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Inspection on 22/08/06 for Dunnington Lodge Nursing Home

Also see our care home review for Dunnington Lodge Nursing Home for more information

This inspection was carried out on 22nd August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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.

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

Service users have their needs assessed and have the opportunity to visit to look at the accommodation before they move in and they are involved in the development and review of their care pans. Service users were consulted about sharing a bedroom and one of the service users said, "They did not mind sharing and you always have company". Service users have opportunities to take part in a range of social and leisure activities both in the home and in the community. Service user have a warm bright clean home to live in where they can have their personal possessions around them and there is a garden and patio area with seating where they can enjoy the good weather. There is a wide range of equipment to help people move around the home safely. The registered proprietors makes sure that there are sufficient staff on duty and that the staff have training and supervision and that they keep accurate records about the service users nursing and personal care needs. One of the service users said, "He was helped by the staff to use the stand aid and given encouragement and confidence to stand and mover about with greater ease." Service users relatives are made welcome and those spoken with at the visit said they were satisfied with the care and support their relative received from the staff.

What has improved since the last inspection?

Staff are now fully aware of the importance of gathering accurate information about service users admitted on an emergency basis and that service users with limited mobility will not be offered a bedroom on the second floor. Staff employed to carry out domestic duties now work over seven days thus ensuring that the home is kept clean at all times. Staff have improved their medication practices including the correct procedures for the disposal of medication and the storage of oxygen cylinders. Arrangements have been made for staff to attend abuse awareness and new staff to attend induction training to increase their understanding of the needs and of the service users and to ensure they are kept safe.

What the care home could do better:

CARE HOMES FOR OLDER PEOPLE Dunnington Lodge Nursing Home 34 Church Street Dunnington York North Yorkshire YO19 5PW Lead Inspector Mary Slattery Key Unannounced Inspection 22nd August 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Dunnington Lodge Nursing Home DS0000028000.V308422.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Dunnington Lodge Nursing Home DS0000028000.V308422.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dunnington Lodge Nursing Home Address 34 Church Street Dunnington York North Yorkshire YO19 5PW 01904 488676 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) Mr Richard Hugh Richardson Mrs Gill Richardson Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19), Terminally ill (4) of places Dunnington Lodge Nursing Home DS0000028000.V308422.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service Users to include up to 19 (OP) and up to no more than 4 (TI) up to a maximum of 19 Service Users. 55 years plus Date of last inspection 31st January 2006 Brief Description of the Service: Dunnington Lodge is owned by Mr and Mrs Richardson and is registered to provide general nursing care and accommodation for up to 19 service users from the age of 55 years. Dunnington Lodge is a large period building situated in the village of Dunnington on the outskirts of York and the local village amenities are within easy reach of the home. The current scale of charges is £465 to £535 and extra charges are made for hairdressing, chiropody, activities and newspapers. The registered proprietor provided the information at the site visit. Dunnington Lodge Nursing Home DS0000028000.V308422.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows an unannounced site visit undertaken on the 22nd August 2006. This was carried out by 1 Regulatory Inspector and took seven hours plus 4 hours preparation time. A number of the services users completed the service user surveys at the time of the site visit. They said they had the support they needed from the staff, that the staff listened to and that they knew the owners of the home well. The site visit comprised of a full inspection of the premises and facilities. The case records of five service users were looked at, which included the pre admission assessment, risk assessments and their care plans. A selection of the homes’ records were looked at, which included polices and procedures, staff records, staff rota, menus, medication and health and safety records. Time was spent talking to five service users, five members of staff and the registered proprietors. Time was also spent in the sitting and dining rooms observing the activity and interaction between the service users and the service users and staff. Information was also used from the Regulatory Inspectors inspection record, which detailed the history of the home and relevant information about what has been happening in the home since the previous inspection visit. The focus of the inspection was on a number of the key standards, inspecting the case records of a number of the service users to establish whether they corresponded to their experiences of life in the home. The registered proprietor was available throughout the site visit and the findings were discussed with her at the close of the visit. Two of ten requirements made at the previous inspection of the service have not been met. Five requirements and two recommendations were made at this site visit and an immediate requirement notice was issued in respect of fire safety and moving and handling practices. Dunnington Lodge Nursing Home DS0000028000.V308422.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Dunnington Lodge Nursing Home DS0000028000.V308422.R01.S.doc Version 5.2 Page 7 A statement of purpose needs to be produced and made available to service users to give them information what the home offers to provide to assist them in making a decision to move in. A copy must be sent to the Commission for Social Care Inspection. Service users must be given a copy of the service users guide for them to refer to. Service users must be kept safe at all times and therefore improvements must be made: • To the fire safety practices. Fire doors must not be held open by wedges • To the moving and handling practices. All wheelchairs must have footplates in place. • Safety checks must be carried out on all equipment and the premises and the required safety certificates must be in place and available for inspection. Redecoration of a number of bathrooms, the hall and stairs and the carpet in the hall and stairs needs to be cleaned which would improve the environment for the services users. 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. Dunnington Lodge Nursing Home DS0000028000.V308422.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Dunnington Lodge Nursing Home DS0000028000.V308422.R01.S.doc Version 5.2 Page 9 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 the following standard(s): 1, 2, 3, 5 and 6. Quality in this outcome area was good. The judgement has been made using available evidence and a visit to the service. While the home has not provided people with written information, service users needs are fully assessed before admission and their needs can be met. EVIDENCE: The provider has not produced a statement of purpose the information available in the office comprised of a brochure and a philosophy statement. There was a service users guide but service users have not been given their own personal copy. Service users are provided with a statement of terms and conditions and are invited to visit the home and look at the accommodation that is available before they make a decision to move in. The assessment records of 5 service users were looked at and there was information about their personal nursing and social care needs, their next of kin and the contact arrangements for external health care including their GP’s. Service users admitted through the care management programme had the care manager’s assessment and care plan in their files. Dunnington Lodge Nursing Home DS0000028000.V308422.R01.S.doc Version 5.2 Page 10 The proprietor reported that the policy of the home is that all service users have their needs assessed before they are admitted to the home and know risk to their safety is assessed. The home accommodates service users for respite care and arrangements are made to undertake an assessment of their needs before they are admitted. Dunnington Lodge Nursing Home DS0000028000.V308422.R01.S.doc Version 5.2 Page 11 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 the following standard(s): 7, 8, 9 and 10. Quality outcome in this area was good. The judgement has been made using available evidence and a visit to the service. Care provided to the service users was good and they are involved in the review of their care plans. EVIDENCE: The care plans of five service users looked at and there was information about the nursing, personal and social care needs. Risk assessments had been carried out and plans were in place for the use of bed safety rails, treatment and relief of pressures ulcers, management of continence, moving and handling and nutrition. There was information about what the service users like to do each day and the level of support and assistance they need from the staff with daily activities. Service users are registered with a general practitioner and records are kept of the contact with any health care professionals and any treatments prescribed. Daily records are kept by the staff, which gave information about the care they have given and any changes in the service users condition. The outcomes of care reviews were recorded and the care plans had been agreed with the service users and/or their representatives. Dunnington Lodge Nursing Home DS0000028000.V308422.R01.S.doc Version 5.2 Page 12 Staff reported that they meet each day to discuss the needs of the service users to make sure they have up to date information about their needs and any changes that may have occurred. Three of the service users were being nursed in bed and they all appeared comfortable and there were records in the room showing the care that staff had given throughout the day and overnight. Screening was in place in rooms that are shared for the staff to use to make sure that the service users privacy and dignity is maintained when they are receiving personal care. There was a wide range of equipment around the home to help people with their mobility including hoists and stand aids. One of the service users who cannot stand unaided said, “He was helped by the staff to use the stand aid and given encouragement and confidence to stand and transfer with greater ease.” Staff were observed transporting one service users in a wheelchair without footplates. This is poor practice and places service users at risk of injury. Dunnington Lodge Nursing Home DS0000028000.V308422.R01.S.doc Version 5.2 Page 13 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 the following standard(s): 12, 13, 14 and 15. Quality outcome in this area was good. The judgement has been made using available evidence and a visit to the service. Service users have many opportunities to take part in social activites of their choice and their privacy and dignity is not compromised by the daily routines EVIDENCE: Service users spoken with at the time of the visit told me that they get up when they wish and that the staff are very responsive to their needs. There are two members of staff who are responsible for organising the activities programme and making opportunities available for the service users to take part in activities in the home including, card games, baking and discussing the and agreeing changes to the menu. They also get out and about in the village and visiting places of interest, the last day out was to the air museum followed by lunch. Outside entertainers and religious ministers visit on a regular basis. There were visitors in the home at the time of the visit and they were all very complimentary about the staff and they said that their relative received a high standard of care and that they were always kept informed of any problems and any changes. The menu does not offer a second choice at meal times but the service users said that the food is really good and they can have anything they want if they do not like what is offered. Dunnington Lodge Nursing Home DS0000028000.V308422.R01.S.doc Version 5.2 Page 14 The care plan records gave information about the service users preferences and any special dietary needs. There were plenty of staff to help the service users at lunchtime and they were offered plenty of drinks throughout the day. Some of the service users have their personal funds held in the homes’ safe and records of all transactions made on their behalf are kept. Dunnington Lodge Nursing Home DS0000028000.V308422.R01.S.doc Version 5.2 Page 15 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 the following standard(s): 16 and 18. Quality outcome in this area was good. The judgement has been made using available evidence and a visit to the service. Service users know that they can make complaints and they are safeguarded by the homes’ recruitment procedures. EVIDENCE: The home has a complaints policy and procedure in place and information about home to make a complaint is displayed in the home. The complaints records looked at showed that a recent complaint made had been investigated according to the homes procedure and the complainant was informed of the finding in writing. An adult protection policy and procedure was available and the minutes of the staff meeting showed that his had been discussed and training for staff on abuse awareness has been arranged. The staff records showed that the required CRB and POVA checks had been carried out on staff Dunnington Lodge Nursing Home DS0000028000.V308422.R01.S.doc Version 5.2 Page 16 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 the following standard(s): 19, 21, 22, 24, 25 and 26. Quality outcome in this area was adequate. The judgement has been made using available evidence and a visit to the service. Service users live in a comfortable environment but their safety may be compromised by the poor fire safety practices. EVIDENCE: The home accommodates service users in single double and one triple bedroom. The decision to allow the continual use of a triple bedroom room will only apply whilst the present registration remains unchanged. Time was spent with two of the service users who share bedrooms and they said that they don’t mind sharing and they have company. There is a range of communal space, which includes sitting rooms and a dining room a well-equipped laundry and kitchen and good provision of moving and handling equipment. There are a number of assisted bathrooms and toilets suitably situated for easy access by the service users. There is a nurse call bell system in all part of home and staff made certain that all service users had a call bell cord within easy reach. Oxygen cylinders were correctly stored. Dunnington Lodge Nursing Home DS0000028000.V308422.R01.S.doc Version 5.2 Page 17 There is a patio area with seating and a lovely well tended garden, which service users said they enjoy in the good weather. There are systems in place for the control of infection and a good supply of protective clothing, gloves and hand washing facilities for the staff. Access to the house is by using steps and there is a portable ramp for service users who use wheelchairs. Portable ramps are also used around the home and there are two stair lifts for access to the first floor. There are stairs up to the second floor and the proprietor reported that no service users are accommodated in that area unless they are safe to use the stairs. The entrance hall, the stairways and the bathrooms on the ground and first floor need to be redecorated and hall and stair carpet need to be cleaned. The hot water temperatures are controlled by mixer valves fitted to all outlets used by or for service users to ensure their safety. The records showed that the fire safety equipment is checked as required but the emergency lighting is checked not checked monthly as required. There was a current insurance certificate available for inspection. A number of the fire doors, which included service users bedroom doors, were held open by the use of wedges. An immediate requirement notice was issued stating that fire doors must not be held open by the use of wedges. The fire safety officer has been contacted and has agreed to visit he home to look at the system and practices around fire safety and the fire risk assessment. The following safety certificates were not available for inspection. A current fixed wiring certificate. gas safety certificate and certificates to show that the hoists had been serviced and were safe for use. Dunnington Lodge Nursing Home DS0000028000.V308422.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area was good. The judgement has been made using available evidence and a visit to the service. The staffing levels and the skill mix ensures that service users nursing and personal care needs are met. EVIDENCE: The service users spoken with said that they were well looked after by the staff and that they always had time to talk and did not appear to be rushed. The staff spoken with said that there were sufficient staff on duty and that they had time to spend with service users making sure their care needs were met and they were not rushed. The home employees qualified nursing staff, care and ancillary staff. One of the registered providers manages the home on a day-to-day basis and is supernumerary to the staffing levels. The rota showed that there is one qualified nurse and 4 care staff on duty each morning, one qualified and 2 care each afternoon, one qualified and 3 care each evening and 1 qualified and one care on duty overnight. There are 2 cooks who work over 7 days and a member of staff to undertake domestic duties over 7 days. All new staff have in-house induction and 3 members of staff are due to do a full induction course in October. All staff have regular supervision and attend staff meetings, fire safety, moving and handling, food hygiene and first aid training as required. Staff meetings are held and the issues discussed are recorded. Dunnington Lodge Nursing Home DS0000028000.V308422.R01.S.doc Version 5.2 Page 19 One member of the care staff has achieved NVQ Level 2 and 3 are due to complete in September. The staff records looked at showed that all staff complete an application form, references are taken up and the required CRB and POOVA checks are carried out and abuse awareness training is planned to ensure the safety of the service users. Dunnington Lodge Nursing Home DS0000028000.V308422.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 37. Quality outcome in this area was adequate. The judgement has been made using available evidence and a visit to the service. Service users needs and wishes are put first but some improvements need to be made to make sure service users are safe at all times. EVIDENCE: Mrs Richardson is one of the registered proprietors and undertakes the day-today management of the home. She a qualified first level nurse and has a number of years of experience in managing a nursing home for older people Mr Richardson’s role is that of administration and all issues relating to the premises and facilities The service users knew both Mr and Mrs Richardson well and said that they see a lot of them and that they are very helpful. The staff said they are supported by the proprietors and they were approachable. The home does not have a formal quality assurance or quality monitoring system in place. A number of the policies and procedures have been reviewed and updated and plans are in place or a full review of the remainder. Service Dunnington Lodge Nursing Home DS0000028000.V308422.R01.S.doc Version 5.2 Page 21 users, their families and care manager’s views are sought about the care and the service provides but their views are not recorded. The staff records are not kept in the home but were made available for inspection. Facilities are provided for the service users to keep their money and valuables safe. Service users have access to their records and they are kept in a secure place and the staff have access to the policies and procedures they need to assist them in their role. The home has a health and safety policy and procedure and all staff are subject to health and safety training. Accidents and incidents are recorded and reported in accordance with Regulation 37 of the Care Homes Regulations 2001. The following records were not available for inspection a current fixed wiring certificate, a gas safety certificate and certificates of service of the hoists and stair lifts to evidence that service users are safe from harm. A number of fire doors were held in the open by the use of wedges. This practice is unsafe and poses a potential risk to service users in the event of a fire. The providers have been recently required to stop this practice but it continues and must now be actioned immediately Staff were seen transporting service users in wheelchairs without footplates. This practice poses a potential risk of injury to service users. Immediate action must be taken to make sure that all wheelchairs are fitted with footplates and used appropriately to reduce the risk of injury to service users. An immediate requirement notice was issued at the time of the site visit requiring the providers to take immediate action to ensure the safety of service users. Dunnington Lodge Nursing Home DS0000028000.V308422.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 1 3 3 N/A 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 1 9 3 10 3 11 N/A 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 N/A 18 2 1 N/A 3 3 N/A 3 3 3 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 3 3 1 N/A 3 3 1 1 Dunnington Lodge Nursing Home DS0000028000.V308422.R01.S.doc Version 5.2 Page 23 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 OP1 Regulation 4 and 5 Requirement The registered person must produce and make available to service users a copy of the statement of purpose and the service user guide. Copies must be sent to the CSCI. The registered person must make sure that wheelchair are fitted with footplates to minimise the risk of injury to service users. An immediate requirement notice was issued regarding this matter. The registered person is required to make arrangements for the entrance hall, the stairways and the bathrooms on the ground and first floor need to be redecorated and hall and stair carpet need to be cleaned. The registered person is required to have the following records up to date and available for inspection. Maintenance records. Quality assurance. Fixed wiring certificate. Fire risk assessment. DS0000028000.V308422.R01.S.doc Timescale for action 01/10/06 2. OP8 13(4)(c) 22/08/06 3. OP19 23 (d) 01/11/06 4. OP37 17 Schedule 1 01/09/06 Dunnington Lodge Nursing Home Version 5.2 Page 24 Gas safety certificate. Safety certificates for the hoists. 5. OP38 13 (2) (c) 23 (4) The registered person is required to cease holding fire doors open by using wedges as this poses a serious risk to the safety of service users. An immediate requirement notice was issued regarding this matter. This requirement remains outstanding from the previous inspection. 22/08/06 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. 2. Refer to Standard OP18 OP28 Good Practice Recommendations It is recommended that all staff attend the planned abuse awareness training. It is recommended that the home work towards 50 of care staff achieving an NVQ Level 2 or above. Dunnington Lodge Nursing Home DS0000028000.V308422.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Dunnington Lodge Nursing Home DS0000028000.V308422.R01.S.doc Version 5.2 Page 26 - 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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