Inspection on 05/02/07 for Briarfield House

This inspection was carried out on 5th February 2007.

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

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

Other inspections for this house

Briarfield House 24/04/08

Briarfield House 15/05/07

Briarfield House 02/10/06

Briarfield House 11/04/06

Briarfield House 21/02/06

Briarfield House 26/07/05

Briarfield House 29/09/04

Briarfield House 14/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Briarfield House 8 Easson Road Redcar TS10 1HJ Lead Inspector Shaun Common Key Unannounced Inspection 5th February 2007 09:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Briarfield House DS0000000079.V328069.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Briarfield House DS0000000079.V328069.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Briarfield House Address 8 Easson Road Redcar TS10 1HJ 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) 01642 488218 F/P 01642 488218 Mr Stephen Metcalf Miss Louise Metcalf Mrs P Creed Care Home 12 Category(ies) of Old age, not falling within any other category registration, with number (12) of places Briarfield House DS0000000079.V328069.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd October 2006 Brief Description of the Service: Briarfield House is a large detached two-storey house, built in 1902. It is a mellow building, which blends well with the surrounding properties and has an enclosed garden. The home is situated in a quiet residential road near to the racecourse. There are shops and a large supermarket within walking distance, and a nearby bus stop provides access to the town centre and sea front. The home provides accommodation for twelve elderly service users, in ten single rooms and one double room with en-suite shower, wash basin and lavatory. Bedrooms are comfortably furnished, and service users are able to personalise their rooms by bringing some possessions with them when they move into the home. Downstairs there is a bathroom/shower room, and separate lavatory and upstairs there is a bathroom and separate lavatory. There is a large spacious lounge, and a pleasant dining room, and a smokers room is provided to the rear of the house. The owner told inspectors that it costs £330 per week for a resident to stay at Briarfield House. Briarfield House DS0000000079.V328069.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit to Briarfield House by two Inspectors. The inspection started on a Monday morning at 9.45am and lasted for 5 hours. The inspectors spoke to residents and observed how the home was running. The inspectors spoke to staff and the manager, as well as looking at records and looking around the home. What the service does well: What has improved since the last inspection? What they could do better: Briarfield has a number of things that it needs to do better. Some need to be done quickly in order look after residents properly and keep them safe. A number of things have still not been done that were raised at previous inspections of the home and this is of concern. Briarfield House DS0000000079.V328069.R01.S.doc Version 5.2 Page 6 Not all assessments are carried out prior to a resident being admitted to the home and where assessments are carried out, they are being undertaken by people at the home who are not qualified or trained to do so. Assessments must only be undertaken by qualified or trained people. Some residents’ files did not contain risk assessments and care plans. Some care plans and risk assessments that were in place did not contain sufficient information to identify how the home intended to meet all of a residents assessed needs and how any risks will be managed appropriately and safely. Medications are not always given out safely as they should be and records could be better and a fire door was propped that should not be. The complaints procedure contains information that is inappropriate for residents and the home has no evidence that it carries out varied activities with/for residents. Staff have not undertaken important and essential training and qualifications that ensures residents are well looked after and helps keep them safe. The recruitment processes and procedures are poor and people are employed at the home without proper checks and information. This places residents at risk. The quality assurance processes have developed somewhat, but need to be extended and robust. Due to the number of serious issues raised in this report and a number of issues raised during previous inspections of the home the Registered Person is not demonstrating the competency to deliver safe and quality care to residents. This competency must be demonstrated through significant and sustained improvements in the delivery of care. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Briarfield House DS0000000079.V328069.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Briarfield House DS0000000079.V328069.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Most assessments are carried out pre-admission, however some are undertaken by unqualified, untrained staff. The home does not provide for people who have intermediate care needs. EVIDENCE: Five residents files were examined and four demonstrated that an assessment of need had been undertaken prior to admission to the home. The other file had an assessment completed very shortly after admission. The Registered Manager explained that the admission was initially planned, however factors outside their control had lead to the admission process being changed to that of emergency placement and therefore the assessment could not take place until the day after admission. This information was not reflected with any clarity in the documentation within the file including the assessment. This left Briarfield House DS0000000079.V328069.R01.S.doc Version 5.2 Page 9 a question as to whether the home could possibly have ascertained whether they could meet this persons needs without carrying out an assessment. A care staff member who has no qualifications or training to undertake such work undertook some of the assessments carried out by the home. This clearly was of concern. The home does not provide for people who have intermediate care needs. Briarfield House DS0000000079.V328069.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents overall needs and how these are to be met are not always recorded or clearly recorded and records that are available lack detail. Medication administration poses risks to the welfare of residents through lack of knowledge of safe procedures and untrained staff. Residents’ privacy and dignity is respected. EVIDENCE: Five residents files were examined. Four had plans of care in place, one did not. Of the four care plans examined, all lacked sufficient detail. The plans did not set out all the assessed needs of each resident and how these needs would be met on a day-to-day basis by staff at the home, including health and social care needs. Briarfield House DS0000000079.V328069.R01.S.doc Version 5.2 Page 11 Two of these files examined did not contain any form of risk assessment. Those risk assessments that were in place were examined. These documents lacked details of essential matters identified through the assessment process and where matters were identified, they lacked clarity and detail. It appeared that risk assessments were being confused with care planning documents and the end result was judged by inspectors to meet the criteria for neither document. As care panning lacked details, outcomes in areas such as health, social needs and other matters were not clear. Files did contain information about when residents are offered and/or take a bath or shower. Medication systems were examined. An inspector observed the administration processes. The Registered Manager was noted to dispense medication into a container. This was then given to a staff member to take upstairs to a resident in their bedroom. This is secondary dispensation and was therefore still occurring at the home. It was evident that the dispensing staff member was not administering the medications. Medication Administration Sheets (MAR) that were handwritten were signed at the bottom of the sheet and not after each individual administration of a medication. Staff that had not been trained in the Safe Handling of Medication were confirmed by the Registered Manager as administering medications to residents. Residents were observed to be treat with respect and dignity by staff at all times. Briarfield House DS0000000079.V328069.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Activities continue to be very limited and therefore provide residents with limited opportunity for stimulation. Contact with family is sometimes recorded. A balanced diet and recorded menu is provided. EVIDENCE: There is continued limited evidence of activities being undertaken in the home. This issue was raised at the last two Key Inspections and remains unaddressed. Evidence of recorded activities was minimal. Contact with family was recorded on some files and residents confirmed that visits go ahead without restriction. The homes’ menu was examined and demonstrated a varied diet with choice. Residents stated that they were happy with what was offered and there was always another choice if they did not like what was on the menu. Briarfield House DS0000000079.V328069.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Complaints processes and procedures are in place but are not in a suitable format for all residents. Safeguarding procedures are in place and known by staff, but not all have received appropriate training. EVIDENCE: The complaints procedure was examined and contained a statement requiring residents to notify the Commission for Social Care Inspection of any complaint via a stated regulation. There is no legal requirement and therefore the home must adjust its complaints procedure so it is in line with National Minimum Standards and the Care Homes Regulations 2001 and re-issue the procedure to resident and their families. The home has a resident who is registered blind, however does not have the procedure in a format suitable for that person. The home has a procedure in place for safeguarding vulnerable people. Staff were aware of the procedure to follow should they suspect an incident of abuse had occurred at the home. Not all staff had been trained in the protection of vulnerable adults, however the Registered Manager stated that a date had been set for the middle of February 2007 for all staff to receive this training. Briarfield House DS0000000079.V328069.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Briarfield House is clean, hygienic, well decorated and furnished. Some matters continue to present risks to the health, safety and welfare of residents. EVIDENCE: The home was noted to be clean and hygienic throughout. The upstairs bathroom flooring has not been addressed from the last inspection and still presents as a potential tripping hazard to residents. The Registered Manager stated that the hot water outlet in the laundry area has now been thermostatically controlled via mixer valves and the kitchen was noted to be locked when not in use. The Environmental Health Authority had visited the home and advised that the home has complied with required standards. Briarfield House DS0000000079.V328069.R01.S.doc Version 5.2 Page 15 The door to the laundry area was observed to be propped open by a laundry basket when inspectors entered the home creating a fire hazard. This issue appears not to have been addressed since the last inspection of the home. It was noted that a door guard had been fitted to the lounge door, which means in the event of a fire the door would automatically close. Briarfield House DS0000000079.V328069.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Staffing is adequate in numbers, however training is significantly lacking and there is a shortfall is qualifications questioning the homes ability to deliver its Statement of Purpose and provide adequate, safe care to residents. Recruitment practices are inadequate and place vulnerable adults at risk of harm. EVIDENCE: The homes’ rota was examined and demonstrated that there are at least two staff dedicated to direct care of residents on duty at all times. A third member of staff is dedicated to domestic and cooking tasks. There is one waking night staff member and one on call sleeping in the building. The homes staffing records were examined. Of nine staff, the home has two qualified to at least NVQ Level 2 in Care. The Registered Manager stated that one staff member is a qualified nurse; however there was no evidence of the qualification held on file. After the inspection, the Proprietor of Briarfield House forwarded documents in relation to the nursing qualification and three staff qualified to at least NVQ Level 2 in Care. Four from nine care staff were therefore qualified to NVQ 2 in Care or equivalent, equating to 44 . Briarfield House DS0000000079.V328069.R01.S.doc Version 5.2 Page 17 Recruitment processes and information for all staff were examined. One member of care staff did not have a file and no recruitment information was available. The Registered Manager stated they did not have any information available for this person, except a Criminal records Bureau disclosure. The disclosure was dated December 2006 and this person had been employed as a member of care staff since the Care Standards Act 2000 and Care Homes Regulations 2001 were enacted on 1st April 2002. A second file was examined of a member of staff recruited in November 2006. One of the references appeared not to be an original copy. The Registered Manager agreed that this was the case. The individual started work at the home on 18th November 2006, however the Criminal records Bureau disclosure was undertaken and received two months later on 5th January 2007. Although a POVA First check was undertaken by the home, this was dated almost a month after the individual started work with vulnerable adults i.e. 11th December 2006. There were gaps that were not accounted for in this person’s employment history. A file was requested for a third staff member who had been provided to the home by an employment agency. The Registered Manager stated that they had no information on record in relation to this person and no confirmatory evidence that the required information had been attained by the employment agency and checked by the Registered Person. Five other files were examined. Of these files, three still contained gaps in their employment history that have not been rectified as recommended at the last inspection of the home. One other file of an individual employed in April 2004 contained only one reference. The Registered Person’s recruitment practices were therefore of serious concern in relation to the safety and welfare of residents. All staff training profiles were examined and inspectors focused on essential training: Three staff from nine had completed training in Adult Protection in accordance with the Department of Health’s ‘No Secrets’ guidance. The Registered Manager had delivered this training in-house. The Registered Manager also stated that a training day for all staff had been set up for mid-February 2007. Three staff from nine had completed training in First Aid. No staff members had completed training in Moving and Handling, two did have certificates however this training had expired. Four staff from nine had completed training in Safe Food Handling and Hygiene. Two staff from nine had completed training in the Safe Handling of Medications. One staff member had completed this training almost five years ago and the other three and a half years ago. One of the above nine care staff members had undertaken no training whatsoever, another had completed one training course in first aid and another staff member had completed one training course in Fire Safety. Briarfield House DS0000000079.V328069.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The competence of management of the home is concerning in relation to the homes overall functioning. The Registered Manager is not fully qualified for her role. Quality assurance processes are developing but still require some work. Residents’ finances are managed by family and health and safety matters are satisfactorily addressed. EVIDENCE: The competency of the management and provision of the home is of concern due to unsafe practices described in this report, as well as lack of thorough risk assessment, care planning and assessment processes, training and qualifications of staff. Briarfield House DS0000000079.V328069.R01.S.doc Version 5.2 Page 19 The Registered Manager advised inspectors that she has registered to begin qualification to NVQ Level 4 in Care from April 2007. The Registered Manager stated that the home is continuing to develop its quality assurance processes and evidence of this was seen on residents’ files in the form of questionnaires. Further work was confirmed with the Registered Manager as still being needed. The Registered Manager confirmed that residents’ monies are no longer kept by the home and are managed directly by families. Health and safety matters were examined at a recent Key Inspection of the home and found to be in order. One outstanding matter was the fire risk assessment and the Registered Manager provided evidence that this had now been undertaken. Briarfield House DS0000000079.V328069.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A 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 1 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 1 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 1 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 2 X 3 X X 3 Briarfield House DS0000000079.V328069.R01.S.doc Version 5.2 Page 21 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 OP3 Regulation 14 Requirement The Registered Person must ensure that a suitable and thorough assessment is carried out in relation to each service user prior to admission to the care home. (the previous timescale of 19/10/06 was not met). The Registered Person must ensure that needs of service users are assessed only by a suitably qualified or suitably trained person. The Registered Person must ensure residents’ files include written information in the form of a risk assessment about how the risks, which have been identified, will be managed and minimised. (the previous timescale of 01/08/06 was not met) Timescale for action 05/02/07 2. OP3 14 05/02/07 3. OP7 15 15/03/07 4. OP7 15 The Registered Person must 01/03/07 ensure that each service user has in place a written care plan as to how their day-to-day needs DS0000000079.V328069.R01.S.doc Version 5.2 Page 22 Briarfield House will be met. (the previous timescale of 01/12/06 was not met). 5. OP9 13 The Registered Person must make satisfactory arrangements for the recording, handling, safekeeping and safe administration of medicines in the care home in that: -Secondary dispensation must not occur -Records of administration must be signed by the dispensing staff member (the previous timescale of 15/11/06 was not met). 6. OP12 16 The Registered Person must provide evidence that varied activities are offered both inside and out of the care home. (the previous timescale of 01/05/06 was not met) The Registered Person must ensure that the complaints procedure does not make a requirement of residents to inform the Commission of any complaint. The complaints procedure must be in a format that is suitable for a resident who is registered blind. The complaints procedure must be further developed as stated above, then provided to all residents in a format appropriate to the person. 8. OP18 13 The Registered Person must ensure all staff at the care home receive the Department of Health’s ‘No Secrets’ training. DS0000000079.V328069.R01.S.doc 05/02/07 01/03/07 7. OP16 22 01/04/07 01/03/07 Briarfield House Version 5.2 Page 23 (the previous timescale of 01/05/06 was not met) 9. OP19 12, 13 & 23 The Registered Person must 05/02/07 ensure that they make adequate arrangements for containing fires at the care home, specifically by: -Ensuring fire doors are not tied back or wedged open (the previous timescale of 19/10/06 was not met) 10. OP19 13 & 23 The Registered Person must ensure that the flooring in the upstairs bathroom of the care home is properly laid and hence safe for service users. (the previous timescale of 15/11/06 was not met). The Registered Person must ensure that a minimum of 50 of staff working at the home are qualified to NVQ Level 2 in Care. The Registered Person must ensure that no person is employed to work in the care home unless the information specified in paragraphs 1 to 7 of Schedule 2 of the Care Homes Regulations 2001 has been attained. (the previous timescale of 19/10/06 was not met). The Registered Person must ensure that all staff at the care home undertake training in: First Aid, Moving and Handling, Basic Food Hygiene and Safe Handling of Medications. (the previous timescale of 01/02/07 was not met). 01/03/07 11. OP28 18 01/04/07 12. OP29 19 05/02/07 13. OP30 18 15/04/07 Briarfield House DS0000000079.V328069.R01.S.doc Version 5.2 Page 24 14. OP31 10 The Registered Person must ensure that the care home is ran and managed by a person competent to do so and ensure that effective management systems are in place, specifically by complying with the Statutory Requirements set out in this report. 05/02/07 15. OP33 24 The Registered Person must put 01/04/07 in place effective quality assurance and quality monitoring systems that measure success in achieving the aims, objectives and Statement of Purpose of the home. (the previous timescale of 01/08/06 was not met) 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 OP9 Good Practice Recommendations The Registered Person should ensure that a second staff member countersigns each entry on Medication Administration Records. The Registered Person should ensure that any gaps in a staff member’s employment history are satisfactorily explored prior to their employment in the care home. Where this has not already been attained for staff already employed, this information should be sought and included in staff members files. (this recommendation is outstanding from the inspection of 2 & 19 October 2006). The manager should be qualified to NVQ Level 4 in Care, or an equivalent qualification. 2. OP29 3. OP31 Briarfield House DS0000000079.V328069.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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