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Inspection on 06/05/05 for Brambles Care Home Limited

Also see our care home review for Brambles Care Home Limited for more information

This inspection was carried out on 6th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

The Brambles gave the residents a clean, comfortable and well maintained home, which was free of offensive odours. A particular strength is the homely relaxed atmosphere. One resident described the home as, `as nice as anywhere could be.` The residents spoken to were very positive about the home and the care they recieve. Staff were described by residents as `excellent`, `kind`, `thoughtful` and `caring`. Some of the staff have worked in the home for many years and said they really enjoyed their work. The new owner and manager both showed a commitment to providing a high standard of care and they used the inspection as an opportunity to discuss their plans and to ask for clarification and guidance. They expressed a wish to work with the Commission for Social Care Inspection to improve standards where there were shortfalls. A letter was received by the CSCI prior to the inspection from a family member complimenting the home particularly on its efficiency and cleanliness.

What has improved since the last inspection?

A new experienced senior member of staff has been employed to support the manager to make improvements. She has already taken responsibility for ensuring that all staff receive the right training so that they are able to do their jobs properly. The new owner is spending a lot of money improving the home. The work is not completed yet, but signs are that residents and staff will benefit from the improvements. Locks have been fitted to bedroom doors to provide privacy and residents who wish can hold their own key. The home is introducing a scheme to assess people`s views on the service they provide so that they can build on what residents like and make improvements where necessary.

What the care home could do better:

The people responsible for the Brambles are aware that there are a number of improvements that must take place and these have been discussed at this and the previous inspection. Following the last inspection the home submitted an action plan, however they have not met the timescales that they agreed. Some progress has been made but there is much more to do. As a priority the home must improve the way they manage medication to ensure the health and safety of the residents. They need to improve their record keeping so that staff have enough information about the residents needs and guidance on the best way to help them. The home must have all the relevant information on new staff before they are employed so that residents are protected. New staff need to be shown the correct way to do their duties and they need regular supervision. The home must look at the possible risks in the garden and the home and take action to reduce them, for example checking that the bath water does not run too hot. From speaking with residents a greater choice at meal times and a wider range of pastimes would be appreciated.

CARE HOMES FOR OLDER PEOPLE Brambles Care Home Limited 22 Cliff Road Leigh on Sea Essex SS9 1HJ Lead Inspector Nikki Gibson Unannounced 6 MAY 2005 10.15 am 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. Brambles Care Home Limited I56-I06-S63786-Brambles-V225525-060505Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Brambles Care Home Limited Address 22 Cliff Road, Leigh on Sea, Essex, SS9 1HJ 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) 01702 472417 01702 472417 Brambles Care Home Limited Mrs Jean Thurston CRH 20 Category(ies) of OP Old Age 20 registration, with number of places Brambles Care Home Limited I56-I06-S63786-Brambles-V225525-060505Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 15 November 2004 Brief Description of the Service: The Brambles provides care and accommodation for up to twenty older people. Generally residents have low to medium dependency needs. The home does not provide nursing care and does not cater for people with a diagnosis of dementia. The Brambles is a large, extended and converted house situated in a residential area. Considerable building work is taking place which will further improve the facilities. Accommodation at present is provided on two floors in twelve single and four double rooms. All rooms have en-suite facilities. The ground and first floor are accessed via a shaft lift. The communal areas include an open plan lounge and dining area. There is also a conservatory and a raised decking area. The homes gardens are very well maintained and include an ornamental pond. There is limited parking at the front of the building. The Brambles is close to a mainline station and bus route Brambles Care Home Limited I56-I06-S63786-Brambles-V225525-060505Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection, which lasted nine hours undertaken by one inspector. During the inspection there was a tour of the premises and records and documents were looked at. Time was spent in the lounge and dining room, and with residents in their own rooms. Five residents were spoken to about life at the Brambles. The manager and four members of staff were also spoken with. The proprietor, manager, staff, and residents were most helpful during the inspection and this was greatly appreciated. Discussion of the inspection findings took place with the senior staff and the manager throughout and at the end the inspection and guidance was given. What the service does well: What has improved since the last inspection? A new experienced senior member of staff has been employed to support the manager to make improvements. She has already taken responsibility for ensuring that all staff receive the right training so that they are able to do their Brambles Care Home Limited I56-I06-S63786-Brambles-V225525-060505Stage 4.doc Version 1.30 Page 6 jobs properly. The new owner is spending a lot of money improving the home. The work is not completed yet, but signs are that residents and staff will benefit from the improvements. Locks have been fitted to bedroom doors to provide privacy and residents who wish can hold their own key. The home is introducing a scheme to assess people’s views on the service they provide so that they can build on what residents like and make improvements where necessary. 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. Brambles Care Home Limited I56-I06-S63786-Brambles-V225525-060505Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Brambles Care Home Limited I56-I06-S63786-Brambles-V225525-060505Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3, 6 Prospective service users and their supporters do not always have adequate information about the home so that they can make informed choices. The admission procedure does not include an adequate assessment, which ensures that service users needs can be met. The home provides a caring environment where visitors are made welcome. EVIDENCE: The home has been given considerable amounts of advice in the past on ensuring that the Statement of Purpose and Service User Guide contains all the information required so that prospective service users can make informed choices. The Service User Guide should be provided to prospective residents before they make a decision to move in and the Statement of Purpose should be available to any interested party. When the improvements to the premises have taken place both documents will need to be reviewed and amended copies must be sent to the CSCI. Brambles Care Home Limited I56-I06-S63786-Brambles-V225525-060505Stage 4.doc Version 1.30 Page 9 A new resident was spoken to and her file studied. Significant information about the resident was not available and the standard of the preadmission assessment was poor. The Brambles does not provide intermediate care. Brambles Care Home Limited I56-I06-S63786-Brambles-V225525-060505Stage 4.doc Version 1.30 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 standard(s) 8, 9, 10 Residents’ health needs were not well documented which led to some residents’ anxieties not being addressed. The systems for the administration of medication were poor and potentially placed residents at risk. Staff treat residents in a manner which promotes their dignity and encourages independence. EVIDENCE: The lack of adequate assessments limited the homes ability to write adequate plans of care. A resident spoke of a hospital appointment, pain and health concerns, which were not adequately documented. This limited the staff’s ability to support the resident or ensure that their health needs were met. Serious concerns were raised regarding the administration of medication. The present system was poor; it was not possible for a medication audit to take place and the system put service users at risk. Concerns included • Medication coming into the home was not checked, signed or dated. • A number of gaps were noted were the medication was not in the blister pack nor signed for and there was no explanation. • One resident had duplicated medication charts. Brambles Care Home Limited I56-I06-S63786-Brambles-V225525-060505Stage 4.doc Version 1.30 Page 11 Different methods of recording were being used. There was considerable confusion on the administration of Warfarin. • Handwritten charts did not include all the required information and were not signed or dated. • There were a number of homely remedies in the medicine trolley without any policy or record. • There was a bottle of eye drops without a label and no date when opened which staff acknowledged was out of date. • There were no care plans for medication prescribed ‘as required’ (PRN). The home needs a senior member of staff who has up to date training in medication to review the medication procedures and monitor practice on a regular basis. The home needs a copy of the Royal Pharmaceutical Society of Great Britain guidelines and staff must be briefed on its contents. All staff who administer medication must have up to date training. The concerns raised at this inspection were raised at the previous inspection and cannot be allowed to continue. Staff are supporting a resident who self-injects with insulin. Staff who are trained also test blood sugar levels. The home was advised to formulate a clear and detailed policy and discuss it with the District Nurse. Residents spoke positively about the way they were treated by staff. A number spoke of being enabled and encouraged to maintain their independence. All bedroom doors have been fitted with locks, and the manager was looking at ways which most suit the individual service users in managing the keys. • Brambles Care Home Limited I56-I06-S63786-Brambles-V225525-060505Stage 4.doc Version 1.30 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 standard(s) 12, 13, 14 A wider range of meaningful pastimes is required to promote the service users mental and physical wellbeing. Links with families are good and contact is maintained. The home provided food in ample quantities but a wider range of meals would be appreciated. EVIDENCE: A variety of activities are provided on an ad-hoc basis, but as yet there is no programme of planned pastimes. A number of service users said that they would like more activities. A session of physical activity had recently been introduced on a Friday and residents were being charged to attend. This was considered inappropriate, as providing physical exercise is an integral part of good care and should be included in the fee. The manager said that she would stop charging and reimburse the residents who had already paid. The manager said that she is changing staff’s focus from tasks such as cleaning and laundry to spending time with the residents. The home may wish to obtain further advice on appropriate activities for the elderly from the National Association for Providers of Activities for Older People on 01376 585225 Email: tessatnapa@aol.com Brambles Care Home Limited I56-I06-S63786-Brambles-V225525-060505Stage 4.doc Version 1.30 Page 13 No visitors were available during the inspection. However, residents said that their visitors were made welcome and offered drinks and there were quiet areas in the home where they could sit and chat. Residents felt that they had choices over their daily routine. Details of an Advocacy service was displayed. Rooms were personalised with residents’ own furniture and possessions. It was evident from observation that residents could eat or spend time in communal or private as they wished. Residents described the food as ‘ordinary’ and ‘passable’. The manager said that she would consider ways of providing a choice of food at each mealtime. Brambles Care Home Limited I56-I06-S63786-Brambles-V225525-060505Stage 4.doc Version 1.30 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 standard(s) 18 The Adult Protection policy seen at the last inspection was appropriate and protected residents. EVIDENCE: Staff are receiving training on protecting residents from abuse and the actions to take if an allegation of abuse is made. There is no plan at present for staff to receive training on dealing with aggression or challenging behaviour, as with the present residents this was not seen as a priority. Brambles Care Home Limited I56-I06-S63786-Brambles-V225525-060505Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25 The Brambles was clean, bright and well maintained and provided the residents with homely and comfortable surroundings. Hazards in the home and garden must be addressed to provide a safe environment. EVIDENCE: The Brambles is decorated and furnished to a good standard. Considerable investment is being put into upgrading the premises. On completion the owner proposes to register two additional bedrooms. The Brambles is situated on a hill in a residential area and is in keeping with other houses in the locality. There are well maintained gardens, which are sadly underused. One resident said that she would like to sit near the fish pond but was unclear how to access the garden. There is a raised decking area with steep steps to the garden, which are potentially dangerous. This needs to be made safer and residents enabled to make use of the garden. Brambles Care Home Limited I56-I06-S63786-Brambles-V225525-060505Stage 4.doc Version 1.30 Page 16 On the day of inspection most of the residents were sitting in the lounge. This area looked crowded with little space between the chairs. It would be beneficial to discuss at residents’ meetings where residents like to sit and what would encourage them to make use of all the space available. The home has a pleasant dining area and tables were attractively laid. All the bedrooms have en-suite facilities. There are three bathrooms, however only one has an assisted bath. With the increase in registered numbers serious consideration must be given to upgrading another of the bathrooms to ensure that the bathing facilities meet the needs of the residents. The home has twisting narrow corridors, which adds to the homely feel, but would be less suited to the confused and those with high dependency needs. Currently the home does not have a hoist, however this is being reviewed taking into consideration accidents or residents needs changing over a short period of time. Bedrooms were comfortable, homely and personalised. Residents spoken to said they were very pleased with their rooms. A couple expressed anxiety regarding the expected upheaval when their windows are replaced. The manager said that she was talking to residents individually, making suitable arrangements and reassuring them. Following a risk assessment restrictors must be put on large opening windows that pose a risk. The inspection took place on a warm spring day, however it was noted that several rooms had additional heating. It was unclear if these had low surface temperatures when on and this must be assessed and action taken if they pose any risk of causing burns. The manager said that temperature control valves were in place, however to ensure the safety of residents the water temperatures should be checked weekly, recorded and adjustments made as required. The home has showers, which are used infrequently which poses a particular hazard. Advice on preventing Legionella can be obtained from the following sources. Booklets Essential information for providers of residential accommodation and A guide for employers are available free for single copies from 01787 881165 or HSE Books, PO Box 1999, Sudbury, Suffolk. CO10 2WA, fax 01787 313995 Website www.hsebooks.co.uk Brambles Care Home Limited I56-I06-S63786-Brambles-V225525-060505Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, 30 Staff numbers and induction do not enable staff to meet residents’ needs. The staff recruitment process is not adequately robust to protect residents. Staff training is improving so that a more competent work force will develop. EVIDENCE: The manager is reviewing the present staffing levels, which from observation and discussion with residents, are insufficient. Domestic staff are required at the weekends and catering staff are required in the afternoons to enable care staff to work with and support the residents. This should enable staff more time to spend with residents, providing stimulation and improving their quality of life. Residents were very complimentary about the staff, however they would like them to have more time to spend with them. The manager said she was aware that staff were very task orientated and she was trying to change this. Files for two new members of staff were studied. The manager acknowledged that both had started work without Criminal Records Bureau checks being in place. Even though the procedure for obtaining POVA first checks was discussed at the last inspection, again this was not undertaken. It is important that the home has a copy of the Department of Health guidelines and that they are followed so that residents are protected from unsuitable people working in the home. The home’s induction programme did not meet the Skills for Care (TOPSS) standard. A senior member of staff had put a lot of work into developing a Brambles Care Home Limited I56-I06-S63786-Brambles-V225525-060505Stage 4.doc Version 1.30 Page 18 training plan for staff and this work could continue with development of the induction programme. Brambles Care Home Limited I56-I06-S63786-Brambles-V225525-060505Stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 35, 36, The manager, supported by the owner, is committed to raising standards and providing a good service, however some changes have been slow or not yet accomplished. EVIDENCE: The manager is dedicated and working hard to make improvements and is also studying for the Registered Managers Award. The manager acknowledged that progress has been slow, however she recently appointed a competent and experienced senior member of staff to whom she has delegated some of the development work. A quality assurance policy and questionnaire have been drawn up. Once the system is in place and views have been obtained the home will need to consider any changes that need to take place. A report of the home’s findings and the actions taken need to be sent to the CSCI. A comments book has been displayed prominently in the hallway. It contains one entry from a Brambles Care Home Limited I56-I06-S63786-Brambles-V225525-060505Stage 4.doc Version 1.30 Page 20 healthcare professional, ’Lovely home, nice atmosphere, residents taken care of properly, staff friendly and genuinely caring’. Residents’ money held in safe keeping was checked and the record and amounts balanced. A new safe has been purchased following a theft from the home. The manager was advised that invoices and receipts should be held for each financial transaction so that the residents’ accounts can be audited. The manager said that she has yet to implement regular supervision with the staff. The manager must ensure that her role is supernumerary to the staffing level to enable her time to undertake her management duties. Brambles Care Home Limited I56-I06-S63786-Brambles-V225525-060505Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 1 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 2 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 3 2 2 3 3 2 x STAFFING Standard No Score 27 2 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 3 x 3 x 2 2 x x Brambles Care Home Limited I56-I06-S63786-Brambles-V225525-060505Stage 4.doc Version 1.30 Page 22 Yes 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 3 Regulation 14(1) Requirement Timescale for action 1 July 2005 2. 8 13(1) 3. 9 13(2) 4. 12 16(2) The needs of prospective residents must be assessed by a suitably qualified or trained person prior to admission and the home must confirm in writing that they are able to meet the residents needs in respect of their health and welfare. The Registered Person must 1 July 2005 ensure that service users receive where necessary treatment, advice and other services from any health care professional. This refers to knowing and recording residents medical needs and ensuring that they are met. The Registered Person must 1 July 2005 make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the home. (Previous timescale of 01.01.05 not met) The Registered Person must 1 July 2005 consult with residents about their interests and provide a programme of activities and provide facilities for fitness and recreation. Version 1.30 Page 23 Brambles Care Home Limited I56-I06-S63786-Brambles-V225525-060505Stage 4.doc 5. 21 23(2) 6. 25 13(4) 7. 27 18(1) 8. 29 Schedule 2 9. 30 18(1) The Registered Person must provide sufficient numbers of suitable baths to meet the needs of the residents. The Registered Provider must ensure that all parts of the home are as far as reasonably practicable free from hazards and that unnecessary risks to residents are identified and as far as possible eliminated. Hazards and risks identified at this inspection are: Risk of falls from the decking. Water temperatures not checked. Freestanding radiators which may have hot surfaces. Windows on upper floors without restrictors. Risk of Legionella. The Registered Person must ensure that at all times there are suitably qualified, competent, and experienced persons working at the home in such numbers as are appropriate for the health and welfare of the residents A copy of the revised staff rota to be sent to the CSCI. The Registered Person must ensure that robust recruitment procedures are in place, and applied consistently. Records required by regulation in respect of staff recruitment must be obtained prior to a staff starting work. (Previous timescale of 01.01.05 not met The Registered Person must ensure that staff receive training appropriate to the work that they perform. This refers to the need for robust induction processes to be in place for new staff (Previous timescale of 01.03.05 1 July 2005 1 July 2005 1 July 2005 1 July 2005 1 July 2005 Brambles Care Home Limited I56-I06-S63786-Brambles-V225525-060505Stage 4.doc Version 1.30 Page 24 not met) 10. 35 17(2) The Registered Person must maintain an accurate record of all residents money held in sake keeping with appropriate invoices/receipts The Registered Person must ensure that persons working in the home are appropriately supervised (Previous timescale of 01.03.05 not met) 1 July 2005 11. 36 18(2) 1 July 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard 14 22 28 33 36 Good Practice Recommendations Residents should be given a choice at mealtimes The registered person should consider the provision of a hoist and appropriate training, in order to provide safe systems for staff in an emergency situation. At least 50 of care staff should have NVQ 2 in Care or equivalent Policies and procedures in the home should be reviewed and updated. (Not inspected) Care staff should have formal supervision at least six times a year) Brambles Care Home Limited I56-I06-S63786-Brambles-V225525-060505Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Brambles Care Home Limited I56-I06-S63786-Brambles-V225525-060505Stage 4.doc Version 1.30 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!