CARE HOMES FOR OLDER PEOPLE
Argyle House The Avenue Dallington Northants NN5 7AJ Lead Inspector
Stephanie Vaughan Unannounced 9 May 2005 10.00
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. Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Argyle House Address The Avenue Dallington Northampton Northants NN5 7AJ 01604 589089 01604 589423 argyle.house@ashborne.co.uk Ashbourne Homes Limited Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Nick Hill Care Home with Nursing 87 Category(ies) of OP Old Age (87) registration, with number TI(E) Terminal Illness - Over 65 (87) of places PD(E) Physical Disability - Over 65 (87) Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 20 Service Users receiving Personal Care will do so by virtue of old age and will not fall under any other category 2. Service Users with Physical Disability may be aged 18 and over. Date of last inspection 7th September 2004 Brief Description of the Service: Argyle House is a purpose built facility, providing accommodation for up to 87 service users in both single and double rooms. Nursing care is provided at the facility. Accommodation is provided on four floors. The facility is located on the Harlestone Road in Northampton, partially secluded by trees. The building is set in well-maintained grounds. There is good access to public transport via a bus route into the town centre. Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This routine unannounced inspection was conducted over a period of six hours. During which the inspector made observations, spoke to several residents and two members of staff. A limited tour of the premises was conducted which involved viewing the communal areas and a selection of the private accommodation. Case tracking is the method used during inspection where a sample of five residents were selected and all aspects of their care and experiences reviewed, including individual plans of care and associated documentation. A selection of staff files were viewed. Two people have complained to the Commission about this home. The complaints were about poor standards of care and prescribed medication not being available. These complaints were investigated by additional visits conducted by the Commission and were upheld. The Commission continues to monitor standards within the home. What the service does well:
Prospective residents and their representatives are provided with good information and have the opportunity to visit the home prior to deciding whether the home is able to meet their needs and expectations. During the inspection care staff were seen to relate well to residents and to respect their privacy and dignity. In addition staff were also able to demonstrate competence in care practices for example movement and handling techniques. Routines within the home are flexible and resident are able to maintain links with their friends, relatives and the local community. The arrangements for meal times are good with flexible arrangements and a variety of choice. Residents confirmed satisfaction with the meals provided and these appeared to be nutritious, well presented and of adequate proportion. Residents and their representatives have access to a complaints policy and there was evidence that resident’s concerns were responded to appropriately. The environment is very pleasant at Argyle House, providing spacious, comfortable, clean and hygienic accommodation to residents. The environment is generally safe and well maintained.
Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 6 Staffing levels are good at Argyle House with the provision of adequate numbers of care staff and support services such as catering, maintenance and domestic staff Staff files are in good order with the inclusion of appropriate documentation, permits and formal clearances. What has improved since the last inspection? What they could do better:
The content of Individual Plans of Care is inconsistent and this impacts on the quality of care received by residents. Improvements must be made in the legibility, content and review processes. Some care practises that were identified in the daily records were not included in the instructions to staff and did not evidence the authority of the specialist overseeing specific interventions. Further improvement to the medication systems is recommended. The home has major shortfalls in the processes associated with the protection of vulnerable adults, which have been compounded by the prolonged absence of a Registered Manager in the home. The issues identified include, the unavailability of the internal Protection Of Vulnerable Adults policy, misdirected referral with consequential delays in processing an investigation, failure to capture evidence or obtain guidance from the police, omissions to the care plan and no system in place to track or manage the progress of an incident. Arrangements for the way the home manages the Protection Of Vulnerable Adults must be reviewed and improved. Some of the rooms are double and these are fitted with appropriate screening. One of the residents confirmed that she shared a room and said that it was all right although she would prefer a single room. Existing residents should be offered the opportunity to move to a single room when one becomes available.
Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 7 Many of the residents had requested that the doors to their individual accommodation be left open and this was being done with the use of door wedges. Although individual plans of care included consent for this practice and the individual residents had accepted the fire risks associated with this practice, it is clearly not in the best interests of any of the residents. An immediate requirement was made at the time of the inspection for the risk assessments to be reviewed for all of the residents, taking into account the ease with which a fire would spread in these circumstances. A further immediate requirement was made for the fitting of automatic closure devices to be fitted to the doors of residents who wished their doors to remain open. Although staff files were in good order in one circumstance a staff member had commenced employment prior to receipt of formal clearance. However the file evidenced an appropriate povafirst check. However the check was not dated and therefore inspectors were not able to establish whether the povafirst check had been obtained prior to the commencement of employment. Staff have a thorough induction training which also includes mandatory training in most health and safety practices, however there was no evidence of staff having training in first aid training and no system in place to ensure that a designated First Aider was on duty on all shifts. The prolonged absence of a Registered Manager has affected the standard of care provided by the home. The issues highlighted by this inspection include Failure to ensure consistent cover during the planned absence of the activities coordinator No one person taking responsibility for the management of the Protection Of Vulnerable Adults Staff described situations where they had been unable to obtain guidance and support regarding specific difficulties e.g. staff direction and discipline There was no evidence of staff supervision on a regular basis and staff confirmed that this had not occurred. Systems to ensure safe working practices must be improved to address the issues identified by this inspection. These includeThe unsafe practice of wedging resident’s doors open
Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 8 The absence of fist aid training and a designated first aider on each shift Maintenance of accurate accident records 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. Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 9 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 Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 10 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 The home has sound admission procedures, which enable residents and their representative to make an informed decision as to whether the home is able to meet their needs and expectations. EVIDENCE: The home has a comprehensive Statement of Purpose and Service Users Guide, which are available to both prospective and existing residents and their representatives. Residents confirmed that this information had been made available to them prior to admission and that their relatives had had the opportunity to visit the home to ensure that the home could meet their needs and expectations. A senior member of staff conducts pre admission assessments prior to admission to ensure that the home is able to meet the assessed needs of residents. Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 & 10 The content of individual plans of care is not consistent and this impacts on the quality of care provided by the home. Medication systems are basically sound although further improvements are required. Residents are treated with respect and dignity is maintained. EVIDENCE: All residents have and individual plan of care generated from the pre admission assessments and further assessments conducted following admission. The standard of individual plans of care were variable in the quantity and quality of information provided. Care plans were not always easy to read due to the standard of handwriting and on occasion value judgements had been made regarding the mental state of one resident. The home uses a standard format, which provides the opportunity to record all of the required information, however areas were often incomplete and very basic information for example, the contact details of the placing authority had been omitted.
Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 12 Residents specific needs identified within the assessment were not consistently supported by the development of an associated care plan to provide staff with detailed instruction on how they were to provide the care needed by the residents. However all residents were seen to have been assessed for falls in general and falls from bed. Care plans were not consistently reviewed on a minimal monthly basis and there was inconsistent evidence of the resident’s involvement in the care planning process. Residents spoken to did not know about their individual plan of care. The service representative confirmed that all the plans were now being reviewed to accommodate recent staff training in the care planning process. All resident had been risk assessed for pressure, with appropriate intervention recorded. Residents had access to appropriate pressure relieving equipment. Residents were seen to have access to continence aids and equipment, however there was no evidence that the guidance from the continence service had been sought. Furthermore one resident had been discharged from hospital with a catheter and however there was nothing recorded within the care plan to justify continuing with this intervention. In addition there was inconsistent recording of the dates that catheters were inserted and therefore no method of ensuring that catheters were replaced within an appropriate timescale. Nutritional assessments are included within the individual plans of care and these were seen to evidence access to special diets and the dietician. However the daily records relating to the management of Percutaneous Endoscopic Gastronomy feeding evidenced the provision of interventions that had not been sanctioned by the dietician. The service representative confirmed that these had been introduced following recent training, however formal authorisation must be obtained and evidenced within the individual plan of care. Residents have access to appropriate primary and secondary National Health Services. However there were some examples where referrals had not been followed up and delays in accessing services had an adverse effect on the resident’s quality of life. Furthermore there were examples of where referrals had been made and there was no record of the reason why the referral had been necessary. Medication systems were viewed and seen to be in order, however liquid medications did not routinely have the date of opening recorded on the bottle and there were inconsistent records for the temperatures of the drug fridge.
Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 13 Residents are spoken to in their preferred form of address as specified within the individual plan of care. Staff were noted to knock on the doors of residents private accommodation and gain permission prior to entering. Residents are well presented in their own clothing and have access to appropriate screening in shared rooms. Residents spoken to confirmed that staff were pleasant although some were nicer than others. Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 14 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, 14 & 15 Daily life is generally managed well at Argyle House. However inconsistencies in management and the provision of cover in the absence of the activities coordinator has impacted on the experiences of residents. EVIDENCE: Residents spoken to confirmed that there were activities provided by the home and these included exercise activities and sing long sessions. One resident stated that she found life boring at the home with little stimulation and no opportunity for outings. This was supported by staff who confirmed that the activities coordinator was on leave, however alternative arrangements have now been made to cover the absence. Residents confirmed that routines in the home are flexible and this was evident from the individual plans of care that detailed residents preferred times of rising and retiring to bed. Residents confirmed that they are able to receive their chosen visitors in privacy should they wish to do so and that visiting time were flexible. Individual accommodation evidenced personalisation with residents being able to bring in personal effects and small items of furniture. Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 15 Residents are able to receive their meals in the dining room or their own rooms. Residents confirmed that the food was good. With the provision of a continental breakfast and hot lunch and evening meal. Residents are able to make choices about the meals they wish to receive and this was evident during the inspection. The provision of special diets is managed by the chef, who visits the residents on a regular basis to discuss their needs and obtain feedback. The lunchtime service was viewed and food appeared well presented, of adequate proportion and to be well received by residents. Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 16 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 & 18 Residents are confident that their views are listened to, however the procedures for the protection of Vulnerable Adults have major shortfalls. EVIDENCE: Residents spoken to confirmed that they knew how to complain and that they were confident that there concerns would be handled appropriately. The complaints policy was seen to be on display in a prominent area within the home and to be included in the Statement of Purpose and Service Users Guide. The Commission for Social Care Inspection have received two complaints since the last inspection. One involving eight issues relating to poor standards of care, which were all upheld. The second relating to the provision of medicines, which was also upheld. These issues continue to be monitored by the Commission for Social Care Inspection. The home currently have two protection of vulnerable adults incidents being investigated by management and involving external agencies. Incidents involve allegations of rough handling by agency staff used by the home. The home has taken action to protect the residents since these allegations. However the incidents have highlighted weaknesses in the internal systems for the protection of vulnerable adults. Although the home have access to the Local and National Guidelines for the protection of Vulnerable Adults, the internal guidelines were unavailable to staff and inspectors.
Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 17 The absence of the Registered Manager, accessible internal guidelines and clear contact information in the individual plan of care had resulted in a misdirected referral being made with associated delays in processing the investigation. Furthermore this delay in response allowed evidence to be lost which ultimately may affect the outcome of the investigation. In addition there was no reference to these incidents recorded within the individual plans of care and no systems in place to track and monitor the progress. Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 18 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 24 & 26 The general environment at Argyle House is good although improvements must be made to ensure the safety of residents EVIDENCE: Argyle house is a modern purpose built home set in pleasant surroundings and in keeping with the local community. It is well maintained and provides a comfortable and generally safe environment for residents. Each floor is a self-contained unit providing two lounges, a dining area and appropriate bathing facilities. Some of the rooms are double and these are fitted with appropriate screening. One of the residents confirmed that she shared a room and said that it was all right although she would prefer a single room. Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 19 Although rooms provided a lockable storage space for valuables the doors were not generally fitted with privacy locks. Inspectors were informed that locks could be fitted upon request. Many of the residents had requested that the doors to their individual accommodation be left open and these kept open with a wedge. Although individual plans of care included consent for this practice and the individual residents had accepted the fire risks associated with this practice, it is clearly not in the best interests of any of the residents. An immediate requirement was made at the time of the inspection for the risk assessments to be reviewed for all of the residents, taking into account the ease with which a fire would spread in these circumstances. A further immediate requirement was made for automatic closure devices to be fitted to the doors of residents who wished their doors to remain open. A limited tour of the premises was conducted and the home well maintained, clean and hygienic. Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 20 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) 27,29 & 30 Staffing levels at Argyle House are good and recruitment practices generally sound. A serious shortfall in staff training was identified. EVIDENCE: The home provides good staffing levels to meet the needs of residents. All floors providing nursing care are staffed by a Registered Nurse at all times and supported by three care staff. On a further floor providing personal care only, care is provided by two members of staff. The overall ratio of staffing for the home was 4.5 residents to one member of the care team. Care staff are further supported by administration, catering and domestic staff. A selection of staff files were viewed, these and staff spoken to confirmed a thorough recruitment process. Appropriate references, employment histories, qualifications and formal Criminal Records Bureau Clearance had been obtained. However one file evidenced that a member of staff had commenced employment prior to the receipt of a formal clearance and although a povafirst check had been conducted there was no evidence of the date of receipt. Staff files evidenced a thorough induction training, which included mandatory training such as Movement and Handling, Fire safety, Food Hygiene and Infection Control. However there was no evidence of First Aid Training and
Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 21 staff that were spoken to were unaware that anyone had received this training or that there must be an identified qualified First Aider on every shift. Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 22 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, 36 & 38 The Management of the home has been inconsistent for a significant period of time, which has impacted on the quality of care provided to residents. EVIDENCE: The Registered Managers post is currently vacant following prolonged periods of absence and other senior positions are also vacant. The position is currently being advertised and a new matron is due to commence employment in the very near future. Interim arrangements are now in place however the inconsistency has impacted upon the stability and care practices within the home. Senior staff spoken to described situations where they had not received adequate support that would have been provided by senior management,
Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 23 examples included staff discipline and staff supervision and these must be addressed. This inspection has highlighted some concerns regarding safe working practices; these include the unsafe practice of wedging residents doors open and the absence of fist aid training and a designated first aider on each shift. In addition residents individual plans of care contained evidence within the daily records of injuries sustained by residents. On examination of the accident record it was evident that not all accidents were being recorded appropriately. Staff spoken to were under the impression that minor accidents need not be recoded in the accident record. On perusal of the Accident Policy it was noted that all injuries must be recorded. This has implications for further staff training and supervision. Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 24 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 x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3
COMPLAINTS AND PROTECTION 1 x x x 2 3 x 3 STAFFING Standard No Score 27 3 28 x 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 1 1 x x x x 1 x 1 Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 25 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 9 & 37 Regulation 17. 1 - 3 Requirement Accurate, legible records must be maintained in good order, in accordance with the Data Protection Act Individual plans of care must be reviewed to ensure that all aspects of health, personal and social care are addressed in detail Individual plans of care must be reviewed at least every month Individual plans of care must evidence that care practices have been authorised by the the specialist overseeing the management of specific interventions. Systems must be reveiwed to ensure refrerals are recorded and processed appropriately Arrangements for the safe storage of medication must be reviewed Systems must be reviewed to ensure appropriate management of the Protection of Vulnerable Adults referrals All residents must have risk assessements in place to assess the risks associated with some residents having doors wedged Timescale for action 01.07.05 2. 7 15 & Scehedule 3 15.2.b.c 14 01.07.05 3. 4. 7 8 01.07.05 01.07.05 5. 6. 7. 8 9 18 12.1.b 13.2 13.6 01.07.05 01.07.05 01.07.05 8. 19 & 38 13.4.b 14.05.05 Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 26 open. Immediate Requirement 9. 19 & 38 12.3 & 23.4 19.1 CSA (2004) 13.4 18.1 8.1 Automatic closure devices must be fitted to residents who wish doors to remain open. Immediate Requirement Povafirst checks must evidence the date of receipt Staff must have access to accredited first aid training A designated First Aider must be included in all shifts The Commission must be notified on the progress made towards the appointment of a Registered Manager Staff must receive the support required to enable them to fulfil their roles and responsibilities Staff must receive formal supervision at least six times a year 09.06.05 10. 11. 12. 13. 18 30 & 38 30 & 38 31 01.07.05 01.07.05 01.08.05 01.07.05 14. 15. 31 31 & 36 12.1 18 01.07.05 01.07.05 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 7 .23 Good Practice Recommendations Individual Plans of care should evidence the involvement of the resident or their representative. Residents occupying double rooms should have the option to move to a single room when one becomes vacant. Argyle House C51 S12599 Argyle House V223924 090505 Stage 4.doc Version 1.30 Page 27 Commission for Social Care Inspection 1st Floor, Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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