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Inspection on 19/04/06 for Balmoral Nursing Home

Also see our care home review for Balmoral Nursing Home for more information

This inspection was carried out on 19th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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.

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

Service users did not move into the home without first having their needs assessed. Each service user had a care plan which was regularly reviewed and health care needs were met. From observations made service users were treated with respect and dignity. This was confirmed by service users and relatives and staff were able to verbalise ways in which they respected service users rights on a daily basis. Activities coordinators were employed and service users were consulted about the activities programme. Service users were able to choose whether to take part. In the main positive comments were received about the food provided. There was a complaints procedure in place that service users and relatives knew about. There were procedures in place for investigating complaints and appropriate recording systems. There have been no complaints received about the home since the last inspection. Service users were protected from abuse and staff had received training in the protection of vulnerable adults. Service users bedrooms were well maintained and personalised. Staff carried out their duties in a way that promoted good hygiene standards and control of infection. Staffing levels and skills that met the needs of the service users were being maintained. 33% of the care staff are trained to NVQ level 2 in care and training is ongoing. Service users and staff said they had confidence in the manager. Service users said thy were satisfied with the arrangements for taking care of their finances and appropriate records were kept. The health safety and welfare of service users and staff was promoted and protected.

What has improved since the last inspection?

Service users are offered a choice of drinks and snacks in between meals. Staff have received training in the protection of vulnerable adults. Secure cupboards have been provided for the storage of service users records. Action has been taken to reduce hazards around the home, wheelchairs are provided for all service users who need them and staff used these appropriately.

What the care home could do better:

Service users were not issued with a contact or terms and conditions. Service users files contained information that was out of date and some information was unnecessarily duplicated. Care plans did not indicate who had contributed to the care plan. There were examples of medication not being administered in line with instructions. All the communal areas, lounges, corridor areas and dining areas are in need of decoration and replacement of furnishings and some furniture. Some of the documentation required to be kept on staff files, as part of the recruitment process was not in place. The manager is not yet registered but is in the process of submitting her application.

CARE HOMES FOR OLDER PEOPLE Balmoral Nursing Home 6 Beighton Road Woodhouse Sheffield South Yorkshire S13 7PR Lead Inspector Shirley Samuels Key Unannounced Inspection 19th April 2006 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Balmoral Nursing Home DS0000021767.V288968.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Balmoral Nursing Home DS0000021767.V288968.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Balmoral Nursing Home Address 6 Beighton Road Woodhouse Sheffield South Yorkshire S13 7PR 0114 254 0635 0114 254 8159 balmoral@fshc.co.uk None Four Seasons Healthcare (England) Limited (Wholly owned subsidiary of Four Seasons Health Care Ltd) Mrs Trudi Ashmore Care Home 90 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) Category(ies) of Old age, not falling within any other category registration, with number (90) of places Balmoral Nursing Home DS0000021767.V288968.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd September 2005 Brief Description of the Service: Balmoral is a purpose built home, which provides nursing and personal care to older people. It is situated in the village of Woodhouse, within easy reach of shops, churches, public transport and small parks. Balmoral is a large home and accommodation is provided over three floors. There are stairs and lifts to each floor. There are TV lounges, sitting rooms and separate dining rooms were service users are able to have meals with other service users or their relatives. Chiropodist, hairdressers and various complementary therapists attend the home. Whist the majority of the service users are permanent, the home also provides short term and respite care. Via the pre inspection questionnaire the manager said the fees ranged from £412-£565. Additional charges are made for hairdressing, chiropody, toiletries, magazines, papers outings and transport. Information about the home is provided in the form of a service user guide this is available in each of the service users bedrooms and available in the entrance to the home along with a copy of the inspection report. Balmoral Nursing Home DS0000021767.V288968.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out over nine and a half hours from 9am –6:30pm. When full the home accommodates 90 service users. At the time of this inspection there were 62 service users living at the home. Ten service users were receiving personal care only; the remainder needed nursing care at varying levels. On the day of the inspection eight service users, three relatives, six members of staff, the deputy and the manager of the home were spoken to at length about the standard of care provided, training, staffing and the overall management of the service. On the day of the inspection questionnaires were handed out to twenty-three service users. 19 were returned to the inspector before the end of the inspection. Observations were made of the care provided, staff attitude, activities, interaction between service users and staff, communication, general routine, team working and the atmosphere within the home. A selection of documents was examined including service users and staff files. An inspection of the building was made to establish how the standards were being met and to identify any areas, which needed further development. The inspector would like to thank, service users, relatives, staff and the manager for their co-operation and contributions. This assisted the inspector in making judgements about the quality of the service and the outcomes for service users. What the service does well: Service users did not move into the home without first having their needs assessed. Each service user had a care plan which was regularly reviewed and health care needs were met. From observations made service users were treated with respect and dignity. This was confirmed by service users and relatives and staff were able to verbalise ways in which they respected service users rights on a daily basis. Activities coordinators were employed and service users were consulted about the activities programme. Service users were able to choose whether to take part. In the main positive comments were received about the food provided. There was a complaints procedure in place that service users and relatives knew about. There were procedures in place for investigating complaints and appropriate recording systems. There have been no complaints received about the home since the last inspection. Service users were protected from abuse and staff had received training in the protection of vulnerable adults. Service users bedrooms were well maintained and personalised. Staff carried out their duties in a way that promoted good hygiene standards and control of infection. Staffing levels and skills that met the needs of the service users were being maintained. 33 of the care staff Balmoral Nursing Home DS0000021767.V288968.R01.S.doc Version 5.1 Page 6 are trained to NVQ level 2 in care and training is ongoing. Service users and staff said they had confidence in the manager. Service users said thy were satisfied with the arrangements for taking care of their finances and appropriate records were kept. The health safety and welfare of service users and staff was promoted and protected. 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. Balmoral Nursing Home DS0000021767.V288968.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Balmoral Nursing Home DS0000021767.V288968.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 & 3. Quality outcome in this area is good. This judgement is made using available evidence including a visit to the service. Service users were not provided with a contract. This resulted in service users and relatives not having written information regarding the terms and conditions of their stay. Service users only moved into the home when their needs had been assessed. This ensured that staff had the information they needed to make a decision about wither or not they could met the needs of potential service users. EVIDENCE: The manager said that all service users had been issued with a contact and terms and conditions. The majority of the service users said via their questionnaires that they had not received a contract. The manager checked one file and found that a copy of the contact was not on the file. Balmoral Nursing Home DS0000021767.V288968.R01.S.doc Version 5.1 Page 9 Four service users files were checked, all contained a copy of the full needs assessment carried out prior to admission. There was evidence in the form of a care plan to show that assessments were used to complete a plan of care, which identified how needs would be met. Balmoral Nursing Home DS0000021767.V288968.R01.S.doc Version 5.1 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 and 10. Quality in this outcome area is adequate. This judgement is made using available evidence including a visit to the service. Service user’s health, personal and social care needs were set out in an individual plan of care. There was evidence to show that service users health care needs were fully met. Service users were in the main protected by the medication policies and procedures, they were treated with respect and their right to privacy was upheld. EVIDENCE: The majority of service users said they always received the support they needed. “We are always told if we need help just ring”. Four care plans were checked they all detailed the needs of the service users and the action staff needed to take to meet the needs of the service users. Risks were identified and details of the action needed to reduce risk were recorded and available to staff. There was evidence to show that care plans Balmoral Nursing Home DS0000021767.V288968.R01.S.doc Version 5.1 Page 11 were reviewed monthly, the records however were not always updated to reflect changing needs and current objectives. There was no evidence to show who had contributed to the plan of care. Records showed that service users received visits from health care professionals. Equipment necessary for the promotion of tissue viability and prevention or treatment of pressure sores was provided. Appropriate continence supplies were available and nutritional screening took place at the time of admission. In the main, medication was administered by nursing staff and by trained team leaders on the personal care unit. Records were kept of medication received into the home and controlled drugs were stored appropriately in a metal cabinet. There were two examples of medication prescribed to be administered at night being administered at 5pm and 7pm. The nursing staff said this was due to service users routines and them retiring to bed soon after tea and not wanting to be woken later for medication to be administered. This practice resulted in medication not being administered in line with instructions. There were some gaps in administration records particularly regarding the application of creams and medication prescribed to be administered on a when required basis. Codes used to indicate why medication has not been administered were not always used. Small discrepancies were found in the balance of medication, when crossed referenced with the records. Service users said they were treated with respect and dignity. Staff were observed approaching service users in a sensitive manner encouragement was offered in an appropriate manner. Relatives said they were happy with the care provided and the attitude of the staff. All rooms were single occupancy except for one where a husband and wife were sharing. Staff were able to verbalise the ways in which they promoted service users rights, privacy and dignity on a daily basis. Balmoral Nursing Home DS0000021767.V288968.R01.S.doc Version 5.1 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): 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Service users were informed of the activities provided. This enabled them to make a choice about taking part. Staff gave service users Information and promoted their independence. This encouraged service users to make choices and have control over their lives. Service users were provided with a varied diet including fresh fruit and vegetables and a choice of hot and cold drinks. This ensured that they received a balanced diet. EVIDENCE: Service users said they were asked about what sort of activities they wanted at the home, and were able to choose whether or not to take part. Information about the activities timetable was posted around the home service users were reminded and relatives also had access to this information. Service users were encouraged to maintain contact with family and friends; they were able to see their relative in private and relatives were made welcome. Balmoral Nursing Home DS0000021767.V288968.R01.S.doc Version 5.1 Page 13 Service users said they usually liked the food provided, they were always offered a choice and were given the opportunity to comment on the meals. Their likes and dislikes were recorded in their care plans. For service users who needed help with feeding this was offered discreetly and sensitively, staff were observed encouraging service users to eat. Hot and cold drinks were offered in between meals and jugs of juice or water were seen in service users bedrooms, which service users and staff said were refreshed each day. Balmoral Nursing Home DS0000021767.V288968.R01.S.doc Version 5.1 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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users, their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. There are polices and procedures in place to protected service users from abuse. EVIDENCE: Service users and relatives said they knew who to talk to if they had a complaint. Written information on the complaints procedures were posted around the home and were issued to service users and their representative at the point of admission. There have been no complaints about the service since the last inspection. Records were kept which detailed the complaints, the outcomes of investigations and the action taken. Relatives and service users said that comments and complaints were acted upon and they were satisfied with the response. Many of the service users said in the first instance they would talk though any concerns with their relative, friend or carer. One service user said, “Staff always ask if we are ok”. Service users said they felt safe at the home. Staff were able to verbalise the action they would take if an allegation were reported to them, or if they Balmoral Nursing Home DS0000021767.V288968.R01.S.doc Version 5.1 Page 15 observed abusive practices. Some staff had received training in the protection of vulnerable adults and the training programme was ongoing. Balmoral Nursing Home DS0000021767.V288968.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is adequate. This judgement has been made using evidence available including a visit to this service. Communal areas are in need of redecoration and refurbishment to ensure that service users life in hygienic well maintained surroundings. EVIDENCE: The location and layout of the home was suitable for it’s purpose. Service users said they felt safe those who were able said they were able to find their way around the home. The manager said there was a plan in place for the redecoration and replacement of furniture and carpets. The budget for this was from a central source for which the manager had no control. The manager managed the budget for the maintenance of bedrooms locally this allowed decoration and replacement of furnishings to happen more quickly. There were two handy persons employed to work at the home. Regular checks were made of the building and prompt action taken to address any health and Balmoral Nursing Home DS0000021767.V288968.R01.S.doc Version 5.1 Page 17 safety issues. Staff had received health and safety training and understood their responsibility for their own safety, the safety of others and for reporting issues. The communal areas including corridors, lounge and dining areas were found to be “shabby”, carpets were stained, wallpaper discoloured and damaged, furnishings and some furniture were in a poor state of repair. Service users said they were satisfied with the standard of hygiene. They said, “staff keep our bedrooms nice and clean, they change the bedding, empty bins dust, and vacuum”. One service user said they enjoyed cleaning and enjoyed the opportunity of cleaning their own bedroom. The laundry was sited away from food preparation areas and soiled linen was washed at appropriate temperatures. Staff said they were provided with gloves aprons and other equipment needed to control the spread of infection. Balmoral Nursing Home DS0000021767.V288968.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30. Quality in this outcome area is adequate this judgement is made from available evidence including a visit to the service. The number and skill mix of the staff were sufficient to meet the needs of Service users. Staff were trained and competent to do their job, ensuring safe working procedures. The homes recruitment policies and procedures did not fully meet the standards, therefore not ensuring the protection of service users. EVIDENCE: Staff rotas examined showed that the staffing levels agreed at the time of registration were being maintained. The service users said that staff were always available relatives said on the occasions when service users did have to wait it was not for long and service users were always checked to make sure they were safe. On the day of the inspection nurse calls were answered in a timely fashion. For those service users being nursed in bed, observations were made of them receiving regular care, which was provided in a respectful and sensitive manner. This promoted service users dignity. Staff had received statutory training including fire and heath and safety. Staff training was ongoing and 33 of the care staff had completed NVQ 2 in care. Balmoral Nursing Home DS0000021767.V288968.R01.S.doc Version 5.1 Page 19 The home has written policies and procedures for the recruitment of new staff. Four staff files were checked. The files did not contain all the information required by the standards including references, checking of gaps in employment and contacts detailing terms and condition of employment. Some of the files were disorganised and retrieving information was, in some cases was difficult. Balmoral Nursing Home DS0000021767.V288968.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users live in a home that is run and managed by a person who is fit to be in charge, of good character and able to discharge their duties fully. Service users benefited from the way the home was run and a staff team who worked well together. The home was run in the best interest of the service users. There were policies and procedures in place to safeguard their financial interest, and to promote the health safety and welfare of service users and staff. EVIDENCE: The manager is qualified, competent and experienced to run the home. The manager is not yet registered for this service but was registered previously for Balmoral Nursing Home DS0000021767.V288968.R01.S.doc Version 5.1 Page 21 another service. During her time as manager she has demonstrated her ability to manage effectively and respond appropriately to the requirements of the Care Homes Regulations and the needs of service users. The manager is in the process of being registered and has commenced on the registered managers award. Service users knew who the manager was and said she did maintain contact with them. Staff spoke positively about the manager, the relationship between managers and staff worked well to the benefit of the service users. Staff said meetings were held where they were able to feedback about the standard of care, their roles and responsibilities and any issues. The operations manager made monthly visits to the home, to check on the conduct of the home. Discussions were held with service users and staff who were asked to comment about the standard of care and the service. A report was written and a copy forwarded to the CSCI. The manager said that service user and relatives meetings were held comments were taken seriously and appropriate action taken. Four service users financial records were checked. The records included all the information required including income expenditure details, dates’ and balance of accounts. Receipts were kept and were able to be cross-referenced with the documentation. Staff had received moving and handling training. Appropriate moving and handling techniques were observed staff were competent and confident when using mechanical lifting aids. Staff said they received fire instruction at least twice a year and the fire system was checked on a weekly basis. Appropriate records were kept of any accidents and the CSCI were informed of incidents required by the Care Homes Regulations. All hazardous substances were securely stored and procedures were in place to maintain a safe environment. Balmoral Nursing Home DS0000021767.V288968.R01.S.doc Version 5.1 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 2 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 x x 3 Balmoral Nursing Home DS0000021767.V288968.R01.S.doc Version 5.1 Page 23 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 OP2 Regulation 5 Requirement Each service user must be provided with a written contract/statement of terms and conditions with the home. (Previous timescale of, 10/1/05 and 01/12/05 not met) Care plans must be updated to reflect changing needs and current objectives. There must be evidence to show who has contributed to the plan. Arrangements must be in place for the recording, handling, safekeeping and safe administration of medicines received into the home. (Previous timescale 10/10/05 not met) Timescale for action 31/05/06 2 OP7 15 31/05/06 3. OP9 13 19/04/06 4. OP19 16 All areas of the home used by 30/06/06 service users, must be well maintained and in a good state of repair. Therefore redecoration, replacement of carpets, furniture and furnishings must take place to ensure that standards are met. (Previous timescale of, DS0000021767.V288968.R01.S.doc Version 5.1 Page 24 Balmoral Nursing Home 10/1/05 and 1/12/05 not met) 5 6 OP28 OP29 18 19 & schedule 2 50 of care staff must be trained to NVQ level 2 in care. The recruitment procedures must include carrying out all the checks detailed in the regulations. For all staff employed at the home the documents listed in schedule 2 must be kept at the home and made available for inspection. 31/12/06 31/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP29 Good Practice Recommendations Records should be organised in a way, which allows information to be easily retrieved. Balmoral Nursing Home DS0000021767.V288968.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Balmoral Nursing Home DS0000021767.V288968.R01.S.doc Version 5.1 Page 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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