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Inspection on 19/11/07 for Amethyst House Care Centre

Also see our care home review for Amethyst House Care Centre for more information

This inspection was carried out on 19th November 2007.

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.

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

What the care home does well

People who use the service said they were always kept informed about what was going on at the home. Regular meetings and informal discussions help people make decisions about activities and menus. People said "they enjoyed going out for pub lunches and recently had a great Halloween party with family and friends". CSCI surveys and relatives said, "care at the home was very good and staff were kind and listened to any concerns they may have". Care plans were comprehensive to enable staff to deliver good care to people. Staff were trained to a high standard and the training and understanding of peoples needs were evident throughout this inspection. Staff confirmed that they felt valued and supported by the manager and nursing team. Mealtimes were well managed and people said the food was always very good and plentiful. Menus were varied and nutritionally balanced. There was a robust complaints procedure, and CSCI surveys confirmed that people and relatives knew how to make a complaint and who to contact. They were confident that their concerns would be taken seriously.

What has improved since the last inspection?

The registered manager has achieved the registered managers award since the last inspection, and continues to attend training to update her professional qualification. People spoke positively about the manager; staff and relatives respected her. All environmental requirements made at the last inspection had been met. Bathroom facilities had been refurbished giving more choice to people, and the home was fresh and clean. Staff were commended for creating a warm and friendly environment. People`s personal space should improve once a government grant is used to purchase new bedroom furniture for nineteen rooms. Activities were better organised with the return of the co-ordinator and people praised her for keeping people active and stimulated, although some comments indicted that when she is not available activities were less likely to take place.

What the care home could do better:

Observations, examination of care plans and medication records and discussion with people and staff, confirmed that the nursing (staffing) levels at the home was insufficient. People could be put at risk if they do not receive nursing intervention in a timely manner. Surveys received also confirmed that people sometimes had to wait longer than necessary for attention.

CARE HOMES FOR OLDER PEOPLE Amethyst House Care Centre Sheepbridge Lane Rossington Doncaster South Yorkshire DN11 0EZ Lead Inspector Valerie Hoyle Key Unannounced Inspection 09:00 19th November 2007 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 Amethyst House Care Centre DS0000015849.V350098.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Amethyst House Care Centre DS0000015849.V350098.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Amethyst House Care Centre Address Sheepbridge Lane Rossington Doncaster South Yorkshire DN11 0EZ 01302 866226 01302 865415 amethyst.house@ashbourne.co.uk 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) Ashbourne Homes Limited Mrs Susan Seale Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39) of places Amethyst House Care Centre DS0000015849.V350098.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th September 2006 Brief Description of the Service: Amethyst House is a care home for older people providing personal and nursing care, registered for 39 service users. Southern Cross Healthcare owns the home and the registered manager is Susan Seale who is a registered nurse and has achieved the registered managers award. The accommodation is a converted older building with a new extension. The home is situated in the village of Rossington, near Doncaster. The home has well maintained gardens that are level, save and accessible to people who use wheelchairs or have mobility problems. Qualified nurses provide the necessary care to those with nursing needs, and trained care staff provides care to the residential service users. Information gained on the 19th November 2007 indicated the current fees range from £380.62 - £426 for residential care and up to £470 ( nursing care top ups) for nursing care. Additional charges include hairdressing (£5.50 - £17.50), newspapers and private chiropody (£9.00). The home provides information to service users and their relatives prior to admission into the home. Service Users Guides are available on request from the manager. The last published inspection report and the homes Statement of Purpose is available on request and a copy is available for visitors to read in the entrance hall. Amethyst House Care Centre DS0000015849.V350098.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place over 6 hours, this included a partial inspection of the home. Eight people who use the service, one relative and five staff were spoken to during the visit; their views are included throughout the report. Occupancy at the home remains high at both units with 35 of the 39 beds occupied. Seven CSCI service users and relative questionnaires were sent to the home and four were returned four healthcare professionals were sent. Three service user surveys, three relatives surveys and one healthcare professional survey were returned. The information has been collated and their views are contained within this report. Two peoples care plans were examined and policies relating to medication, complaints, protection of vulnerable adults and handling of people’s monies were looked at. Three staff recruitment and training records were examined to ensure people were protected. Susan Seale, the registered manager was present throughout this visit and assisted with the inspection process. She had completed and returned the Annual Quality Assurance Assessment dated July 2007, and the information gained is included in this report. An annual quality assurance assessment (AQAA) is a self assessment and a dataset that is filled in once a year by all providers whatever their quality rating. It is one of the main ways that we will get information from providers about how they are meeting outcomes for people using their service. The AQAA also provides us with statistical information about the individual service and trends and patterns in social care. What the service does well: People who use the service said they were always kept informed about what was going on at the home. Regular meetings and informal discussions help people make decisions about activities and menus. People said “they enjoyed going out for pub lunches and recently had a great Halloween party with family and friends”. CSCI surveys and relatives said, “care at the home was very good and staff were kind and listened to any concerns they may have”. Care plans were comprehensive to enable staff to deliver good care to people. Staff were Amethyst House Care Centre DS0000015849.V350098.R01.S.doc Version 5.2 Page 6 trained to a high standard and the training and understanding of peoples needs were evident throughout this inspection. Staff confirmed that they felt valued and supported by the manager and nursing team. Mealtimes were well managed and people said the food was always very good and plentiful. Menus were varied and nutritionally balanced. There was a robust complaints procedure, and CSCI surveys confirmed that people and relatives knew how to make a complaint and who to contact. They were confident that their concerns would be taken seriously. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Amethyst House Care Centre DS0000015849.V350098.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Amethyst House Care Centre DS0000015849.V350098.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service were assessed before moving into the home to ensure their needs could be met. EVIDENCE: All new people receive a full comprehensive needs assessment before admission this is carried out by manager or responsible person who have the required skills and competencies. The service is highly efficient in obtaining a summary of any assessment undertaken by the placing authority, and insists on receiving a copy of the care plan before admission. Staff confirmed that information contained in the assessment was essential to understand what they needed to do to ensure people’s needs were met. Two assessments were examined and they focused on achieving positive outcomes for people who use the service. Before agreeing admission the Amethyst House Care Centre DS0000015849.V350098.R01.S.doc Version 5.2 Page 9 manager and staff carefully considers the needs assessment for each individual prospective person and the capacity of the home to meet their needs. CSCI ‘Have your say..’ surveys received from relatives and people who use the service said they received sufficient information about the home before they moved into the home. One relative said she had visited a number of homes before selecting Amethyst House as the best home to meet her fathers care needs. Amethyst House Care Centre DS0000015849.V350098.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans provided staff with sufficient information to meet the needs of people who use the service. Medication policies and procedures were well managed ensuring the safe administration of medication. EVIDENCE: Two care plans were examined; these were well-written and provided sufficient information to enable staff to meet the needs of the people who use the service. The care plans include regular evaluations, and daily records assess the individual’s progress. Risk assessments ensure people can maintain their independence, while remaining safe. CSCI surveys received confirmed that people’s needs were always met by staff that was well trained, the survey returned by the health professional said staff were very good at following nutritional plans which included the monitoring of people’s weight and ensuring people get the supplements they required. One relative said staff always kept Amethyst House Care Centre DS0000015849.V350098.R01.S.doc Version 5.2 Page 11 them informed about any changes to their relatives care needs. “staff are very kind and always make me feel welcome”. People who use the service said staff always listens to what they say and provide the support they needed. Records examined and discussion with the staff confirmed people’s healthcare needs were met. An audit of medication stocks and records was examined and were found to be correct ensuring the health and safety of people. Senior carers had responsibility for administering medications to people who were assessed as having residential care needs, while nurses administer medication to those who have nursing needs. The inspector found that the nurse was still administering medication late into the morning. The nurse said a number of people required extra help to take their medication which took extra time, and this contributed to the delay in people receiving their medication. The local pharmacist is contracted to undertake periodic checks to ensure the stock levels were maintained and procedures were followed. Medication was stored securely; there was a separate, locked room for storing medication that contain a locked fridge and a controlled drugs cabinet. Throughout this inspection staff were seen interacting with people in a kind manner, they spent time talking to people and were observed knocking on bedroom doors before entering. All people were referred to by their first name and this was agreed in the care plans examined. CSCI service user surveys received, confirmed staff always treated people with respect and maintain their dignity at all times. One person said staff helped to maintain contact with family and always included them when making important decisions. Amethyst House Care Centre DS0000015849.V350098.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Excellent social activities are organised which are appropriate to the needs of the people who use the service. Mealtimes are well managed and people are encouraged to make choices and control over their own lives. People who use the service can maintain contact with family and friends, and have good opportunities to maintain links with the local community. EVIDENCE: There was a pleasant atmosphere in the home with people chatting to friends and staff. The hairdresser was attending to people’s hair in one of the lounges, which generated banter between the ladies and gents waiting for their appointment. The entrance hall had posters advertising weekly activities, which were arranged by the co-ordinator. A book containing pictures of trips to the coast and a recent Halloween party showed people enjoying the occasions. People said they were able to join in activities, although some said they preferred to spend time in their bedroom watching television. There was a Amethyst House Care Centre DS0000015849.V350098.R01.S.doc Version 5.2 Page 13 newsletter, which highlighted people’s forthcoming birthdays, and advertised forthcoming events. Residents/relatives meeting take place regularly and the manager also holds surgeries where relatives can arrange to see her to talk over any problems. People were actively encouraged to keep in contact with family and friends living in the community. Visitors were welcome at any time and facilities were available for them to have a drink or a meal with there relative. People could choose to entertain visitors in their own rooms or in the lounge or garden areas. One visitor said she was always made to feel welcome and offered a drink. Staff asks people what foods they liked and the meals were included in the menus. The meals were served directly to the dining rooms from the kitchen. Mealtimes were well managed by staff who have a good understanding of peoples dietary needs. Staff were seen giving assistance in an unobtrusive way, and meals served to people in their bedrooms were accompanied with a drink. People said they had enjoyed their meals mincemeat pie and fresh vegetables. One person said he preferred to have a lighter meal of cold meat and salad. He said, “the cook always tried to provide food what people liked”. The quality was very good and plentiful. People said the food was excellent, one person said they liked all of the food served and was very satisfied. Menus were displayed, although the size of the printing was not suitable for people with poor vision. Amethyst House Care Centre DS0000015849.V350098.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service could access the complaints procedures and the manager ensures any concerns were recorded and investigated appropriately. Adult protection policies, procedures and training of staff promote the protection of people from abuse. EVIDENCE: There was a complaints procedure that was available to people who use the service and visitors. The procedure was also referred to in the service users guide, identifying the stages to follow; this included the time scales to respond to complaints. The address and telephone number of the Commission for Social Care Inspection is included in the procedure. Examination of the complaints records showed that there had been four complaints recorded since the last inspection at the home. The complaints had been investigated appropriately to the satisfaction of the complainant. People who use the service said that they were confident that the manager or the responsible person would deal with any concerns they may have. Commission for Social Care Inspection surveys received confirmed that people know what to do if they had any concerns, and relatives said although they had never had to make a complaint and were confident that the manager would deal with any issues. Amethyst House Care Centre DS0000015849.V350098.R01.S.doc Version 5.2 Page 15 There was a comprehensive Adult Abuse and Whistleblowing policy and staff follow the procedures to those standards. The registered manager would investigate fully any allegations of abuse and would follow the necessary procedures if any were substantiated. The registered manager holds discussions with staff to talk over issues and how to recognise different forms of abuse. The manager was aware of the new adult safeguarding procedures and was intending to send a representative to the launch of the procedures. The manager had also attended relevant training on the Mental Capacity Act and was cascading the information to the relevant staff at the home. Amethyst House Care Centre DS0000015849.V350098.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 22, 26 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service were provided with a clean, comfortable environment. There was sufficient staff to maintain good hygiene standards. EVIDENCE: The registered provider continues their refurbishment of the home to ensure the environment is safe and suitable for people to spend their time. A partial tour of the building found bedrooms to be homely and personalised to individual taste; people said they liked their bedroom and have things around them to remind them of family and friends. All requirements made at the last inspection had been met. A new shower facility had been fitted to the bathroom on the first floor. The shower enables people to have more choice, Amethyst House Care Centre DS0000015849.V350098.R01.S.doc Version 5.2 Page 17 when deciding which facility they want to use. The flooring in the bathroom has been thoroughly clean and extractor fans had been repaired. The manager said that government grant money is to be used to replace bedroom furniture and easy chairs in 19 rooms. The furniture will enhance people’s personal space. Amethyst House Care Centre DS0000015849.V350098.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have the skills and knowledge to fulfil their roles within the home, a stable staff group ensures continuity of care by staff that knows the people who use the service. Recruitment policies are followed ensuring the safety and protection of people who live at the home. EVIDENCE: Training records examined show the staff have the required skills and competencies to deliver a good service to people who use the service. A training plan helped the deputy manager to identify when staff required refresher training. She is commended for all her work to develop staff. Discussion with the deputy manager and staff confirms that there was a stable staff group who had worked at the home for a good number of years. Staff said they enjoy working at the home, and feel supported. There was a robust induction and probationary package, which was service specific. The manager only confirms permanent employment when satisfied that competence and progress had been shown to be satisfactory against their high standards. Amethyst House Care Centre DS0000015849.V350098.R01.S.doc Version 5.2 Page 19 Staff rotas and observation during this visit show there was sufficient care staff to meet the needs of people who live at the home. However the nursing levels were insufficient to meet the complex needs of people with nursing needs. A number of people were cared for from bed and were very frail, and required more time and attention. Medication was still being administered late into the morning, indicating that an additional nurse during the morning period was needed. Staff had the required skills to meet the needs of people, and they are commended for meeting the requirement of 50 NVQ level two qualified staff. A number of staff are progressing with or completed NVQ level three There were robust recruitment and selection procedures that ensure people who use the service are safe and protected. A number of staff recruitment files were examined, and there was evidence that all the required employment checks have been undertaken prior to commencing work at the home. Evidence confirms all staff had a Criminal Record Bureau check (CRB check) and two references. The registered manager should check the date on the CRB as good practise suggests that a new CRB check should be carried out every three years, to ensure the information is up to date. Examination of nurses PIN and qualifications confirmed that the nursing needs of people were met. The registered manager said the nurses continue to develop their own knowledge, by attending relevant training courses. Amethyst House Care Centre DS0000015849.V350098.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service were protected by sound management practises, and their views were actively sought to improve the service, although not by formal quality surveys. The financial interests of people were safeguarded, and good health and safety procedures ensured they are protected. EVIDENCE: The manager had the required nursing qualifications and experience and is competent to run the home. She works to continuously improve services and provide an increased quality of life for people who live at the home. The Amethyst House Care Centre DS0000015849.V350098.R01.S.doc Version 5.2 Page 21 manager successfully achieved the Registered Managers Award (RMA) in August 2007, and attends training to maintain her professional qualification. Residents/relatives meetings were used to gain the views of people who use the service, including suggestions for menus and activity programmes. Quality surveys were used twice a year to formally gain the views of people and their relatives and the registered manager collates the data. The last quality assurance surveys was undertaken in September 2007 and the manager said areas requiring further development had been identified and addressed. Accident reports were analysed by the manager to ensure risk assessments were developed where required. Maintenance and service records examined were up to date and current to the services provided. The manager had the required Health and Safety policies and procedures and displays the relevant notices. Fire safety procedures were in place and service records were examined and were current, ensuring the safety of people who use the service. People were able to manage their own finances, although most prefer the manager to assist with dealing with their personal allowances. A number of people’s pocket money records were checked and these were accurate. Amethyst House Care Centre DS0000015849.V350098.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME 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 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 3 X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Amethyst House Care Centre DS0000015849.V350098.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP27 OP29 Good Practice Recommendations There should be sufficient nursing staff to meet the needs of people who use the service. CRB checks should be renewed after 3 years to ensure the information is up to date Amethyst House Care Centre DS0000015849.V350098.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Amethyst House Care Centre DS0000015849.V350098.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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