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Inspection on 26/04/05 for Claremont Nursing Home

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

This inspection was carried out on 26th April 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

What the care home does well

The home provides a safe environment for the client`s to live in that is warm, well decorated and comfortably furnished. The Manager has provided positive leadership to the care staff that has improved moral and consequently care. The inclusion of relatives has improved the relationship between staff and relatives with the benefit of improving communication about their views on the care needs of there relative.

What has improved since the last inspection?

What the care home could do better:

Staff records need to be improved to include such things necessary to prove the identity of the staff member. A comprehensive audit system, but not complicated, needs to be established that will include the views of the client`s or their relative or advocate, and show where areas of improvement are needed as well as where the service is achieving its aims and objectives.

CARE HOMES FOR OLDER PEOPLE Claremont Nursing Home 5 Nelson Gardens Stoke Plymouth PL1 5RH Lead Inspector Douglas Endean Announced 26 April 2005 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. Claremont Nursing Home D52-D04 S3579 Claremont V210470 260405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Claremont Nursing Home Address 5 Nelson Gardens, Stoke, Plymouth, Devon, PL1 5RH 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) 01752 606799 01752 606799 St Nicholas Homes Limited Acting Manager: Ian Johnstone Care Home with Nursing 32 Category(ies) of Dementia (3), Dementia - over 65 years of age registration, with number (32), Mental disorder, excluding learning of places disability or dementia (3), Mental Disorder, excluding learning disability or dementia - over 65 years of age (32), Physical disability (3), Physical disability over 65 years of age (32) Claremont Nursing Home D52-D04 S3579 Claremont V210470 260405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for maximum of 3 DE 2. Registered for maximum of 32 DE(E) Service Users 65 years and over. 3. Registered for maximum of 3 MD. 4. Registered for maximum of 32 MD(E) Service Users 65 years and over. 5. Registered for maximum 3 PD. 6. Registered for maximum 32 PD(E) Service Users 65 years and over Date of last inspection 20/10/04 Brief Description of the Service: Claremont Nursing Home is situated in Stoke, a suburb of City of Plymouth, which is a short distance away by road. It is a large property built on four floors each of which provides some accommodation for the Service Users. Nelson Gardens is a private road that offers some parking at the front of the building accessed directly from the road. There is a five-person shaft lift that travels up through the centre of the building stopping at each floor. There is also a staircase that opens onto each floor of the home. The home is registered to care primarily for up to thirty-two (32) Service Users who have a mental health problem or dementia and are over the age of retirement. There is also capacity for the home to admit up to three (3) Service Users under the age of 65 years who have dementia. The ground floor provides the day space for the Service Users by way of a large lounge to the rear of the ground floor and a dining room in the middle of the building. There are plans to rearrange some of the living space to provide a quiet lounge/visiting room also located on the ground floor. Claremont Nursing Home D52-D04 S3579 Claremont V210470 260405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, the first since the appointment of the Acting Manager Mr I Johnstone. It took place over a 5.75-hour period and all the core standards plus many of the remaining standards were inspected. Prior to the inspection the Commission for Social Care Inspection received a completed pre-inspection questionnaire and comments from one client and three relatives/advocates. The inspection included a full tour of the home, discussion with five visiting relatives, three members of staff and several client’s. It should be noted that due to the nature of the disease process suffered by the client’s, being dementia, obtaining an informed opinion from the client’s was understandably difficult. However, at the time of the inspection none of the clients looked agitated and all appeared to be appropriately dressed and comfortable. There were 28 client’s resident in the home at this point in time. Sample of clients files, including their care plans, staff files, maintenance records, policies and procedures and records showing the management of clients personal monies were also seen during the inspection. What the service does well: What has improved since the last inspection? There has been a notable improvement in the moral of staff and the atmosphere at the home. Relatives that were spoken to all commented on the atmosphere being the thing that made them choose Claremont as the place for their relative. Records relating to the clients have improved in structure and content and include “family liaison” notes that are used when reviewing care. The overall décor of the home has improved. Claremont Nursing Home D52-D04 S3579 Claremont V210470 260405 Stage 4.doc Version 1.30 Page 6 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. Claremont Nursing Home D52-D04 S3579 Claremont V210470 260405 Stage 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 Claremont Nursing Home D52-D04 S3579 Claremont V210470 260405 Stage 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) 1,2,3,4 and 5.Standard 6 does not apply to this home. The change in the management structure and trained nurse compliment has improved moral, the recording of information and communication methods. This coupled with attention to the premises has resulted in a positive atmosphere that has benefited the care given to the clients. EVIDENCE: In addition to the Statement of Purpose, which is under review by the Manager, there is brochure that was seen to be available to prospective clients and their advocates. These provide the information required by Schedule 1 of “The Care Homes Regulations 2001”, which includes information about the service and its aims and objectives to the Service Users and their advocates. The brochure was read during the inspection and a copy taken for evidence. The Manager told the inspector that all relatives are given a copy of the “Care Aware” information leaflet that provides advice on issues such as funding placements in care homes. These leaflets were seen in the home. The home’s private contract was seen to include a breakdown of the fee’s that are received along with the National Health Service determination payment where nursing is being provided, thus meeting Regulation 5A. Claremont Nursing Home D52-D04 S3579 Claremont V210470 260405 Stage 4.doc Version 1.30 Page 9 A sample of five (5) client files was inspected. All prospective clients are fully assessed prior to admission. A complete, comprehensive pre-admission assessment was seen in each file along with other assessments and care plans from individuals such as Community Psychiatric Nurse’s and hospitals were clients had been patients prior to admission. The Manager told me that the information was to assist in the decisions regarding the suitability of each admission. The inspector felt that the home exceeded standard 3 requirements through the level of information that they gather for the pre-admission assessment to be informative. A tour of the home, with the Manager describing the use of each area, showed how the building has been made suitable for the purpose of caring for older people with mental health problems. A sample of five staff training records were seen and certificates showed that staff have been trained or updated in manual handling and fire. The training audit file showed that 90 of the trained and social care staff have attended the Plymouth Social Services “Protection of Vulnerable Adults” training. There is evidence of other training appropriate to the client group that staff has commenced such as challenging behaviour training. Claremont Nursing Home D52-D04 S3579 Claremont V210470 260405 Stage 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) 7,8,9,10,11 There has been a positive improvement in the standard of records being kept on the clients. The “staff team” are more cohesive with a noticeable improvement in moral that has had a good effect on the care of the clients and the environment. EVIDENCE: A sample of care plans seen by the inspector were clearly written and well constructed. They included identified areas of need following (re) assessment and how the staff was to address them. There was evidence that each care plan had been reviewed regularly. One care plan that was read showed how the involvement of the family in care and care planning had benefited the clients when a review was undertaken. There is now an inclusive service openly involving the family in the care that is provided through better communication, which is recorded on the “family liaison” sheet that were seen in a sample of files that were inspected. The inspector observed, during the tour of the home, how staff and relatives communicated freely with each other. One relative was introduced to a more open level of communication with the Manager in the presence of the inspector. Of the five relatives spoken too during the inspection each commenced their response to open questioning that the first thing that they noticed about the Claremont Nursing Home D52-D04 S3579 Claremont V210470 260405 Stage 4.doc Version 1.30 Page 11 home was the “attitude” of the staff, being very good. The evidence of how the staff communicates with clients, and the respect they afforded them, was observed by the inspector, and commented upon by the visiting relatives, during the tour of the home. Collaborative notes that were seen and read in the sample of client files read during the inspection provided evidence of the involvement of the General Practitioner, Dentist, and Optician, etc in the care of the clients. The home has policies relating to the care of the dying that the Manager said helps to focus on the needs of the client and there relatives/friends. There has been eight deaths recorded since the last inspection. Claremont Nursing Home D52-D04 S3579 Claremont V210470 260405 Stage 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 and 15. The collaborative working with relatives has resulted in more information being available on some clients and that has helped with individualised care planning. EVIDENCE: The social likes and dislikes are recorded in the clients records and the Manager told the inspector that family liaison arrangements have improved the level of information of this type that they have collected. This has helped to design individual social care plans. One client goes to church on Sundays with her support worker that was organised by her Community Psychiatric Nurse. Other clients have it recorded in their care plans that they will attend Holy Communion in the home. The Manager showed the new activities register to the inspector. This provided some evidence of the activities that take place in the home, who carried out the activity and who took part. It also provided evidence of the cost of each activity to a client where one had occurred such as hairdressing. A record of purchases of toiletries obtained for individual clients was seen with evidence of the cost being recorded in the audit trail for each client’s personal money that is kept in safekeeping. Claremont Nursing Home D52-D04 S3579 Claremont V210470 260405 Stage 4.doc Version 1.30 Page 13 The dining room provides an environment suitable for the clients to eat in with appropriate furniture and a non-slip floor covering that is reasonably easy to clean. All meals are prepared on the premise in a kitchen that was inspected by the Environmental Health Department in February 2005. The inspector saw the report and no requirements were made at that time. A nutritional assessment is carried out for each client and samples of these were seen in the files. The information is used to help in individual menu planning for the home. During the midday meal clients were seen by the inspector to be fed, or supervised by staff, so that adequate nourishment was taken. This was done in an unhurried way that also considered individuals behaviour and respected their needs. The families spoken too were happy with the care provided by the home. Claremont Nursing Home D52-D04 S3579 Claremont V210470 260405 Stage 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) 16,17 and 18 The staff changes and improved moral has resulted in a positive change in the attitude of staff and the care provided. Staff training in “Protection of Vulnerable Adults” has shown recognition of the importance in understanding how ones approach can be beneficial or detrimental to situations encountered every day in care homes. EVIDENCE: The home has their complaints procedure on display in the front entrance, and also in the Statement of Purpose, which informs every one who reads it of the course of action the home will take if a complaint is raised. It also explains how the Commission for Social Care Inspection can be contacted if the complainant is not happy with the response to a complaint by the Manager of the care home. Evidence was provided to the inspector on how the “Right to Vote” is addressed. Completed forms for three (3) clients to be able to vote in the general elections were being prepared for posting. The home has links with “Care Aware” and the Manager told the inspector that they have been allocated a reprehensive, who is also a Solicitor, for the home. Evidence was provided in the homes training file that showed that 90 of the care staff have attended Protection of Vulnerable Adults training provided by Plymouth Social Services. Other Protection of Vulnerable Adults training aids and guidance such as the homes policies and procedures were seen by the inspector during this inspection and found to have an adequate level of information to inform the reader how to recognise forms of abuse and report it. Claremont Nursing Home D52-D04 S3579 Claremont V210470 260405 Stage 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 and 26. The home’s redecoration and furniture replacement program has continued making the visual presentation of the communal areas and bedrooms pleasing, with the home looking clean and fresh. EVIDENCE: The lounge has been completely redecorated since the last inspection providing a more attractive environment for the clients and their relatives when they visit them. An assessment of the home by an Occupational Therapist has been undertaken and the recommendations are being acted upon. There is a non-slip surface to the garden ramp and the toilet in the lobby has a call bell installed that is linked to the main call bell system. There is evidence of maintenance having taken place throughout the home with contractor’s invoices to support this, i.e. hoist maintenance, shaft lift and fire equipment. The Risk Assessment file has details of the premises risk assessment and ongoing review of such things as window restrictors. Claremont Nursing Home D52-D04 S3579 Claremont V210470 260405 Stage 4.doc Version 1.30 Page 16 One visitor commented on the need for additional storage space for wheel chairs that clutter the dining room and a separate visiting area to reduce the distractions when the visit takes place in a communal area. The Manager stated he has plans to provide a quiet room/quiet visiting room on the ground floor. The inspector was shown this room and how the premise can be reorganised to achieve this. The tour of the home provided visual evidence that bedrooms were personalised, adequately furnished and that safety of the clients had been assessed and provided for with such things as window restrictors and non-slip flooring where carpet had not been provided (following risk assessment). There is a mobile hoist and stand-aid for those identified as needing them and the home has a Parker bath in a large bathroom on the lower ground floor. All wash hand basins in the home, including client’s bedrooms, have thermostatic restrictor valves fitted. There are two disinfecting sluices in the home, one on the lower ground floor and one on the first floor that are used to clean bed pans and improving infection control management. There is also a laundry on the lower ground floor that has two commercial cloths dryers and two commercial washing machines, one with a sluicing cycle to manage fouled laundry and therefore again address infection control issues. The laundry was inspected and found to be in good working order and clean cloths were stored safely for return to client’s bedrooms. Claremont Nursing Home D52-D04 S3579 Claremont V210470 260405 Stage 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) 27,28,29,and 30. There are sufficient numbers of staff on duty that have adequate training to meet the needs of the clients resident at the home. EVIDENCE: Each shift is managed by a trained nurse with experience in planning for the needs of the elderly with mental health problems. The registered nurse team is made up of nurses with either registration in Mental Health Nursing or General Nursing and all have a current pin number as seen in the staff records. The duty sheets provided information on the number of staff deployed on each shift in the week prior to this inspection and the plans for the following week. The Manager felt that based on his knowledge of the needs of the clients resident at the home and the qualifications and experience of the staff he was providing staff in adequate numbers to meet the homes aims and objectives. The training records provide evidence that out of seventeen Social Care staff employed at the home five presently hold a National Vocational Qualification in care. The records also showed that 90 of the care staff has attended a recognised course of training in Protection of Vulnerable Adults provided by Plymouth Social Services. The Manager is a Manual Handling trainer and he has updated the care staff in this aspect of care. The staff records were inspected and found to be insufficient in providing evidence of individual staff member’s identity although each member of staff has had a Criminal Records Bureau check with the result being on file. Short Claremont Nursing Home D52-D04 S3579 Claremont V210470 260405 Stage 4.doc Version 1.30 Page 18 files in the records included no photographs and no copies of birth certificates or proof of address like a utility bill. The staff has also had an update on the importance of record keeping by an external training organisation that has improved the way client information has been recorded. This is evident in the way the client files are compiled and the information the inspector read when inspecting a sample of the client’s files. A number of staff were spoken to during the inspection and they each had positive things to say about the changes in the way the home is functioning that was evident during this inspection. They were pleased to be included in decisions about how the home is run and the training that they receive. Claremont Nursing Home D52-D04 S3579 Claremont V210470 260405 Stage 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, 32, 33, 34, 35, 36, 37 and 38. The change in trained staff at the home and the employment of a new Acting Manager has resulted in a positive change in the character of the home and a raise in standards of care. The leadership qualities of the Acting manager and the support he is given by the staff at the home has had a positive effect on the care the client’s receive. There are some areas in the administration of the home that are still in need of work. EVIDENCE: The majority of areas of concern that were raised in the last year of inspection have been addressed by the Manager and the staff now employed at the home. There are clear organised client files that included the input of relatives where this has been possible. This was seen in the sample of client files inspected. The training records are evidence of a commitment to improve the skills of the workforce and in turn the care given to the client’s resident at the home. Claremont Nursing Home D52-D04 S3579 Claremont V210470 260405 Stage 4.doc Version 1.30 Page 20 The staff who were spoken to during the inspection gave positive comments about the direction the home has taken under the new leadership. There was evidence of good accounting of the client’s money where it is kept in safekeeping and used on their behalf. Records of client’s accounts are held in locked containers, in a locked cabinet inside a locked room with access limited to only those with a pin number. Clients accounts are balanced monthly. The Manager made available a statement from an accountant that says that the establishment/business is financially viable. The Manager is now carrying out staff appraisals and provided records of those already undertaken. The staff have been given an explanation of what supervision is and the benefits to them and the service. It has not commenced as the Manager is finalising a procedure to follow that will be in place prior to the establishment commencing the “ Investors in People Award”. The Commission for Social Care Inspection has not received any Regulation 26 reports from the Registered Person. There is a full risk assessment on the premise that was seen in the office that was completed by a competent person and the actions taken as a result of any identified risk such as thermostatic control valves installed on baths and wash hand basins. Also, each client is assessed for risk of falls, tissue viability, moving and handling and a general risks assessment. The care plan is used to identify how risks are to be reduced where they involve the client, perhaps due to behaviour, and not a piece of equipment such radiators, windows or a radiator. The Manager has audited training, and some other activities but there has been no audit yet that includes the views of the client’s and their advocates. Claremont Nursing Home D52-D04 S3579 Claremont V210470 260405 Stage 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 3 4 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 2 3 3 2 2 2 Claremont Nursing Home D52-D04 S3579 Claremont V210470 260405 Stage 4.doc Version 1.30 Page 22 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 33 Regulation 24(1) Requirement The Registered Person shall establish and maintain a system for reviewing at appropriate intervals, and improving the quality of care provided at the home, including the quality of nursing where nursing is provided at the care home. The Registered Person shall not employ a person to work at the care home unless he has obtained in respect of that person the information and documents specified in paragraphs 1 to 7 of Schedule 2. Timescale for action 1st October 2005 2. 29, 37 and 38 19(1)(b)(i ) 1st 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. Refer to Standard 36 Good Practice Recommendations Care staff are to receive formal supervision at least 6 times a year. Claremont Nursing Home D52-D04 S3579 Claremont V210470 260405 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ3 2QA 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 Claremont Nursing Home D52-D04 S3579 Claremont V210470 260405 Stage 4.doc Version 1.30 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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