Inspection on 28/11/05 for Amberley House

This inspection was carried out on 28th November 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.

Other inspections for this house

Amberley House 09/03/09

Amberley House 17/04/08

Amberley House 01/10/07

Amberley House 17/07/06

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 Amberley House 44-48 Amberley Road London N13 4BJ Lead Inspector Karen Malcolm Unannounced Inspection 28th November 2005 08:45 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 Amberley House DS0000065136.V263077.R02.S.doc Version 5.0 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. Amberley House DS0000065136.V263077.R02.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Amberley House Address 44-48 Amberley Road London N13 4BJ 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) 020 8886 0611 Waterfall House Residential Home Care Home 16 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (16) of places Amberley House DS0000065136.V263077.R02.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th July 2005 Brief Description of the Service: Amberley House is a privately owned care home for older people who are over the age of sixty five. The home is registered to accommodate sixteen older people, five of whom may have a diagnosis of dementia. There are fourteen single bedrooms and one shared room. There is a lift and a chair lift. The dinning room and lounge are situated on the ground floor overlooking an attractive garden. The home is situated in Palmers Green, with good bus and train links. All the amenities of Palmers Green are within a short distance, including restaurants, shops, churches and a large park. Amberley House DS0000065136.V263077.R02.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over three and a half hours. Present on arrival were the senior carer/cook and two carers. The current manager and two of the providers arrived later. The first part of the inspection the inspector was assisted by the senior carer/cook followed by the manager and the two providers. The inspection was positive and open. The inspector would like to thank the staff and management for their time and patience during this time. The home has recently changed owner the new owners are Waterfall House Residential House. The registered manager/provider has now left and a new manager has been appointed. The home is registered for sixteen service users over the age of sixty-five, five of whom may have a diagnosis of dementia. At the time of the inspection the home had three vacancies and two service users were in hospital. As part of the inspection process the inspector was able to speak to approximately five service users and two members of staff, completed a tour of the building this included the inspector completing a fire risk assessment, examining a number of service users care plans and staff personal records. Service users interviewed expressed their satisfaction with the quality of care offered by the home and were happy living there. What the service does well: What has improved since the last inspection? At the previous inspection six areas of improvement were made. It was evident at this inspection that four areas of improvement had been addressed. The areas of improvement addressed at the time of this inspection are: • Care plans in place now include evidence that individual’s service users goals and objectives in place and reviewed monthly. • Risk assessments have been completed and updated • Activities for service users with dementia are clearly recorded and monitored • Service users cultural dietary needs have been appropriately addressed, records made and monitored. Amberley House DS0000065136.V263077.R02.S.doc Version 5.0 Page 6 What they could do better: This inspection has identified eleven areas of improvement two of which have been restated with no recommendations. While it is evident that the staff are experienced and competent, there are still a number of areas that need to be addressed. It is therefore required that the registered person submit an action plan to the Commission for Social Care Inspection (CSCI), which describes how they will address these matters of: • All care staff are to complete adult protection training that is in line with the local authority’s procedures • All complaints whether verbal or written are to be acted on appropriately and a record made of the action that has taken • To ensure that the home’s environmental risk assessment includes a section on fire, fire doors and window restrictors • The window restrictor in the home must be reviewed • To ensure all fire doors are not wedged open and the registered person to consult with the London Fire Emergency Planning Authority (LFEPA) with regards to door closures • The stair landings or fire exit must be kept clear at all times and this must be reviewed with all visitors to the home • Weights charts for individual service users are to be maintained monthly and reviewed accordingly. • Medication administered to service users must be signed for straightaway, if not given for any reason and explanation must be recorded on the back of the Medication Administration Records (MAR) Chart. • The manager must ensure all new employee have a satisfactory CRB certificate prior to starting work • The registered providers are to submit an application to the Commission to register the current manager in post • The registered person must review the current staffing levels in the home The two requirements made at the last inspection that have not yet been met and have been restated in this report, with a new timescale of compliance. Unmet requirements impact upon the welfare and safety of service users. Failure to comply by the revised timescale will lead to the Commission for Social Care Inspection considering enforcement action to secure compliance. Please contact the provider for advice of actions taken in response to this Amberley House DS0000065136.V263077.R02.S.doc Version 5.0 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Amberley House DS0000065136.V263077.R02.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Amberley House DS0000065136.V263077.R02.S.doc Version 5.0 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 the following standard(s): 3 Service users are confident that their needs will be assessed before moving into the home. Therefore service users receive appropriate care and support pertaining to their individual’s needs. EVIDENCE: The home supports sixteen older people, five of whom may be admitted with dementia and one specified service user who have dementia who is under sixty-five years. It is therefore reminded that any changes to the home’s Conditions of Registered must be notified to the Commission in writing, as soon as a change to the Conditions occur. At the time of the inspection there were three vacancies and two service users were in hospital. The home does not supply intermediate care. Amberley House DS0000065136.V263077.R02.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 9 Service users care plans are comprehensive and clear, addressing individual’s health and care needs. Therefore service users can be assured that their care needs are monitored appropriately. Health care needs are addressed appropriately by the home, however, this is not always consistent with regards to monitoring individuals weights. Service users know that their prescribed medications are protected by clear and comprehensive policies. However, this is not always consistently monitored, whether medication is given. Therefore service users may be potentially at risk from harm if medication administration is not monitored appropriately. EVIDENCE: At the previous inspection two requirements were made. These relate to the registered person ensuring that care plans includes goals/objectives reflects the needs, wishes and aspirations of service users and these are to be reviewed monthly. The second requirement relates to risk assesments to be completed, containing clear and comprehensive information on how to minimise identified needs. A number of care plans were sampled. It was Amberley House DS0000065136.V263077.R02.S.doc Version 5.0 Page 11 evident that care plans were in place, reflecting individual’s goals and objectives which were comprehensive and clear. Monthly reviews were completed, dated and signed. Risk assessments were also very clear recording each individual’s care, support and nighttime needs. Nighttime records were impressive as the nighttime actitivies for each service users throughout the night was recorded on an hourly basis. Healthcare needs are maintained regularly, containing detailed information of visits by various health professionals. Weight records are also maintained. However, two service users weight charts examined, last recorded entry was on in August 05. Discussions with service users confirmed that staff upheld their privacy and dignity at all times. Medication Administration Records (MAR) charts was also examined. A number of omissions were found. It was advised that any refusal or other reasons for medication not given must be recorded with the correct coding and the reason why recorded on the back of the MAR charts. The senior carer/cook informed the inspector that at the time of the inspection three service users had pressure areas and the district nurses’ visit daily if needed to support these individuals. Amberley House DS0000065136.V263077.R02.S.doc Version 5.0 Page 12 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 & 15 The home has made a great improvement on meeting individual service users with dementia needs with regards to social activities. Therefore service users social needs are now appropriate and meaningful, ensuring that individual’s quality of life is maintained. Service users maintain family and friends contact. The meals in this home are good offering both choice and variety and catering for special dietary needs. Therefore service users cultural needs are being appropriately meet by the home. EVIDENCE: The home has various activities to keep service users occupied and stimulated. An activities timetable was displayed in the lounge and activities listed included poetry, quizzes, board games, skittles and old films. The home employs an activity co-ordinator who visits weekly. At the previous inspection it was required that the registered manager ensures that service users with dementia have the opportunity to engage in meaningful and appropriate activities at the home. it was evident from the records of activities seen that service users particapated well. This was impressive and commended by the inspector on the day. Service users spoken to stated that there are a number of activities provided by the home which they particiapate in and enjoy when they so wish. At the previous inspection it was required that the registered person ensures that service users are provided with culturally appropriate food. It was evident Amberley House DS0000065136.V263077.R02.S.doc Version 5.0 Page 13 that the service users from different culture background needs around meal times has been addressed by the home. The cook/senior carer stated that since the previous inspection she has done some reaseach around different food, cultures and traditions. It was evident that individual’s cultural dietary needs had been appropriately catered for in the home. it was evident on the day that the cook/carer was cooking rice ‘n’ peas for the Caribbean service user and Halal meal for the service user who was Muslim. Menu plans clearly record individuals’ daily diet. This was also commended by the inspector. Service users interviewed stated that although they were unaware of what was on the menu for lunch on that day, the information was displayed on a board in the entrance foyer. The visitor’s book was positioned at the entrance to the home. Amberley House DS0000065136.V263077.R02.S.doc Version 5.0 Page 14 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 The home has a satisfactory complaints system with some evidence that service users feel that their views are listened to. However, this is not consistent. Therefore service users cannot be assured that verbal complaints are listened to and acted upon appropriately by the home. Service users are protected from abuse; however, care staff are not fully trained in the local authority’s procedures. Therefore service users cannot be assured that the correct procedures are being followed through by the home in any event of abuse occurring. EVIDENCE: No complaints were recorded. Complaint/s was discussed with the manager and the providers. With regards to how care staff record verbal concerns made by service users. It was advised that any concerns or verbal issues must be recorded and appropriately action/s followed through and recorded, for example ‘a complaint around not liking a particular type of food’ how this is addressed and monitored by the manager. At the previous inspection it was required that the registered person ensures that all staff working in the home receive appropriate adult protection training. The manager stated that she is in the process of arranging training for staff and this will be completed in a couple of month. It was advised that the training that is to be undertaken must be in line with local authority’s adult protection procedures. Therefore this requirement is restated. Amberley House DS0000065136.V263077.R02.S.doc Version 5.0 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 the following standard(s): 19, 24 & 26 The home is decorated to a high standard, which meets the needs of the service users, therefore providing the service users with a warm and inviting pleasant environment they can call home. However, the health and safety aspect needs to be monitored regularly by the manager. EVIDENCE: A tour of the home revealed that the home is well maintained and comfortably furnished. The décor and furniture are suitable for service users. There is a large, well-maintained and attractive garden accessible to service users. All service users who were able to express an opinion said that they felt the home provided a comfortable and safe environment. All bedrooms are of a high standard and personalised to individual taste and style. The standard of cleanliness in the home was very high and no offensive odours were detected. The communal areas are the dining room and a large extended comfortable lounge. The kitchen and laundry area are adequately sized. Part of the inspection process included the inspector completing a fire risk assessment whilst touring the building. It was evident that there were a Amberley House DS0000065136.V263077.R02.S.doc Version 5.0 Page 16 number of good practices regarding fire extinguishers, signage and those with self closuring devices where appropriately placed. It was evident that a fire risk assessment was in place. It was advised that the risk assessment in place must include a section on fire doors. During the tour of the building that the lounge, kitchen door leading from the dining room and dining door were wedged open at the time of the inspection. It was stated to the inspector the reasons for this was enable care staff to support service users appropriately in and out of these areas safety. It was advised that fire door must not be wedged open. Appropriate action must be taken in respect of fire doors that continue to be propped open, self-closing device must be sought to ensure that these doors are able to remain open and close in the event of a fire happening. It was also advised that consultation with the London Fire Emergency Planning Authority (LFEPA) is also to be sought. It was also evident that a number of windows within the home that did not have window restrictors in place, therefore it was advised that the windows without restrictors must be reviewed along with the fire doors and documented in the home’s environmental risk assessment which is in place. A storage basket was found on the landing between two bedrooms during the tour of the buidling. The manager stated that the hairdresser had placed the basket on the landing in order to access the bathroom whilst supporting service users with their hair. It was advised that the manager must ensure that the hairdresser or any person/s visiting the home are aware of all the health and saftey procedures with regards to obstructing internal or external routes used as a means of escape in the event of fire or an emergency. The gate at the top of the stairs leading to the basement must be risk assessed and the evidence included in the enviromental risk assessment. Amberley House DS0000065136.V263077.R02.S.doc Version 5.0 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 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 & 29 Staff morale is very good resulting in staff working positively with service users to improve their quality of life. Service users also benefit from a competent and qualified staff team, however the registered provider needs to review the current staffing levels in the morning as they are deemed inadequate at times. The manager has failed to ensure all care staff that are employed have been vetted appropriately. Therefore this can potentially place service users at risk from harm. EVIDENCE: In the home were the manager, two care staff, one senior carer/cook. This was reflected on the rota shown to the inspector. It was evident that the staffing levels within the home must be reviewed, especially at the time when the senior carer/cook is completing the task of cook in the morning. The senior carer/cook was interviewed. She stated that staff morale within the home is good although there have been some recent management changes. It was also evident that the senior carer/cook was very knowledgeable about each service users care and support needs. Two care staff records were examined. At the previous inspection it was required that the registered person ensures that two written references for the named member of staff and proof of eligibility to work is sought for the other two named members of staff. It was evident that the two care staff references and eligibility to work were sought by the manager. However the authencity of the references seen was discussed. It was advised that the registered person Amberley House DS0000065136.V263077.R02.S.doc Version 5.0 Page 18 has a responsiblitly to ensure that service users are safeguarded and to ensure that new appointed care staff references received are to be checked throughly. It was also evident that Criminal Records Bureau’s (CRB) cedrtficates shown were not completed by the home but transferred from another organisation. It was advised that since July 2004 CRB certficate are portable, new employment, new CRB must be completed. Care staff inductions records was examined. It was evident that this was fully completed. Amberley House DS0000065136.V263077.R02.S.doc Version 5.0 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 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 & 38 The management of the home is satisfactory and overall the records are well managed. Service users are assured that their health and safety is promoted and protected. However, this is not always consistently, therefore service users health, safety and welfare is not always fully promoted and protected. EVIDENCE: The management of the home has recently changed to Waterfall House Residential Home. The previous registered manager/provider has left and the new providers have appointed a new manager. It was evident at the time of the inspection that the providers had not submitted an application to the Commission with regards to registering the current manager. It was advised that an application should be sought from the Commission. The health and safety certificates were not examined at this inspection. These will examine at the next inspection. The area of concern relating to health and Amberley House DS0000065136.V263077.R02.S.doc Version 5.0 Page 20 safety was the fire and environmental risk assessment that must be up-dated and reviewed annually or when any changes occur. Amberley House DS0000065136.V263077.R02.S.doc Version 5.0 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 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 3 8 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X X X 3 X 3 STAFFING Standard No Score 27 2 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X X X 2 Amberley House DS0000065136.V263077.R02.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP18 Regulation 13(6) Requirement Timescale for action 28/02/06 OP16 2. 3. OP19 4. OP19 The registered person must ensure that all staff working in the home undertake adult protection training. The training undertaken must be in line with the local authority’s procedures. (Previous requirement of 11/10/05 not met.) 17(2) Sch The registered person must 30/01/06 4.11 ensure all complaints especially verbal complaints are recorded and actioned appropriately. 13(4) The registered person must 30/03/06 ensure that the environmental risk assessment that includes a section on fire doors, window restrictor and gate leading to the basement. This must be reivewed annually or when any changes occur. 13(4)(a)( The registered person must 30/01/06 b) & 23(4) ensure that all fire doors are able to effectively self –close at all times and are not wedged open. Magnetic door hold or a release mechanisms must be fitted to any fire doors in the home that young people/staff members Amberley House DS0000065136.V263077.R02.S.doc Version 5.0 Page 23 5. OP19 13(4) routinely prefer to leave open for extended periods of time during the day or night. Alternatively, the registered person must consult with the London Fire Emergency Planning Authority (LFEPA) fire officer with regards to risk assessment with regards to the safety aspect of fire doors and provide evidence that LFEPA are satisfied with fire doors being propped open. The registered person must 20/01/06 ensure that stair landings and fire exits are free from obstruction at all times. This must be reviewed and monitoried daily and a record is maintained. The registered person must ensure that all visitors to the home are aware of the health and saftey aspects of the home. This is to be reviewed and monitoried regularly and evidence. The registered person must 20/01/06 ensure wieght monitoring records are completed monthly. If changes occur to an individual’s weight this must reviewed and referred to the GP. The registered person must 30/01/06 ensure that staff references authenticity is checked and verified. (Previous timescale of 11/10/05 was not met.) The registered person must 20/01/06 ensure all medication administered to service users are signed immediately on the Medication Administration Records (MAR) chart. If not administered then the correct code must be recorded and DS0000065136.V263077.R02.S.doc Version 5.0 Page 24 6. OP8 17 & 14(2) 7. OP29 7, 9, 10, Sch 2.5 8. OP9 13(2) Amberley House 9. OP29 7, 9, 10 Sch 2 10. OP31 8&9 11. OP27 18(1) evidence on the back of the form. The manager must monitor this regularly. The registered person must not 30/01/06 employ any further person to work in the care home in any capacity without first obtaining a satisfactory CRB Disclosure check including a POVA check along with other information required by regulation. All staff employed since 27th July 2004 without an enhanced CRB Disclosure that includes a POVA check, must only work under the individual and direct supervision of a named staff member who has been appropriately checked. So as to safeguard service users, the registered person must in respect of these specific staff undertake a POVA First check for each person through their Umbrella Body. The strict supervision arrangements must then, remain in place until the full CRB Enhanced Disclosure is received and is seen to be satisfactory. This includes all staff including temporary or volunteer staff. The registered person must 30/01/06 submit an application form to the CSCI with regards to registering the new manager for Amberley House. The registered person must 30/01/06 review the current staffing levels in the home. An action plan of the proposal must be submitted to the Commission. Amberley House DS0000065136.V263077.R02.S.doc Version 5.0 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Amberley House DS0000065136.V263077.R02.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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. 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