Inspection on 18/10/05 for Court House Nursing Home

This inspection was carried out on 18th October 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Court House Nursing Home 22/06/09

Court House Nursing Home 04/06/08

Court House Nursing Home 30/11/06

Court House Nursing Home 13/06/05

Court House Nursing Home 11/10/04

Court House Nursing Home 07/04/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Court House Nursing Home Barnards Green Malvern Worcestershire WR14 3BS Lead Inspector N Richards Unannounced Inspection 18th October 2005 10:00 X10029.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 Court House Nursing Home DS0000004106.V253726.R02.S.doc Version 5.0 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 and Care Homes for Adults 18 – 65*. 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. Court House Nursing Home DS0000004106.V253726.R02.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Court House Nursing Home Address Barnards Green Malvern Worcestershire WR14 3BS 01684 561276 01684 577949 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) BUPA Care Homes Limited Care Home 79 Category(ies) of Dementia - over 65 years of age (19), Old age, registration, with number not falling within any other category (41), of places Physical disability (19), Physical disability over 65 years of age (41) Court House Nursing Home DS0000004106.V253726.R02.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. A maximum of 16 people may be accommodated in Beacon House (categories OP and PD(E)). A maximum of 25 people may be accommodated in Midsummer House (categories OP and PD(E)). A maximum of 19 people may be accommodated in Bredon House (category DE(E)). A maximum of 19 people may be accommodated in Hollybush House (category PD). 13th June 2005 Date of last inspection Brief Description of the Service: Court House is situated close to the shops and commands views of the Malvern hills. Court House provides care in four individual houses for the elderly frail, elderly mentally infirm and young physically disabled. Some bedrooms have an en-suite facility, and all are single occupancy. Most bedrooms are located on the ground floor, while the two units with accommodation on the first floor level possess a central passenger lift. Court House Nursing Home DS0000004106.V253726.R02.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 5 hours, and was carried out to examine the homes physical environment and estates-related issues. A tour of the premises took place, and issues relating to staffing and administrative records were inspected. Six staff on duty were interviewed. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Court House Nursing Home DS0000004106.V253726.R02.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Court House Nursing Home DS0000004106.V253726.R02.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1. Residents and their representatives are provided with suitable information prior to admission to ensure that an informed choice can be made. EVIDENCE: The homes Statement of Purpose and Service User Guide are satisfactory and readily available to people – providing residents and prospective residents with details of the services the home provides, and enabling an informed decision about admission, and the suitability of the home to meet individual residents’ needs to be made. The home does not contract to provide Intermediate Care. Therefore Standard 6 is not applicable to the home. Court House Nursing Home DS0000004106.V253726.R02.S.doc Version 5.0 Page 8 Court House Nursing Home DS0000004106.V253726.R02.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for the following standard(s): These Standards were not examined during the course of this inspection. EVIDENCE: These Standards were not examined during the course of this inspection. Court House Nursing Home DS0000004106.V253726.R02.S.doc Version 5.0 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Meals are well managed, creative and provide daily variety and flexibility for people living in the home. Contact with family and friends is openly maintained, and residents are able to maintain as much control over their lives as is practicable. EVIDENCE: Menus were inspected and found to be balanced and interesting, and mealtime arrangements are also flexible enough to accommodate individual preferences. Catering staff demonstrated a detailed knowledge and understanding of individual residents’ dietary preferences and requirements. Court House Nursing Home DS0000004106.V253726.R02.S.doc Version 5.0 Page 11 Care staff were seen providing direct assistance to people with their lunch in a sensitive and relaxed manner. During the inspection, some relatives were seen visiting people, and staff greeted visitors politely. Residents spoken to said that they could receive visitors at any time of the day, thereby maintaining links with family members. Residents confirmed that there were “no restrictions” on visiting. Significant developments in the provision of social, recreational and leisure activities continue, and the home has recently won an award as a result of innovative practice involving animal therapy. One activities co-ordinator is recruited specifically for younger adults within the home, and has developed a good rapport with the younger-aged residents – who confirmed their appreciation of their activities co-ordinator. Two other activity co-ordinators are employed within the home and provide social, recreational and leisure activities for older people who are resident in Beacon House, Bredon House and Midsummer. The culture within the home serves to promote residents’ welfare, and staff on Hollybush Unit actively attempt to enhance residents’ quality of life. Court House Nursing Home DS0000004106.V253726.R02.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18 Complaints are handled objectively and residents are confident that their concerns will be listened to, taken seriously and acted upon. The culture within the home protects residents. EVIDENCE: The home has a simple and clear complaints procedure. A copy of the complaints procedure had been given to all residents, and was available to visitors and relatives. Residents spoken to were confident that concerns could be raised with the home. The Commission has received two complaints about the service since the time of the previous inspection. Neither complaint was substantiated. The complaints register was examined, and clearly demonstrated that concerns, no matter how small, are taken on board, investigated and addressed. The home also retains letters of appreciation. The letters of appreciation strongly outweigh any letters of concern. A procedure for responding to allegations of abuse is available, and staff have received training in abuse recognition and minimisation. Court House Nursing Home DS0000004106.V253726.R02.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26. While investment within the homes physical environment has been undertaken helping to enhance the appearance of Beacon and Hollybush House, the environmental standards within Midsummer House and Bredon House are in need of improvement and development to create a more comfortable and pleasing homely environment. EVIDENCE: Court House Nursing Home DS0000004106.V253726.R02.S.doc Version 5.0 Page 14 Many bedrooms seen had been furnished with residents’ personal possessions, thereby generating ownership and a sense of autonomy for individuals, and several residents confirmed that they appreciated the physical environment. However, there were some areas within the home (predominantly Midsummer House and Bredon House) where bedrooms could be enhanced through redecoration and the provision of better quality furnishings – which were, in several bedrooms, looking worn. It was also noted that many bedroom doors failed to possess approved locking devices, which would enable residents to lock their doors for privacy purposes and open their doors when they are within their room using just one movement. On Beacon House, it was noted that inappropriate locking devices had been fitted to en-suite toilet doors. This presented a risk of residents being inadvertently locked in en-suites. This was discussed with the unit manager at the time of inspection, and the inspector was told that the locks would be removed. Although the environmental layout of Midsummer is generally suitable for residents, it was noted that corridors were narrow, making it difficult for residents with mobility problems to independently manoeuvre around the unit. This has resulted in walls and coverings being marked and scratched. Hollybush House had benefited significantly from refurbishment and redecoration, and residents were very appreciative of the environmental standards within the unit. However, it was noted that, due to the physical limitations of some residents, some decorative work was necessary to ensure that positive decorative standards are maintained within the unit. The enhanced environmental standards on Hollybush serves to emphasise the need for environmental investment on Midsummer and Bredon House. Hot water temperatures have been risk assessed and had been regulated to prevent people being accidentally scalded when they have a bath. Water temperatures were being routinely checked to ensure that temperatures were safe. Radiators had been guarded and restricted to prevent people being accidentally burnt through intentional or unintentional contact, and all the windows located above first floor level had been restricted to prevent people from being injured through falling out of the windows (accidentally or deliberately). Most areas within the home were clean and tidy, with the exception of several bedrooms on Bredon House, which were odorous due to the behaviours of some people who possess memory loss problems. This issue was identified within the previous inspection, when impervious floor coverings were discussed. It was noted that some corridor doors located on Beacon House were heavy, thereby making it difficult for some residents to independently mobilise around the unit and open doors. As the doors also provided a level of fire protection, opportunity needs to be taken to ensure that (a) residents can mobilise Court House Nursing Home DS0000004106.V253726.R02.S.doc Version 5.0 Page 15 independently around the unit and (b) fire protection is not compromised. This could be achieved by either (i) ensuring the doors are attached to an electromagnetic opening device that releases in the event of the fire alarm sounding or (ii) devices are fitted to the doors which hold them open, but release the door to close into the doorframe recess in the event of the fire alarm sounding. Court House Nursing Home DS0000004106.V253726.R02.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Although staffing levels and competencies are generally suitable to ensure that residents’ needs are identified and met, the provision and deployment of staff requires review to ensure that sufficient numbers of staff are available throughout the entire 24-hour period. EVIDENCE: Each unit within the home has a core number of staff allocated for the purpose of staffing each unit. There is flexibility to enabling staff to rotate, when necessary, around different units to ensure that staffing levels are maintained in accordance with the needs of residents. Unit managers, when interviewed, expressed the opinion that staffing numbers could be increased to enhance care delivery. For example, Beacon House and Hollybush House were each staffed by just one registered nurse and one carer from 8pm through to 8am each day. Staffing rotas for Hollybush House did indicate that there was an additional carer on duty, but this was to provide 1:1 care for a designated resident. Many residents required the assistance of two staff members to help Court House Nursing Home DS0000004106.V253726.R02.S.doc Version 5.0 Page 17 with their personal care. The unit manager of Midsummer House expressed her concern that staffing levels did not allow residents two baths each week, although the unit manager did state that residents were not being neglected. She continued by saying that dependency levels had been calculated, that residents were “highly dependent”, but staffing levels had not been increased. Recruitment procedures were examined, and three staff files were examined. All files examined contained the relevant information necessary to ensure that the home had undertaken the correct procedures in the recruitment, selection and appointment of staff. This is important to ensure that any person working within the care sector has been effectively screened to confirm their suitability to provide intimate and personal care to vulnerable people. Training has been provided to staff, and includes infection control, first aid and moving and handling. Training was identified as a result of the needs of residents, to ensure that care delivered was appropriate to and in response to the needs of residents. The home employs a total of 21 registered nurses and 45 carers of which, 20 hold a National Vocational Qualification in care while a further 11 are undertaking a National Vocational Qualification in care. Work is needed to ensure that at least 50 of carers are qualified to (at least) NVQ 2. Court House Nursing Home DS0000004106.V253726.R02.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36 and 38. There is clear leadership, guidance and direction to staff to ensure residents receive consistent care, resulting in practices that promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: Court House Nursing Home DS0000004106.V253726.R02.S.doc Version 5.0 Page 19 The manager-designate has made application for registration to the Commission, and at the time of the inspection, the application was being processed. She is competent and appropriately qualified and experienced to manage the service. Once the application is approved, the manager-designate will become the registered manager for the home. Staff and residents spoke very highly of her, and significant diligence and action has been undertaken to improve the quality of the service provided by the home. Residents clearly expressed their opinion that the home was being run in their best interests. The homes financial recording system remains robust. Staff were being informally supervised but formal supervision was not yet being undertaken in accordance with the National Minimum Standards. Supervision is necessary to ensure that staff understand their roles, the homes philosophy of care and how that philosophy is put into practice. It is also necessary to ensure that staff development needs are understood, recognised and actioned accordingly – with a view to improving service delivery. Opportunity was taken to interview the maintenance person for the home, and examine maintenance records. Documents examined confirmed that hot water temperatures were being routinely tested to ensure residents were not being placed at risk of accidental injury through scalding, radiators had been restricted to ensure that surface temperatures did not present a burns risk to residents, a gas safety certificate was available, and maintenance contracts were available for hoists and lifts, electrical systems, water systems and fire detection and prevention systems. A legionella risk assessment had been undertaken, and water samples tested. Test results were negative. Court House Nursing Home DS0000004106.V253726.R02.S.doc Version 5.0 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 3 2 X 3 X 4 X 5 x 6 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 ENVIRONMENT Standard No Score 19 2 20 3 21 3 22 2 23 3 24 2 25 3 26 2 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 3 33 3 34 3 35 3 36 2 37 X 38 3 Court House Nursing Home DS0000004106.V253726.R02.S.doc Version 5.0 Page 21 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 19 Regulation 12 Requirement Locks, of a type specified by the CSCI and Fire Authority, must be fitted to the doors of all service users’ bedrooms. The home’s physical environment must be reviewed to ensure that accessibility for mobility-restricted service users is promoted and facilitated. Fatigued items of bedroom furniture and furnishings must be replaced. Keep all parts of the care home free from offensive odours. A review of staffing levels must be undertaken to ensure that there are sufficient staff on duty at all times to meet the assessed needs of residents within the home. Strategies must be developed and implemented to ensure that at least 50 of carers are qualified to NVQ 2 (or equivalent). Staff must be formally supervised at least six times within every 12-month period in accordance with the DS0000004106.V253726.R02.S.doc Timescale for action 31/03/06 2 22 23 31/03/06 3 4 5 24 26 27 16 16 19 31/03/06 18/10/05 31/12/05 6 30 19 31/12/05 7 36 18 18/10/05 Court House Nursing Home Version 5.0 Page 22 specifications of Standard 36 “National Minimum Standards – Care Homes for Older People”. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Court House Nursing Home DS0000004106.V253726.R02.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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. Court House Nursing Home DS0000004106.V253726.R02.S.doc Version 5.0 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. 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!