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Inspection on 13/07/05 for Croft House Nursing and Residential Home

Also see our care home review for Croft House Nursing and Residential Home for more information

This inspection was carried out on 13th July 2005.

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

The inspector 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

Residents spoken with said that they were extremely happy with the home and the standards of care. One residents described the home, the manager and the food as "quite outstanding", and said that the staff "carry out care beautifully". Another resident said that what was particularly good about the home was the "ability to spend time where you like, and do what you like" and added, "I can`t think of anything that needs improving". Staff considered that there was an emphasis on meeting residents` individual needs, and maintaining their quality of life. The home is to be commended for the fact that a shortage of nursing staff prior to the inspection had not resulted in a reduction in standards of care.

What has improved since the last inspection?

The home has been improving the range of equipment and mattresses for the prevention and treatment of pressure sores.

What the care home could do better:

Some improvements in care documentation were noted, but records were not of a consistent standard. Care was not always provided in a manner that preserved residents` privacy and dignity. Some chairs in the home needed to be cleaned or replaced, and some areas of the kitchen needed a more thorough clean. The majority of staff required training in the recognition of the different types of abuse that can occur, and in the actions to take if any poor care was observed or abuse was suspected. The majority of staff also requiredtraining or updates in safe working practices, such as moving and handling, infection control and health and safety. The manager confirmed that the nursing vacancies were in the process of being filled, and said that training would be given a higher priority once the new staff were in post.

CARE HOMES FOR OLDER PEOPLE Croft House Nursing and Residential Home Braintree Road Great Dunmow Essex CM6 1HR Lead Inspector Francesca Halliday Unannounced 13 July - 26 July 2005 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. Croft House Nursing and Residential Home I56-I05 S15400 Croft House V238752 130705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Croft House Nursing and Residential Home Address Braintree Road Great Dunmow Essex CM6 1HR 01371 872135 01371 874727 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) BUPA Care Homes (BNH) Limited No. 2079932 Bridge House, Outward Lane, Horsford, Leeds, LS18 4UP Care Home (CRH) 38 Category(ies) of Old age, not falling within any other category registration, with number (OP) - 7 of places Physical disability over 65 years of age (PD(E)) 31 Physical disability (PD) - 2 Croft House Nursing and Residential Home I56-I05 S15400 Croft House V238752 130705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. A person of either sex, aged 55 years and over, who requires nursing care by reason of a physical disability (not to exceed 1 person) 2. Persons of either sex, aged 65 years and over, who require nursing care by reason of a physical disability (not to exceed 31 persons) 3. Persons of either sex, aged 65 years and over, only falling within the category of old age (not to exceed 7 persons) 4. No more than 2 persons may attend the home on a daily basis in addition to those 38 accommodated 5. The total number of service users accommodated must not exceed 38 persons 6. One service user over the age of 54 years, who requires nursing care due to a physical illness/disability, whose name is known to the Commission Date of last inspection 16 March 2005 Brief Description of the Service: Croft House Nursing and Residential Home is registered to provide nursing and personal care for up to a total of 38 residents over the age of 65 years, and up to 2 residents over the age of 55 years. The home can also provide day care for up to 2 people. Croft House is in a purpose built two-storey building. The home has 32 single and three double rooms. All rooms have en-suite facilities. The home is on two floors and a passenger lift is available. There is a sitting room on each floor and a large dining room on the ground floor. The home has attractive gardens and a paved area with seating. The home is located five minutes from Dunmow town centre and there is a bus stop outside the home. Croft House Nursing and Residential Home I56-I05 S15400 Croft House V238752 130705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection visit took place on 13th July 2005. The inspection lasted 5 hours 15 minutes. The inspection process included discussions with 3 residents and 6 members of staff. The premises and a sample of records were inspected. A discussion was held with the manager on 25th July, as she was not present at the time of inspection. Additional information was requested, which arrived on 26th July and this concluded the inspection process. 22 of the 38 standards were inspected: 2 exceeded the standard, 12 met the standard, 5 standards had minor shortfalls and 3 standards were not met. The judgements made within the report are based on the observations and evidence gathered during this inspection. What the service does well: What has improved since the last inspection? What they could do better: Some improvements in care documentation were noted, but records were not of a consistent standard. Care was not always provided in a manner that preserved residents’ privacy and dignity. Some chairs in the home needed to be cleaned or replaced, and some areas of the kitchen needed a more thorough clean. The majority of staff required training in the recognition of the different types of abuse that can occur, and in the actions to take if any poor care was observed or abuse was suspected. The majority of staff also required Croft House Nursing and Residential Home I56-I05 S15400 Croft House V238752 130705 Stage 4.doc Version 1.40 Page 6 training or updates in safe working practices, such as moving and handling, infection control and health and safety. The manager confirmed that the nursing vacancies were in the process of being filled, and said that training would be given a higher priority once the new staff were in post. 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. Croft House Nursing and Residential Home I56-I05 S15400 Croft House V238752 130705 Stage 4.doc Version 1.40 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 Croft House Nursing and Residential Home I56-I05 S15400 Croft House V238752 130705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3 and 5 (6 not applicable) The information provided enables prospective residents and their representatives to make informed choices about the suitability of the home. The pre-assessment process ensures that residents are only admitted if the home can meet their needs. EVIDENCE: The home had a good range of information for prospective residents and their representatives. A resident said that a relative had visited the home on their behalf, and that they had been fully involved in the assessment process and decisions about admission to the home. Detailed assessments with information about individual preferences and needs were seen. A resident who had developed some mental health problems had been referred to the local mental health services, and was being appropriately reassessed. Prospective residents and their representatives are encouraged to visit and stay for lunch, prior to making a decision about admission. Pre-admission assessments are always carried out and a trial period is offered. Croft House Nursing and Residential Home I56-I05 S15400 Croft House V238752 130705 Stage 4.doc Version 1.40 Page 9 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 and 10 The care documentation does not consistently provide staff with the information they need to satisfactorily meet residents’ needs. Residents consider that their health needs are met. Care is not always provided in a manner that upholds residents’ privacy and dignity. EVIDENCE: There had been some improvement in the overall standard of care documentation since the last inspection. The care plans generally contained more details of residents’ needs and preferences, and some were of an excellent standard. However, some care needs and care plans had not been evaluated for six months. One resident who had been in the home for a number of months had no care plans at all, despite the fact that their health had changed since admission (the manager confirmed that this had been addressed following the inspection). The daily progress records were mainly a record of physical care given, and more detail was needed on residents’ physical and psychological health and how they had spent their day. The home had a range of risk assessments, but some of the assessments had not been regularly reviewed despite changes in some residents’ condition. A good evaluation of a wound, which demonstrated the progress of healing, was Croft House Nursing and Residential Home I56-I05 S15400 Croft House V238752 130705 Stage 4.doc Version 1.40 Page 10 seen. Staff said that they had excellent support from local health professionals. One resident had been admitted to the home with pressure sores, which were healing well. The manager said that the district nurse provided support and advice on wound care when necessary. The manager said that two new pressure-relieving mattresses and three electric profiling beds had been ordered, and that the home had purchased new mattresses for some of the beds, which had improved pressure relieving properties. The manager confirmed that the home had sufficient pressure relieving cushions. Residents considered that the standard of care in the home was very good. They said that they felt involved in decisions about their care and health, and were not interested in seeing their care documentation. A resident said that they could see the GP when they wanted. There was no keyworker system in the home, but the manager said that she was hoping to introduce a keyworker system in the near future. Medicines were not inspected at this visit, but it was noted that new nurses received an assessment of competence prior to administering medicines in the home. Residents spoken with considered that staff respected their privacy and dignity, and treated their bedroom as their private space. A resident said “they never forget to knock and ask whether they can come in”. However, a member of staff was seen wheeling a resident to or from the bathroom inadequately covered by towels. This did not preserve their privacy and dignity. Croft House Nursing and Residential Home I56-I05 S15400 Croft House V238752 130705 Stage 4.doc Version 1.40 Page 11 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 Residents consider that the activities are stimulating, varied and meet their expectations. Visiting arrangements are open and relaxed. Residents exercise choices, influence services and initiate changes in the home. Meals are of a high standard and cater for individual needs and preferences. Some improvement in the cleanliness of the kitchen and labelling of food is needed. EVIDENCE: Residents were extremely complimentary about the range of activities that took place throughout the week. These included a variety of games, an exercise class, painting, crafts and outside entertainers. The activity coordinator held both group and individual sessions. A social evening and exhibition was due to be held in the home, with residents’ art and crafts on display. A resident said that communion was held once a month in the home, and that they had hymns each Sunday in one of the lounges. One resident said that they had attended the local church. Another resident attended a local club for the disabled. Two volunteers regularly played music in the home, and children from local schools and clubs visit the home. The manager said that they were hoping arrange for some outside speakers to visit the home, through an initiative sponsored by a local radio station. Residents said that they sat out in the garden in good weather, and confirmed that there were Croft House Nursing and Residential Home I56-I05 S15400 Croft House V238752 130705 Stage 4.doc Version 1.40 Page 12 sunshades available. The home has no restrictions on visiting hours, and a resident said that staff were always very welcoming to visitors. A member of staff considered that the routine “could be more flexible”. The manager said that in the past some routines had not been very flexible, but considered that this had improved. She said that this issue was regularly discussed at staff meetings, and that staff were now questioning the need for some of the previously established routines. Residents spoken with considered that they were able to make choices, be independent and felt that they had considerable autonomy within the home. A resident gave examples of when residents’ feedback had effected changes to the care and services in the home. The dining room was laid out in restaurant style with table linen and menus. There was evidence of choices at all mealtimes. The menu clearly stated the range of alternatives on offer, and the fact that snacks or late supper items were available throughout the evening and night. The home had a five week rolling menu, and the manager confirmed that residents were consulted before the next menus were drawn up. On the day of inspection some areas in the kitchen were in need of a more thorough clean, this was only in part due to the fact that the dishwasher was out of order. Freezer stock and some stock in fridges was not dated. The chef said that there was a stock rotation system, which ensured that all stock was used or disposed of within safe timescales. However, this would not necessarily have been obvious to any staff taking over, in the event of catering staff sickness. The chef confirmed that a range of diets was available. Residents described the food as “perfect, with terrific variety” and as “quite outstanding”. Croft House Nursing and Residential Home I56-I05 S15400 Croft House V238752 130705 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Residents are confident that all concerns raised will be addressed promptly. Insufficient staff have received protection of vulnerable adults training to ensure that different forms of abuse are recognised, and appropriate action taken if abuse is suspected. Appropriate action is now being taken to ensure staff receive training as soon as possible. EVIDENCE: The manager said that the home had not received any complaints since the last inspection. The manager confirmed that she spoke to all residents on a very regular basis and checked whether they had any concerns. Residents spoken with said that they had not had any complaints or concerns about the home, and felt confident that the manager would address any concerns raised. The majority of staff had not received protection of vulnerable adults training at the time of inspection. The manager said that training sessions had been set up and that all staff should have completed training by mid August. Croft House Nursing and Residential Home I56-I05 S15400 Croft House V238752 130705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 24 and 26 Residents live in a clean environment, but some chairs need more regular attention. Staff are aware of the areas in the home that need redecoration. Residents have comfortable rooms, with their possessions around them. Laundry staff provide a good service. EVIDENCE: The home was in fairly good decorative condition, but some areas needed attention. Some staff felt that the home “was in need of brightening up”. The home has a rolling programme of refurbishment and redecoration. The downstairs lounge had been redecorated and a new carpet had been ordered. The dining room and the upstairs corridor were due to be repainted in the near future. The manager said that residents’ rooms were redecorated before a new resident was admitted, and if needed when residents were away from the home. Seven bedrooms had been redecorated in the two months prior to the inspection. The home has a large lounge on each floor and a separate large dining room. Some upright chairs, and armchairs in the home were extremely Croft House Nursing and Residential Home I56-I05 S15400 Croft House V238752 130705 Stage 4.doc Version 1.40 Page 15 stained. The manager said that a number of new upright chairs had been ordered. Residents’ rooms were very well personalised with items of their own furniture, photographs and pictures. The call bell system had a portable box, which could be used anywhere in the home and garden. A resident said that the call bell was generally answered “almost immediately”. However, they said that the calls were not answered so promptly between 19.40 and 20.20, the evening staff handover period. The manager said that she did a regular checks on call bell response times. She said that there was an increase in the volume of calls around this time in the evening, but thought that the wait was not usually more than 5-6 minutes. She said that staff usually checked to see whether calls were urgent, even if they could not attend to the resident immediately. A resident said that they were very happy with the laundry service and said that clothes were always well washed, but considered that there should be more flannels in circulation. The manager said that she had recently ordered more flannels, towels and bed linen for the home. Some staff considered that the standard of cleaning could sometimes be improved. The manager said that the laundry staff hours had been increased, and that this had freed up more time for housekeeping staff to concentrate on cleaning. The home was clean on the day of this unannounced inspection. Croft House Nursing and Residential Home I56-I05 S15400 Croft House V238752 130705 Stage 4.doc Version 1.40 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 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 and 30 Staffing levels and skill mix are appropriate for the current dependency and needs of residents. Training is obtained in order to ensure that staff meet the specific nursing and care needs of residents. EVIDENCE: The agreed staffing levels are 7 staff from 08.00-14.00, 6 staff from 14.0020.00 and 4 staff from 20.00-08.00. The manager said that the home usually kept to the agreed staffing levels. At the time of inspection there were nursing vacancies in the home. The home had not used agency staff. The shifts were being covered by additional hours from the nurses in post, and by the manager herself. This provided continuity of care for the residents, and ensured that good standards of care were maintained. Recruitment for the nursing posts was underway, and the manager was confident that the posts would be filled in the near future. The manager said that she had requested a number of places for National Vocational Qualification (NVQ) training. She said that she had requested a teaching session on the principles of wound healing, in infection control and also in Parkinson’s disease, as four residents had been diagnosed with the condition. The manager said that informal training in the management of challenging behaviour had been given, and was hoping to set up formal training in the near future. Croft House Nursing and Residential Home I56-I05 S15400 Croft House V238752 130705 Stage 4.doc Version 1.40 Page 17 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) 32, 33, 36 and 38 The home has an open, positive and inclusive atmosphere, in which both residents and staff feel that they can effect changes and improvements in services and care. Staff have insufficient training in safe working practices to be confident that residents are in a safe environment. EVIDENCE: Residents confirmed that the manager created an open, positive and inclusive atmosphere within the home. There was evidence that she enabled residents and staff to affect the way that services and care were delivered. One resident described the manager as “outstanding”. A member of staff considered that the manager gave staff “plenty of support”. The manager said that the home was planning to carry out an internal survey with residents at the end of July 2005, covering catering, housekeeping and Croft House Nursing and Residential Home I56-I05 S15400 Croft House V238752 130705 Stage 4.doc Version 1.40 Page 18 activities. The company carry out an independent survey each quarter and the home carries out an annual internal quality self-audit. Nearly half the staff had completed a “personal best” course. The course encourages staff to reflect and improve the care and services they personally provide to residents. Residents and staff gave examples of how their feedback had influenced services and care. Staff said that they had informal supervision and feedback on the way they delivered care, but did not have formal supervision sessions. The manager was advised to remove a mattress from one of the stairwells, as it was a potential fire hazard. No other obvious hazards were noted during the inspection. The manager was aware that a large number of staff were very behind with their training and updates in safe working practices, and was taking steps to address this. She considered that the home would be able to give training a much higher priority once the nursing vacancies had been filled. Croft House Nursing and Residential Home I56-I05 S15400 Croft House V238752 130705 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 1 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 3 x x x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 1 x 4 3 x x 2 x 1 Croft House Nursing and Residential Home I56-I05 S15400 Croft House V238752 130705 Stage 4.doc Version 1.40 Page 20 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 7 Regulation 15(1)(2) Requirement The registered person must ensure that care needs and care plans are evaluated on a regular basis, and updated following changes in residents condition. Informed at the time of inspection. The registered person must ensure that the daily progress records provide details of residents physical and psychological health, and how they have spent their day. Informed at the time of inspection. The registered person must ensure that risk assessments are regularly reviewed and updated following changes to residents condition. The registered person must ensure that care is always provided in a manner which upholds residents privacy and dignity. Informed at the time of inspection. The registered person must ensure that there is a clear system for ensuring that all parts of the kitchen are cleaned, and that fridge and freezer foods are Timescale for action 13.07.05 2. 7 12(3) 13.07.05 3. 8 14(1) 13.07.05 4. 10 12(4) 13.07.05 5. 15 16(2)(j) 13.07.05 Croft House Nursing and Residential Home I56-I05 S15400 Croft House V238752 130705 Stage 4.doc Version 1.40 Page 21 6. 18 13(6) 7. 19 23(2)(d) 8. 9. 36 38 18(2) 23(4) 10. 11. 12. 13. 38 38 38 38 13(5) 23(4) 13(3) 13(4) 14. 38 13(3) dated. Informed at the time of inspection. The registered person must confirm that all staff have received protection of vulnerable training. The registered person must ensure that all chairs are regularly cleaned and replaced if badly stained. Informed at the time of inspection. The registered person must ensure that systems of formal supervision are put in place. The person registered must ensure that items of combustible material are not stored in stairwells. Informed at the time of inspection. The person registered must ensure that all staff receive moving and handling training. The person registered must ensure that all staff receive fire training. The person registered must ensure that all staff receive infection control training. The person registered must ensure that all staff receive health and safety and COSHH training. The person registered must ensure that all staff who handle food receive food hygiene training. 1.09.05 1.09.05 1.09.05 13.07.05 1.09.05 1.10.05 1.12.05 1.12.05 1.01.06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Croft House Nursing and Residential Home I56-I05 S15400 Croft House V238752 130705 Stage 4.doc Version 1.40 Page 22 Refer to Standard Good Practice Recommendations Commission for Social Care Inspection First Floor Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Croft House Nursing and Residential Home I56-I05 S15400 Croft House V238752 130705 Stage 4.doc Version 1.40 Page 23 - 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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