Inspection on 13/01/06 for Elm Royd Nursing Home

This inspection was carried out on 13th January 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Elm Royd Nursing Home 18/06/08

Elm Royd Nursing Home 19/06/07

Elm Royd Nursing Home 23/05/06

Elm Royd Nursing Home 05/07/05

Similar services:

Snydale Care Home

Abbey The

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Elm Royd Nursing Home Brighouse Wood Lane Brighouse West Yorkshire HD6 2AL Lead Inspector Liz Cuddington Unannounced Inspection 14:00 13 & 18 January 2006 th th 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 Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. 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. Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Elm Royd Nursing Home Address Brighouse Wood Lane Brighouse West Yorkshire HD6 2AL 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) 01484 714549 Philip Bennett (Elmroyd) Ltd Mr Edward Bazunu Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (45) of places Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Can provide accommodation and care for one service user under 65 years of age category physical disability (PD). Can provide 5 intermediate care for older people over 65 years of age. Date of last inspection 5th July 2005 Brief Description of the Service: Elm Royd Care Home offers nursing care, personal care and accommodation for up to 45 people over 65 years of age. This includes 5 places registered for intermediate care as well as 1 place for an adult with a disability under 65 years of age. The private bedrooms consist of 31 single rooms, 22 of which have en suite facilities, and 7 twin rooms. The home is located in a residential area of Brighouse just a short distance from the town centre and near to the bus routes between Brighouse, Elland and Halifax. Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over two days and lasted a total of ten hours. During this time I spoke with eight of the people who live at Elm Royd, six relatives, five members of staff and two visiting healthcare professionals. I made a tour of the premises and, during the second day, I spent time talking with the home’s manager and a senior manager within the organisation. I also examined the home’s documentation, including care plans and daily records, medication records, staff rotas and staff files. During and after the inspection some serious concerns were expressed to me about the standard of care, medication practice, access to healthcare and staffing levels at the home. These were looked at and taken into account during the inspection. On this occasion I assessed twenty of the thirty-eight National Minimum Standards. Most of the other standards, including the key standards, were assessed during the last inspection in July 2005. I have made eight statutory requirements; four of these are brought forward from the last inspection, although two were then good practice recommendations. I have also made ten good practice recommendations; six of these are brought forward from the last inspection. This number of requirements and recommendations brought forward suggests there needs to be a greater commitment to service quality improvement within the home. I would like to thank everyone who took the time to talk to me and express their views. What the service does well: Visitors are always welcome and there is a quieter lounge for service users and visitors to use. The home is clean and hygienically maintained. The staff are provided with opportunities to take training courses to keep their skills and knowledge levels up to date. The organisation has a range of quality assurance systems, which it uses to inform its service quality improvement plans. Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: The staffing and accommodation provided for people using the home’s intermediate care service would benefit from a review, in consultation with the healthcare professionals who are involved in the service. Service users, where possible, and their relatives need to be involved in developing their individual plans of care. These plans must be reviewed regularly to make sure they reflect the current needs of the service users. The administration of medicines must be made safe and accurate, in accordance with the Royal Pharmaceutical Society’s guidance. The home must make sure that service users always wear their own clothing. Suitable leisure and recreational activities should be regularly offered to provide stimulation and interest for service users. Information about independent advocacy services should be readily available for service users and their relatives, should they wish to use this facility. The home needs to have the new chair/hoist installed to make one of the bathrooms usable again. All the bedroom doors which do not have locks should have them fitted without further delay. Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 Page 7 The staffing levels and shift patterns need to be reviewed without delay to make sure that the home’s staffing is sufficient to meet the current assessed needs of the service users. More care staff need to complete an NVQ qualification in care. Individual staff supervision has started and this needs to take place at least once every two months to give staff the proper support to do their job effectively. The service users medicines administration record charts must be securely stored and not left loose on top of the medicine trolleys. Fresh, frozen and dry foods should be stored properly to ensure proper stock rotation as well as maintaining the foods’ optimum freshness. The fire safety officer should be consulted to advise on alternatives to the present unsafe system of using wedges to prop open doors. 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. Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 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 Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 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): 6 There is no separate accommodation for people who are on a rehabilitation programme. The care staff are allocated on a daily basis from the staff team and do not receive specialist training. EVIDENCE: The home is registered to provide intermediate care for up to five people, although it currently accepts no more than four people at any one time. The staff who work with this group of service users are assigned from the general rota on a day-by-day basis. They do not appear to receive any special training to enable them to support the work of the visiting physiotherapists and occupational therapists. Although this group of people has different needs and aspirations from the permanent residents they are not offered any special facilities or separate accommodation within the home. The other establishments in Calderdale which offer intermediate care and rehabilitation each employ a dedicated, trained staff team and provide separate accommodation from the rest of the residential home. This is in order to maximise the service users opportunity for recovery and ultimate return to Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 Page 10 their own homes. The management should consider the best way forward for this service. Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 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, 9 & 10 Service users or their relatives are not routinely involved in developing their care plans. Plans are not being reviewed each month. The medication administration is inaccurate, unsafe and lacks attention to detail. Service users should wear their own clothes at all times. EVIDENCE: One of the organisation’s senior managers carried out an audit in December, which showed that individual care plans are not being reviewed each month. I examined a number of plans and found evidence to support this. Care plans must be reviewed regularly to ensure they meet the assessed needs of the individual. One person told me that they had been involved in drawing up and reviewing their relative’s plan, but this was not found to be the case in other care plans. Although the medication administration systems have improved since the last inspection there is still a considerable amount of work to be done. The Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 Page 12 Medicines Administration Record (MAR) charts showed inaccuracies, omissions and duplication. One person had two record charts for the same medicines; both charts had been signed to show that the medications had been administered, although the times for administering two of the medicines were different on each chart. There were no records of the quantities of medicines prescribed for use ‘when required’, which had been brought forward from the last record chart. Some records had gaps where the nurse should have signed to show that the medicine had been administered. Signatures had been put in for each day when only one dose per week of a particular medicine was prescribed and dispensed. The qualified nurses who administer the medications at Elm Royd are responsible and accountable. This lack of attention to detail and accuracy potentially puts service users at risk and calls into question this area of the professional practice of the nurses responsible. All medicines must be administered in accordance with the Royal Pharmaceutical Society’s guidance. This includes signing the record chart at the same time as the dose is administered. During discussions with service users families I was informed that their relatives did not always wear their own clothes. It is very important that each person’s clothes are marked with their name to make sure they return to them from the laundry. For the dignity of the service user it is not acceptable that they wear someone else’s clothes. Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 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 There was little evidence that meaningful and stimulating activities are available. Some, but not all, of the care plans now include a social profile of the service user. Visitors are able to call at any reasonable time and there are quiet areas for service users and visitors to use. Easily accessible information about independent advocates needs to be readily available. EVIDENCE: On both days the television in the lounge was switched on continuously with no apparent consultation with the service users about what, if anything, they wished to watch. The picture was of a poor quality, although I was assured this would soon be put right. Relatives confirmed that there is very little provided in the way of recreational and social activities. Some care plans now include a ‘social profile’ of the individual. An activities co-ordinator would be able to use such information to help plan a range of leisure and social activities. Service users can receive their visitors in the main lounge or their own bedroom. There is also comfortable seating in the hallway and a separate, quieter lounge upstairs. Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 Page 14 Service users bedrooms are made attractive and personal with the possessions they bring with them from home. The home should be able to provide service users and their relatives with information about independent advocates, should they wish to use an advocacy service. There was no information readily available at Elm Royd when I asked for it on the first day of the inspection. Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 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): None of these standards was assessed at this inspection. EVIDENCE: Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 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): 22, 24 & 26 One of the bathrooms has not yet had the replacement bath hoist fitted. Wheelchairs and other aids and adaptations are still being stored in the corridors and bathrooms. Service users bedroom doors in the newer part of the building have locks, but no progress has been made towards fitting locks to the rest of the bedrooms. The laundry floor is now level and has an impermeable surface. EVIDENCE: At the last inspection one of the bathrooms was without a suitable chair/hoist to help people get in and out of the bath. This situation has not changed. At the last inspection I was assured that the remaining bedroom doors would be fitted with locks to give service users the choice of that additional privacy. No progress appears to have been made since then and the people with rooms in the old part of the building are still unable to lock their doors, if they wish. Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 Page 17 Since the last inspection the uneven laundry floor has been levelled and the floor surface has been made impermeable. Such a surface is an important infection control measure. Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 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 & 30 The management need to consider whether the current staffing levels and shift patterns are sufficient to meet the assessed needs of the service users. The work of updating the staff files is almost completed. More care staff need to complete an NVQ qualification in care. Induction training, followed by foundation level training is provided for all newly recruited care staff. Most staff will also complete at least three days training each year. EVIDENCE: Service users relatives have expressed their concerns that the staffing levels in the home are often insufficient. Staff also confirmed that there are sometimes staff shortages, which have not been filled by the home’s own staff or agency staff. I examined the staff rotas. There are two nurses and six care staff on the early shift, one nurse and five care staff rota’d for the late shift and one nurse and three care staff on the night shift. Agency staff are used to cover when there are not enough permanent staff available. Although these staffing levels appear satisfactory the home is a large building and provides care for up to forty-five people, a high proportion of whom are very dependent on the staff to support them with all their daily living needs. The staffing levels must reflect the current needs levels of the service users. The home’s management need to look very closely at whether the numbers and deployment of the staff can properly meet service users needs. I am aware that rotas and shift patterns are under review and any new system must Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 Page 19 be designed to improve staff effectiveness. It has been suggested that a member of staff should be available in the large downstairs lounge at all times. From my own observation I would recommend that the management look closely at implementing this. Of a total of thirty-two care staff only seven have so far achieved an NVQ qualification in care. Ten staff are studying for the award at level two and three care staff are working towards the NVQ level three in care. There needs to be a minimum of 50 of care staff with an NVQ qualification in care in order for the home to meet the standard. The process of updating all the staff files is almost complete. Two Criminal Records Bureau (CRB) checks have been unaccountably delayed at the CRB office. A newly appointed member of staff’s file showed that the recruitment procedures include all the necessary information and safety checks. New care staff are supernumerary to the rota during their induction period. The manager informed me that all staff are expected to complete their mandatory training and take refresher courses every six months. Most staff complete a total of three days training over the course of a year. Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 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, 33, 36, 37 & 38 The registered manager has just started working towards the Registered Managers’ Award. There are quality assurance systems in place, which are able to inform the improvement programme. Individual staff supervision sessions have only just started taking place. Secure storage of confidential records has improved but medicines records were still being left on top of the medicine trolleys. The standard of cleanliness in the kitchen has improved and accurate records are now being kept. The storage of dry and frozen foods needs improvement. Many of the doors are propped open with wedges, creating a fire safety hazard. Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 Page 21 EVIDENCE: The registered manager has completed his most recent professional training course and has now started working towards achieving the Registered Managers’ Award. Quality audits are undertaken regularly and the home’s performance is reviewed annually. Quality assurance questionnaires are sent to relatives, staff and suppliers at least every year. I have seen a copy of the organisation’s response to the questionnaires that were sent to relatives in summer 2005. A residents and relatives meeting was held in November 2005 and minutes of the meeting were sent out to all families. The group have set up a small committee to look at specific issues such as staffing and activities. The manager told me that individual staff supervision sessions have just been started. These need to take place at least every two months, with training provided to enable the senior staff to carry out the supervision effectively. The office door has been fitted with a lock to make sure that confidential information kept there is secure when the room is unoccupied. Staff must make sure that they always lock the door when leaving the room empty. My observations showed that while this usually happens, there were occasions when the door was not locked when the room was empty. Service users Medication Administration Record (MAR) charts were still being left on top of the medicine trolleys in the dining room. They must also be stored securely when not in use. The standard of cleanliness in the kitchen has improved since the last inspection. Cleaning records are now being kept and show a fair degree of accuracy. The refrigerator, deep freezer and hot food temperatures are now being taken and recorded daily. As at the last inspection, there were still two unwashed frying pans containing used oil stored on top of the cooker. The kitchen has no dry goods storage area. Packets of breakfast cereal and other goods are stored loose on top of the kitchen wall cupboards. This is unhygienic as well as untidy and makes proper stock rotation very difficult. Consideration should be given to creating a separate storage room for dry and tinned goods. Opened packages of food had been returned to the freezer without being sealed or labelled with the date they were opened. This needs to be done to ensure the food remains in good condition and accurate stock rotation is achieved. Suitable heavy gauge freezer bags should be used to freeze foodstuffs. The only bags available were too flimsy for this purpose. During my tour around the home I noticed that a number of doors were propped open with wedges. This creates a potential hazard in the event of a Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 Page 22 fire. Magnetic fixtures, connected to the fire alarm system would provide a safe alternative. The local fire safety officer can provide advice on this matter. Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 Page 23 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 X X X X X 2 HEALTH AND PERSONAL CARE Standard No Score 7 1 8 X 9 1 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 2 18 X X X X 1 X 2 X 3 STAFFING Standard No Score 27 1 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X X 1 1 1 Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 Page 24 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 OP7 Regulation 15 Requirement All individual care plans must be reviewed regularly and show evidence, wherever possible, that the service user or their representative has agreed the plan. The administration of all medications must be carried out in accordance with the guidance from the Royal Pharmaceutical Society. Brought forward from last inspection. Original timescale: 30/09/05 The home must provide stimulating activities, in accordance with the service users wishes The large upstairs bathroom must have a new hoist fitted to make the bath usable. NB This was a recommendation of the last inspection. It is now a requirement to ensure adequte assisted bathing facilities are available in the home. The staffing levels must reflect the assessed needs and DS0000061813.V255478.R01.S.doc Timescale for action 31/03/06 2. OP9 13(2) 28/02/06 3. OP12 16(2)(m) 31/03/06 4. OP22 23(2)(n) 30/06/06 5. OP27 18(a) 31/03/06 Elm Royd Nursing Home Version 5.0 Page 25 6. OP36 18(2) 7. OP37 17(1)(b)& Sch3(3)(i) 8. OP38 13(4)(c)& 23(4)(a) dependency levels of the service users. All care staff must receive six 30/06/06 individual supervision sessions per year. Brought forward from last inspection. Original timescale: 30/09/05 All confidential information must 28/02/06 be stored securely in accordance with the Data Protection Act 1998. Brought forward from last inspection. Original timescale: 30/09/05 Doors must not be wedged open, 30/06/06 as this constitutes a fire hazard. If doors are to be held open a safe alternative method must be found, in consultation with the Fire Safety Officer. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP6 Good Practice Recommendations Service users admitted for intermediate care should have the use of a dedicated area of the home and a staff team who are trained to support the rehabilitation work of the visiting healthcare professionals. Service users should wear their own clothes at all times. Information about advocacy services should be available for service users and their families. Suitable storage facilities for wheelchairs and other equipment should be found. All wheelchairs need to have their own footplates attached. The programme for fitting locks to the remaining bedroom doors should be completed. A minimum of 50 of all care staff should have completed NVQ 2 in care by the end of 2005. The home needs to complete the updating of all staff files DS0000061813.V255478.R01.S.doc Version 5.0 Page 26 2. 3. 4. 5. 6. 7. OP10 OP14 OP17 OP22 OP24 OP28 OP29 Elm Royd Nursing Home 8. 9. OP31 OP38 10. OP38 with minimal delay. The registered manager should complete the NVQ 4 qualification in management. Opened food packages stored in the refrigerators and deep freezers should be sealed and labelled with the date it was opened. All food stored in refrigerators and deep freezers should be clearly labelled and wrapped in suitable packaging, such as freezer gauge plastic bags. Suitable kitchen storage needs to be found for dry goods. Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 Elm Royd Nursing Home DS0000061813.V255478.R01.S.doc Version 5.0 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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