activities for the week is kept on the notice board in the main hallway (opposite the two lounges) and the specific activities for the day are also written up on the large notice board outside the dining room. The home has its own transport and this is used to take interested residents shopping or on day trips. Several residents Alver Bank G52-G02 S22717 Alver Bank V243837 120805 Stage 4.doc Version 1.40 Page 12 mentioned to the inspector how much they had enjoyed the day trips to Richmond Park, Paddock Wood and the flower gardens. Outside events are also held in the home grounds. This year there has been an Easter parade, for which residents made hats, a “Celebrating Our Differences” garden fete, to which staff came in national costumes and a food and drink festival. Although the home is run by an organisation of a particular Christian faith, residents of all or no faiths are welcome and services and clerical visits for different denominations are arranged according to individual resident’s wishes. There was one resident from a minority ethnic group at the home on the day of inspection. Unfortunately, he was unwell and could not speak with the inspector but verbal and documentary evidence indicated that his cultural needs, such as in the area of food and activities, were being met according to his personal choice. Recently the independence day of his home country had been celebrated with flags on his table and culturally appropriate food. Residents spoken with confirmed that they were able to exercise choice in aspects of daily living, for example by choosing which time they got up and went to bed, when they had baths and what they did during the day. Verbal evidence from residents and documentary evidence in care plans showed that residents are encouraged and supported to maintain contact with family and friends. On the day of inspection the inspector ate lunch with a resident and his visiting wife. The relative said that she was always made welcome at the home and often participated in the lunch with her husband. The meal on the day of the inspection was tasty and well presented. Residents had been offered a choice both of main meal and dessert. There was a jug of cold drink available on each table for self-service and a hot drink was offered after the meal and dessert. Residents spoken with confirmed that they liked the meals offered and could also get snacks and drinks outside mealtimes. Apart from breakfast, lunch and supper, residents are also offered drinks and a snack mid morning, mid afternoon and later in the evening. A full range of medical diets is provided, such a diabetic and liquid as appropriate. One resident enjoyed the meal so much that she asked for the comments book and wrote in it. The inspector perused this book and found that the majority of residents’ comments written in it were in praise of the food offered. Alver Bank G52-G02 S22717 Alver Bank V243837 120805 Stage 4.doc Version 1.40 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 standard(s) 16 and 18 Complaints are listened to, taken seriously and acted upon. Residents are protected from abuse. EVIDENCE: The home has a clearly written complaints procedure that is fully explained in the Statement of Purpose, which is provided to all residents. A copy of the Salvation Army Housing Association complaints procedure is also displayed on the notice board in the main hallway, where it is easily accessible to residents and visitors. This does not however state that complainants can approach CSCI and does not provide CSCI contact details and so a requirement to remedy this has been made. The residents and the relative spoken with by the inspector were aware of how to make complaints and said that they found the manager very approachable in regard to any problems they may have. The complaints book was seen and showed that there had been three complaints received in the last year. All three complaints had been investigated in a thorough and timely manner and had been appropriately resolved. Verbal evidence from staff and documentary evidence from care plans showed that verbal and physical aggression from service users is understood and dealt with appropriately. The home has the appropriate policies in place to respond to suspicion of abuse. The home’s own abuse policy is comprehensive and the home also keeps a copy of the local authorities’ procedure and of the policy document “No Secrets”. Since the last inspection an investigation had been carried out following the finding of a bruise on a residents’ arm. The home had followed procedures, relatives had been informed and appropriate local authority personnel had been involved. No evidence of abuse was found and the family were satisfied with the outcome. However, arising from the Alver Bank G52-G02 S22717 Alver Bank V243837 120805 Stage 4.doc Version 1.40 Page 14 investigation findings the home had the resident’s medication reviewed and all staff re-trained in manual handling, which was good practice. Alver Bank G52-G02 S22717 Alver Bank V243837 120805 Stage 4.doc Version 1.40 Page 15 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) 20 and 21 Residents have access to safe, comfortable and well-maintained indoor and outdoor communal facilities. Although the home has an appropriately number of bathrooms, several are not suitable for residents’ needs and therefore restricts their choice, dignity and comfort. Hairdressing facilities are inadequate and also restrict residents’ dignity, privacy and comfort. EVIDENCE: The home has several indoor communal areas, including two large lounges, a large dining room, two offices and a large furnished reception area. It therefore has sufficient space to facilitate the variety of social, cultural and religious activities that are offered and to provide private space if residents do not wish to entertain visitors in their own bedrooms. All communal areas are decorated, fitted and furnished to a high standard and are attractive and comfortable. There are large, landscaped and well maintained grounds that are accessible to all residents, including wheelchair users and those with restricted mobility. The home has four bathrooms (with toilets), one shower room and two additional toilets on the first floor. It has three toilets and two bathrooms Alver Bank G52-G02 S22717 Alver Bank V243837 120805 Stage 4.doc Version 1.40 Page 16 (with toilets) on the ground floor. These are conveniently sited for communal areas and bedrooms and are sufficient in numbers for the 27 residents at the home. However, only two of the upstairs bathrooms and the upstairs shower room are suitable for the needs of the residents of the home and hence the other four bathrooms are not used. This is because the baths in these four bathrooms are too low for residents to step in and out of. This therefore restricts independence and choice. Residents can only access the two bathrooms which have Parker baths and the disability shower room. In addition, the controls in the disability shower room cannot be used by residents when they are sitting down and therefore independence, choice and privacy are restricted as it is necessary to have staff assistance in order to use the shower. Furthermore, as there is no hairdressing room at the home, residents sit in the first floor lift area and corridor to have their hair done and one of the only two bathrooms that is useable is used by the hairdresser for hair washing. This is not conducive to privacy or dignity and further restricts choice for residents wishing to bathe. The lack of suitable bathing and hairdressing facilities has been raised by the previous two inspection reports but no progress has been made to date by the Salvation Army Housing Association which owns the home. A requirement has therefore been made for bath and hairdressing facilities to be upgraded so that they meet the needs of residents and safeguard their privacy, dignity and choice. This should include the conversion of the ground floor bathroom at the entrance of the home to a hairdressing room, the provision of an electronically self-operated chair in the second ground floor bathroom, the provision of an electronically self-operated chair in one of the first floor bathrooms and the conversion of one upstairs bathroom to a shower room whose shower can be operated by residents whilst seated. Alver Bank G52-G02 S22717 Alver Bank V243837 120805 Stage 4.doc Version 1.40 Page 17 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) 27, 28 and 29 Staffing numbers and skills mix are sufficient to meet the assessed needs of residents. Staff are suitably trained to ensure that residents are in safe hands at all times. Residents are supported and protected by the home’s recruitment policy and practices but not all staff have signed to accept their terms and conditions of employment. EVIDENCE: Rotas showed that there are always three care staff on early and late shifts, comprising two care assistants and one senior care assistant, with a third care assistant for peak morning periods as necessary. There is also a manager, deputy and administrator at the home during weekdays who are supernumery. At night there are two waking night staff with another member of staff on call. Observation and verbal evidence indicated that this is sufficient staffing to meet the assessed care needs of residents. Over 50 of the care assistants at the home have achieved NVQ Level 2 and several have achieved NVQ Level 3 or are currently studying for it. In addition, one care assistant is an enrolled nurse, one has a diploma in nursing and one senior care assistant has a Masters degree in physiotherapy. Staff also confirmed that they had undertaken a full range of relevant internal and external training courses, including food hygiene, lifting and handling, first aid, dementia and hearing aids. The Registered Provider operates a robust recruitment policy and procedure, which was confirmed verbally by staff and by documentation at the home. Suitable procedures are followed to ensure the safety and protection of Alver Bank G52-G02 S22717 Alver Bank V243837 120805 Stage 4.doc Version 1.40 Page 18 residents. However, the previous inspection report noted that not all staff files had a signed acceptance of terms and conditions and a requirement was made for this to be done. The manager reported that although she had reminded the personnel department about this, no effective action had been taken and hence this requirement remains outstanding. Alver Bank G52-G02 S22717 Alver Bank V243837 120805 Stage 4.doc Version 1.40 Page 19 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, 32 and 33 The Registered Manager is suitably qualified, competent and experienced to run the home and residents benefit from the management approach at the home. Residents’ views are regularly sought, both formally and informally, to ensure that the home is being run in their best interests. EVIDENCE: The registered manager of the home is a registered nurse, has NVQ Level 4 in Management, a qualification in geriatric nursing and is a NVQ assessor. She has several years senior management experience and in addition is beginning a Bachelor of Science degree in health and social work. The deputy manager has NVQ Level 3 in customer services, is undertaking NVQ Level 4 in management, has a City & Guilds qualification in advanced management for care and has several years experience of care and management with the client group. Both managers have a thorough understanding of the needs and conditions of elderly people and a detailed knowledge and understanding of the personalities, interests and needs of individual residents at the home. Alver Bank G52-G02 S22717 Alver Bank V243837 120805 Stage 4.doc Version 1.40 Page 20 Observation indicated that there is an open, positive and inclusive management style at the home and this was confirmed by staff spoken with. Staff said that they felt part of a team, that they felt able to express their ideas and suggestions about the home and residents’ care and that these were taken seriously and acted upon. They said that the management team at the home was accessible and supportive. Evidence from speaking with residents, relatives and staff and perusal of documentation showed that that home has effective quality assurance and monitoring systems which are based on seeking the views of residents, visitors and external specialists. These views are sought informally on a daily basis and formally using residents’ surveys, the comments book and the complaints procedure. Residents’ views are sought by survey two months after admission to the home and then annually. Residents meetings are held bi-monthly and the Registered Provider carries out monthly visits and its own annual inspections. In addition, two residents’ surveys are held each year on behalf of the Salvation Army Housing Association in regard to their tenancy rights. Alver Bank G52-G02 S22717 Alver Bank V243837 120805 Stage 4.doc Version 1.40 Page 21 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 3 x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 x 15 3 COMPLAINTS AND PROTECTION x 4 1 x x x x x STAFFING Standard No Score 27 3 28 4 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 3 3 3 x x x x x Alver Bank G52-G02 S22717 Alver Bank V243837 120805 Stage 4.doc Version 1.40 Page 22 No 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 16 Regulation 22 (7) (a) Requirement The Registered Person must ensure that the complaints procedure includes the name, address and telephone number of CSCI. The Registered Person must ensure that bath and hairdressing facilities are upgraded so that they meet the needs of residents and safeguard their privacy, dignity and choice. The Registered Person must ensure that all staff have signed and accepted terms and conditions and that copies of these are held on ther personnel files. The previous timescale of 31 March 2005 was not met. Timescale for action 30 September 2005 30 April 2006 2. 21 23 (2)(n) 3. 29 19 30 October 2005 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 Good Practice Recommendations Alver Bank G52-G02 S22717 Alver Bank V243837 120805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection SE London Area Office Ground Floor, 46 Loman Street Southwark London SE1 0EH 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 Alver Bank G52-G02 S22717 Alver Bank V243837 120805 Stage 4.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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