CARE HOMES FOR OLDER PEOPLE
Cross Lane House Cross Lane Ticehurst, Wadhurst East Sussex TN5 7HQ Lead Inspector
Jason Denny Unannounced 21 August 2005 11:15 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. Cross Lane House H59-H10 S32397 Cross Lane House V239060 210805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Cross Lane House Address Cross Lane Ticehurst Wadhurst East Sussex TN5 7HQ 01580 200747 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) Mrs Amanda Patricia Newport Mrs Amanda Patricia Newport Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (OP) 18 of places Cross Lane House H59-H10 S32397 Cross Lane House V239060 210805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The maximum number of residents to be accommodated is Eighteen (18) 2. Residents must be aged sixty-five [65] years or over on admission, 3. Residents who are admitted will have old age falling under no other category. Date of last inspection 12 January 2005 Brief Description of the Service: Cross Lane House provides care and accommodation for 18 older people. The registered providers are Mr V and Mrs A Newport. Mrs Newport is also the registered manager. The home itself is a large detached converted country house, situated in the village of Ticehurst. The house is set back from a quiet road just off the high street. Accommodation is provided in 14 single and 2 double bedrooms on three floors. The homes current policy is to offer the large double bedrooms as singles unless a married couple wish to share. This means that numbers of residents does not go usually go above 16 which was the case during this inspection. A shaft lift is available for Residents who may have mobility problems. The home is situated within large well-tended gardens. Stonegate railway station is approximately three miles away and bus routes run through the village high street which is within a few hundered yards from the home. Cross Lane House H59-H10 S32397 Cross Lane House V239060 210805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an Unannounced routine inspection [first of two planned before April1st 2006], which took place on a Sunday between 11.15am and 3.15pm. The Inspection found that of the 19 National Minimum Standards inspected, that 12 of these standards had been fully met, with all others nearly met. One standard was exceeded in relation to meals. The overall focus of the inspection was on staffing, how the home is managed, the way the rights of residents are protected, health and safety, the environment of the home, and on new residents. The inspector started the inspection by speaking with residents [8] and visitors [2] and touring communal areas of the home to inspect the building. A discussion with the manager/owners took place around progress since the last inspection. Meal arrangements were looked at along with a kitchen inspection. Care and staff records, along with safety documentation were inspected. The inspector looked at activity arrangements. The inspector observed how staff supported residents along with how the home meets resident’s medication needs. What the service does well: What has improved since the last inspection?
The home has continued its programme of installing radiator guards with four remaining to be fitted over the next 4 months. Most of the home’s flooring has
Cross Lane House H59-H10 S32397 Cross Lane House V239060 210805 Stage 4.doc Version 1.40 Page 6 been replaced with a high quality carpet, which creates a good impression. Curtains and beds have also been replaced in each room. The manager has now started a relevant Management course, which will assist her knowledge. The home now has enough care staff on the National Vocational Qualification course. The staff and Manager have undertaken formal adult protection training to support them to better protect residents from harm. The training induction of new staff is good and now meets the standard required. Overall training arrangements have improved with the home linking in with an external training provider. The home’s policies and procedures are gradually improving and being reviewed. The homes resident guide is displayed in reception with the most recent inspection report and relevant contact numbers. Medication arrangements were found to be sound. Most bedroom doors now have working locks. Recruitment procedures have also improved. An occupational therapist has recently visited the home and produced a positive report on the premises and activities, with a few minor recommendations. 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. Cross Lane House H59-H10 S32397 Cross Lane House V239060 210805 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 Cross Lane House H59-H10 S32397 Cross Lane House V239060 210805 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 The inspector found that with one exception, the home provides both prospective and existing residents, with a good level of information. Moreover, the way in which the home assesses prospective or existing residents ensures, that it currently meets needs. EVIDENCE: A copy of the home’s resident’s [service user] guide including a complaints and suggestions procedure is given to each prospective new resident or their family. During the inspection the home’s guide was also put on display in reception with the last inspection report, in case any resident had not seen it or wanted to refer to it. During the inspection the home were advised to ensure that social service contact numbers are in the guide. The guide itself was generally full and easy to read. The guide currently lacks resident’s views, something that would be useful for prospective residents to base a judgement upon [see standard 33]. During the inspection the manager agreed to commence again a full survey and collect and publish the findings. Residents and visitors were found to be knowledgeable about their rights. The Inspector found that most of the home’s assessment information looked at, was full, and tallied up with his observations and discussions with individual residents. One of the three assessment files looked at had most sections not filled in. The
Cross Lane House H59-H10 S32397 Cross Lane House V239060 210805 Stage 4.doc Version 1.40 Page 9 manager explained that as this was a privately funded resident she was dependent on the resident and her family for information, which she was still gathering over the month since she moved in. This person was still within their probationary period where a care-plan was gradually being developed. The inspector spoke and observed this resident and found that this temporary shortfall in information was not affecting outcomes with the resident highly able. The manager also agreed to keep all assessment information in the home for inspection. Staff were observed to be particularly mindful of the mobility needs of residents. The inspector found that all newly admitted residents had been assessed by the home’s manager before moving in. The manager also confirms in writing to relevant people whether or not the home could meet their specific needs. The homes practice is to provide a service to people with low needs who have a degree of independence so that all needs can be met within exiting staffing levels. The one resident who had increased mobility needs following a hip problem was found to be supported to make a recovery with her family informing the inspector how pleased they were with her progress with her being able to weight bear with minimal support. Residents who the inspector observed were found to move freely and independently. Cross Lane House H59-H10 S32397 Cross Lane House V239060 210805 Stage 4.doc Version 1.40 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 & 9 Resident’s needs are not fully set out within a care-plan although the home have a clear plan of how to organise all this information and review ongoing needs. The home was found to be meeting resident’s health needs and was fully aware of what additional support it required. The inspector judged that resident’s rights were upheld. Medication arrangements were found to be sound with all staff well trained and experienced. EVIDENCE: Three Individual plans of care were inspected with some found to be lacking all the necessary information as set out in the standard which is based on a comprehensive assessment. The plans required all the information from the assessment to be transferred over. Plans did not include agreements such as any agreed restrictions, or the decision about whether the resident wanted a room key. The plans overall needed more information to show how needs will be met in practice. The care-plans were in a range of formats and formed a mixed system. It was not clear from the plans when they were being reviewed and whether this was monthly. Some plans had a lot of detail such as the persons likes and dislikes, preferred name, interests and hobbies. On a positive note the manager has previously recognised this shortfall and showed the inspector an appropriate care-planning format she has purchased which is used by a number of other homes. The manager showed the inspector the
Cross Lane House H59-H10 S32397 Cross Lane House V239060 210805 Stage 4.doc Version 1.40 Page 11 start she had made transferring the care-planning information of one resident over to the new format. This format was found to be suitable and easy to follow. The manager and her deputy will be transferring all necessary information relating to the 16 residents over to this system over the next few weeks and within 6 months. The system will be easy to update with any careplan review. The new care-planning system will also include the introduction of photographs of each resident to go on the front of their care-plans to assist staff to put a face to the information contained. The plans had clear information on residents medication needs. The inspector observed staff administering and dispensing medication, which was given individually to residents. The medication cabinet was looked at including the controlled drugs register, other records, and storage of all drugs and medicines. Staff have since the last inspection undertaken formal certified medication training as shown in records. All aspects of medication arrangements were found to be in order. The Commission’s pharmacist found the medication arrangements to be in order following a visit since the last inspection. Cross Lane House H59-H10 S32397 Cross Lane House V239060 210805 Stage 4.doc Version 1.40 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 & 15 Residents are able to make a range of choices about their lives. The home provides a good range of stimulating activities at flexible times to suit people’s expectations. Residents are encouraged to be as independent as possible. The extensive garden areas and the local village setting, provide popular opportunities for residents to relax or explore. Food served by the home was found to be exceptional in terms of the range of choice, the quality, and the opinion of residents and visitors. EVIDENCE: Summer coach outings and the weekly exercise classes were among some of the more popular activities with residents, spoken with. Other activities such as bridge, skittles, crosswords, basketball and bingo are organised depending on individual choice, which is surveyed each day. Exercise classes occur every Friday. Residents spoken with have a range of visitors as evidenced in the inspection and strong community links with most having lived in the nearby surrounding villages. Residents spoken with had their own clear ideas of what activities they enjoy with them going about organising these themselves as well as tapping into what the home offers such as occasional summer coach trips. Relatives and visitors are also involved in seasonal events such as garden parities. Residents were observed to be going out for a Sunday walk, out on trips with visitors, relaxing in the vast rear gardens, reading the newspapers, playing cards, or watching television in their own rooms.
Cross Lane House H59-H10 S32397 Cross Lane House V239060 210805 Stage 4.doc Version 1.40 Page 13 The inspector looked at menus, which are regular discussed with residents. The kitchen had a range of supper menus and clear information about resident’s preferences and choices. Most food served was found to be homemade, with a range of additional vegetarian dishes. The home was found to have a range of fresh meat, vegetables, fruit and plentiful stocks of general food. Cross Lane House H59-H10 S32397 Cross Lane House V239060 210805 Stage 4.doc Version 1.40 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 & 18 The home operates in an open manner and has not had a formal complaint for several years. All residents and visitors are made fully aware of how to complain or raise concerns. Staff continue to demonstrate a sound understanding on how to prevent abuse and have benefited from recent adult protection training. Residents continue to be registered to vote and have all their rights upheld. EVIDENCE: The manager and staff team have received formal training in adult protection and prevention of abuse on a recent one-day workshop by a training provider as shown in certificates seen. Staff who have been interviewed across several inspections continue to demonstrate a full and sound understanding of all the issues involved, including whistle blowing and who to report concerns too. The manager stated that staff had found that the training had made them more aware of the many different forms, which abuse can take and as result has made them more careful. The home was found to have an updated policy on all areas concerned with whistle blowing and preventing and reporting suspected abuse. All residents spoken too confirmed the sensitive care they receive from a long established staff team who were observed by the inspector to operate in an appropriately caring and patient manner. The home has a comprehensive complaint policy and form for reporting concerns. This procedure and forms are given to residents. There was no record of any complaint made to the home over the two years. The home maintains a suggestion and complaints book in reception. All visitors spoken with, confirmed that the complaints procedure and how to raise concerns is clearly explained when their relatives move into the home. In addition the complaints procedure is clearly displayed in the home’s reception area.
Cross Lane House H59-H10 S32397 Cross Lane House V239060 210805 Stage 4.doc Version 1.40 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) 19,22 & 25 Residents [Service users] benefit from living in superb, spacious, well maintained, and safe environment in a sought after location. Fixtures and fittings such as carpets are of a high standard in keeping with the home and expectations of residents. The home is well appointed both internally and externally within a quiet countryside setting. The garden areas are particularly popular with residents. The premises have been approved by an occupational therapist. Most radiator guards are now fitted with the remaining planned by the end of the year. EVIDENCE: The only areas of the environment inspected where the communal areas including the downstairs reception area and lounge, along with the external garden areas. The kitchen was also inspected. The front and rear gardens were found to be well maintained, and had a range of furniture. The home was fitted throughout [with the exception of a bedroom] with a brand new carpet. The manager stated that curtains and beds had also been replaced in all rooms. The inspector noticed that all radiators in communal areas where now guarded. The manager stated that only four radiators in low risk rooms are awaiting guards to be fitted. The guards are being specially made to fit in
Cross Lane House H59-H10 S32397 Cross Lane House V239060 210805 Stage 4.doc Version 1.40 Page 16 with the style of the home. Risk assessments and the placing of furniture has reduced the risk of injury potentially caused by unguarded radiators. The inspector saw a report carried out by an occupational therapist in July 2005. The report approved the layout of the home with the only main recommendation being the fitting of lever style taps, which the home will gradually implement. Cross Lane House H59-H10 S32397 Cross Lane House V239060 210805 Stage 4.doc Version 1.40 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 & 30 There is sufficient numbers of staff on shift with sufficient skills to meet the needs of the resident group. Staff training has improved and is closer to meeting requirements. The level of staff with National Vocational Qualifications is too low but the home have recently taken positive steps to try and address this. The Recruitment practice now being undertaken by the manager ensures that all reasonable steps are being taken to protect residents from harm. New staff now receive appropriate inductions which cover the basic ground. Staff are experienced and described by residents and visitors as being good at their jobs. EVIDENCE: The Inspector examined staffing levels with reference to the home’s rota and through discussions with the Manager. The only area, which needed extended discussion, was around suppertimes. The manager assured that along with the two staff for the 16 residents there is either the manager or deputy present when suppers are being prepared and served. The group of residents are assessed to have low needs, especially during this evening period. Staffing numbers also increase around health appointments or if someone’s needs increase. The home uses their experience, and a clear method, for reviewing staffing levels. Residents needs continue to be low with all having a high degree of independence. The inspector observed that all residents’ needs were being promptly met by the available staffing, with routines unhurried. The home has an appropriate induction programme should any new staff be employed. The inspector saw evidence of new staff going on a one day
Cross Lane House H59-H10 S32397 Cross Lane House V239060 210805 Stage 4.doc Version 1.40 Page 18 induction course and completed their 6 week basic induction before either going on to foundational training or NVQ. Although no staff have passed a NVQ qualification at the basic level, one staff person is nearing completion of the advanced level 3, and two the level 2 course. Two others are half way through with two others enrolled and about to start. Once all these staff have completed these courses then at least the required 50 of care staff with this qualification will be achieved. All staff were found to have compulsory training such as Moving and Handling, First Aid, food hygiene and Fire. The overall planning of training was shown to have improved. The inspector sampled staffing files on a number of staff. Recruitment of staff procedures was sound with all checks carried out including P.O.V.A checks, which is an improvement since the last inspection. The inspector sampled two staffing files and found appropriate references, application forms and police CRB’s. The manager stated that she is awaiting 3 other CRBS disclosures to come back. The Manager was advised to instruct the umbrella body which carries out POVA checks to send those documents to the home. No staff commence employment without the home first receiving appropriate references and at least a POVA first. All new staff are closely supervised during their first few months. The inspector advised the home that the application form should have a separate section for applicants to account for any gaps in their employment history, to encourage all former employment to be declared. Cross Lane House H59-H10 S32397 Cross Lane House V239060 210805 Stage 4.doc Version 1.40 Page 19 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,36 & 38 The home continues to benefit from a well-established and motivated manager who is gradually developing a fuller range of management skills and understanding of best practice, and appropriate policies. The manager has started work on the required NVQ 4 qualification, which will support this process. The overall management of the home need to collect and publish the views of residents to improve information sharing and the development of the service. A professional formal written system to show regular supervision of staff needs to be evidenced and in place. All incidents such as deaths need to be promptly reported to demonstrate transparency and accountability. EVIDENCE: The manager has just started a management course [NVQ 4 in care and management] and is advised to work through this to achieve the qualification in a timely manner. The manager/owner previously managed a home for people with dementia before purchasing Cross Lane House.
Cross Lane House H59-H10 S32397 Cross Lane House V239060 210805 Stage 4.doc Version 1.40 Page 20 The manager has developed quality assurance satisfaction questionnaires which were seen to have been completed for a small number of residents but undated. These need to be offered to all residents and their families/friends, with the results published in a report to provide the home with feedback and direction. This information will also be useful for prospective new residents who can see what existing residents think about the home. Records of staff supervisions had not been produced although the manager stated that staff are regularly supported with training and have instant access to management. The inspector and manager discussed a supervision format which will be introduced over the coming month which deals with personal development, performance, and support needs. Supervisions will then be booked to occur at least 6 times yearly. The inspector noted that no deaths or incidents had been notified to the Commission since the new owners/manager, took over the home. The manager confirmed that there had been at least 3 deaths of residents in the home from natural causes. It was made an immediate requirement that incidents such as deaths including the circumstances need to be reported to the Commission without delays along with incidents which involve the emergency services. A range of safety certificates showed that the home’s equipment such as the Gas boiler and fire equipment are regularly serviced. Staffing records showed a range of health and safety related training such as Moving and Handling, First aid, and food hygiene. Cross Lane House H59-H10 S32397 Cross Lane House V239060 210805 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 4
COMPLAINTS AND PROTECTION 3 x x 3 x x 2 x STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 x 2 x x 2 x 2 Cross Lane House H59-H10 S32397 Cross Lane House V239060 210805 Stage 4.doc Version 1.40 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7 Regulation 15 Requirement That the Registered person must ensure that each Service user [Resident] has a comprehensive and clearly presented, Care-Plan which shows all needs and how these will be met in practice . That Care-plans are regularly reviewed. That all service user information is transfered over to the new appropriate careplanning format purchased by the home, within the 6 month timescale indicated. That the four remaining radiators accessible to service users are covered within the extended timescale indicated. That all staff must formal written supervisions based on the requirements of the standard. To be scheduled to occur at least six times yearly. [Requirement of the last 5 inspections] That the Registered Person must give notice without undue delay, of any death, including the circumstances of his death along with all other types of incident listed in the standard and regulation. That any such notification is confirmed in Timescale for action 21/02/06 2. 25 13[4] Timescale Extension 21/01/06 Timescale Extension 21/11/05 3. 36 18[2] 4. 38.7 37[1]&[2] Immediate Cross Lane House H59-H10 S32397 Cross Lane House V239060 210805 Stage 4.doc Version 1.40 Page 23 writing. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard 28 29 31 33.4 Good Practice Recommendations That 50 of Care staff achieve NVQ Level 2 as soon as possible. That the application form accounts for any recent gaps in employment history. That the Manager achieves the NVQ Level 4 in Care and management as soon as is practically possible. That the results of Resident [Service user] surveys are collected into a report and published and made available to exisitng and prospective new Residents [service users]. Cross Lane House H59-H10 S32397 Cross Lane House V239060 210805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Ivy House 3 Ivy Terrace Eastbourne East Susssex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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