Inspection on 02/08/06 for Elmwood House Nursing Home

This inspection was carried out on 2nd August 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Elmwood House Nursing Home 17/09/09

Elmwood House Nursing Home 03/09/07

Elmwood House Nursing Home 23/01/06

Elmwood House Nursing Home 22/09/05

Elmwood House Nursing Home 17/11/04

Elmwood House Nursing Home 25/05/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Elmwood House Nursing Home Elm Street Hollingwood Chesterfield Derbyshire S43 2LW Lead Inspector Ray Coonan Unannounced Inspection 2nd August 2006 10:00 Elmwood House Nursing Home DS0000002055.V302691.R01.S.doc Version 5.2 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 Elmwood House Nursing Home DS0000002055.V302691.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Elmwood House Nursing Home DS0000002055.V302691.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elmwood House Nursing Home Address Elm Street Hollingwood Chesterfield Derbyshire S43 2LW 01246 477077 01246 477111 devoncourt@elmcare.wanadoo.co.uk 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) Elmcare Limited Mrs Susan Patricia Durrant Care Home 40 Category(ies) of Learning disability (40) registration, with number of places Elmwood House Nursing Home DS0000002055.V302691.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. LD Learning disability not falling within any other category Date of last inspection 23rd January 2006 Brief Description of the Service: Elmwood House provides care for up to 40 younger adults with learning disabilities (some of whom also have physical disabilities). The home is organised into four houses, each having 10 beds, namely The Lodge, The Villa, The Cottage and The Penthouse. There is 75 single room accommodation and 25 shared. Each house has separate lounge and dining facilities, together with suitably equipped bathroom and toilet facilities. There are no en suite bedrooms. Kitchen and laundry facilities are centralised. There is a small kitchen in the Cottage, which service users can access under supervision to prepare snacks and drinks. There is also a ‘white room’ located in the Cottage with snoezelen equipment in place. The Registered Manager has the support of a Deputy Manager, both of whom are Registered Nurses Learning Disabilities, together with a team of Registered Nurses. Each house has its own care staff team, with Registered Nurses currently working across two houses. There is access for service users to outside healthcare professionals, including that of routine health care screening and also specialist needs as well as advocacy services. A variety of activities are organised on a daily basis both in and outside the home. As well as accessible sitting areas externally, a workshop area has been developed at the rear of the premises and garden areas are used for growing vegetables and fruit as well as keeping hens and ducks. At the time of this inspection visit the scale of charges at the Home ranged from £641.90p to £1,029.46p. Elmwood House Nursing Home DS0000002055.V302691.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of seven hours on the 2nd August. The Home’s manager, Sue Durrant, was present throughout the visit. There was the opportunity to meet with several of the staff on duty at the time. There was also the chance to meet and talk with many of the residents, though some were out on various activities during the day. A range of documentation was examined including care plans, staff files, health and safety records and relevant policies and procedures. A tour of the premises, taking in all four houses, was undertaken in the morning. What the service does well: What has improved since the last inspection? What they could do better: There were no major areas requiring improvement though the arrangements for the individual supervision of staff needs to be looked at. Elmwood House Nursing Home DS0000002055.V302691.R01.S.doc Version 5.2 Page 6 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. Elmwood House Nursing Home DS0000002055.V302691.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Elmwood House Nursing Home DS0000002055.V302691.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefited from having their needs assessed appropriately before admission and being given the opportunity to visit the Home prior to the confirmation of the placement. EVIDENCE: Several care plans were examined in detail, including the care plan of a resident who had come to live at the Home in the past six months. This demonstrated that a good range of information had been obtained prior to any admission. Also included was relevant background information such as a social and personal history, which identified particular interests of the resident in the form of a personal profile. Relevant physical and emotional health assessment reports were obtained as required, together with general aims and objectives of the placement. Files also contained notes on trial visits undertaken and recordings of the individual resident’s ‘hopes and fears’. Elmwood House Nursing Home DS0000002055.V302691.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 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, 7, 8 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ care is planned in a thorough manner, taking into account their competencies, needs, potential vulnerability and also their interests and preferences. EVIDENCE: Four individual care plans was examined in detail and they were comprehensive and informative, providing a real sense of each resident’s individual personality. Strengths and needs were assessed around daily living activities and there was clear evidence of involving the resident in care planning with sections on ‘what is important to me’ using visual representation to establish particular views and preferences. Individual resident’s ‘hopes and fears’ were also established. Care plans were suitably detailed and contained clear instructions and guidance for staff and long-term objectives. There was also evidence of plans being regularly updated and reviewed. The Home is looking at ways of making plans more visually accessible for residents and some of them were becoming bulky and in need of ‘pruning’. Elmwood House Nursing Home DS0000002055.V302691.R01.S.doc Version 5.2 Page 10 Resident’s files also contained a wide range of related risk assessment information in such areas as behavioural/psychological issues, matters affecting physical health such as skin integrity, nutrition and mobility, and also any risk that might involve general health and safety and social activities. Activity timetables were included on care files. Risk assessments were also monitored appropriately and one file had details of further ongoing psychological risk assessments initiated following a specific incident at the Home. Care is delivered through a named nurse and key worker system. Several residents have the use of independent advocacy services and an advocate was used for a resident at a recent case conference dealing with abuse and protection. An independent advocate also visits the Home regularly and holds meetings with residents. There were some mixed messages in the service user surveys as to the amount of choice available in daytime activities, though discussions with residents on the day of the inspection indicated that residents were not unduly ’pushed’ into taking up particular activities and were able to opt out though they would be encouraged if necessary. Elmwood House Nursing Home DS0000002055.V302691.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoyed a varied and active lifestyle with a wide rage of social and recreational programmes available that linked in with their expressed interests and assessed developmental needs. Residents were provided with a suitably healthy diet that took into account any individual preferences or needs. EVIDENCE: Activity records and reports for residents are maintained at the Home and a wide range of programmes have been developed. Care plans contain information on residents’ interests, skills, strengths and social, therapeutic and developmental needs with specific risk assessments undertaken as necessary. Links have been developed with several community resources such as Chesterfield College, Gamelea Farm, and local churches. Discussions with staff and residents confirmed that they use local facilities and visit local pubs, parks and shops, with each resident having allocated individual time with a staff Elmwood House Nursing Home DS0000002055.V302691.R01.S.doc Version 5.2 Page 12 member on a regular basis. Local community education classes are also accessed by some of the residents as well as specific resources such as the ‘First Movement’ project in Matlock. Regular day outings and trips are arranged, the Home having its own transport. Care plans contained reports on holidays taken by residents. The Home itself has a generally busy atmosphere. Examples of residents’ craft and artwork and holiday photos are used to decorate rooms and corridor areas. Individual residents and communal areas have music, DVD and video equipment. Programmes for daily developmental activities around the Home are in place. An activities coordinator is also employed to work intensively with a small group of residents throughout the week, though on the day of this inspection she was on annual leave. These residents use a room with a snoezalan facility on a regular basis and engage in specific craftwork using a variety of materials and textures. The Home’s rear gardens have been used to develop a workshop facility, allotments, and space for keeping and rearing hens, ducks and geese, with several residents participating regularly in supervised activities in these areas. The home also lease several allotments and on the day of the inspection several residents were at the Bakewell Show exhibiting vegetables, for which they won several prizes. Care plans contained information on residents’ social and family history and network charts were developed identifying family and other important relationships for each resident. In some instances these relationships had been problematic and contact was monitored accordingly. The Home had a system of rotating menus operating over a nine weekly period though for one week during this time each house would devise their own menu. Catering staff kept a list of individual preferences and any specific dietary needs were also noted. Menus were varied and nutritious with alternatives available and feedback from residents was positive about meals at the Home. Elmwood House Nursing Home DS0000002055.V302691.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personal and health needs of residents were fully assessed and actively promoted, with specialist advice obtained appropriately. EVIDENCE: Care plans examined demonstrated that the physical and emotional health needs of residents were assessed in detail and kept under review. Care staff stated they received appropriate guidance and support regarding the medical needs of residents from the qualified nursing staff. Complex and specialist needs were well documented within individual care records, and care practice developed within a framework of risk management. Assessment information was also documented in terms of individual’s capacity to consent and make informed decisions. Inputs from outside healthcare professionals, such as dentistry, physiotherapy, chiropody and optician, were provided for individual service users in accordance with their assessed needs and via GP referral. The manager stated the local G. P. practice was very supportive. One of the registered nursing staff is a link person with the area Primary Care Trust regarding continence and wound management issues. Notes on files showed that specialist advice and Elmwood House Nursing Home DS0000002055.V302691.R01.S.doc Version 5.2 Page 14 relevant reviews were routinely obtained from Ash Green Community Hospital for people with learning disabilities. There was evidence of careful preparation and support and clear documentation in respect of consent to treatment. The Home had a separate and secure room for the storage of medicines. The Home now uses four separate drug trolleys for use around the Home. Only qualified nursing staff administer medication and there were clear systems in place for the ordering and disposal of medicines. Administration records viewed were up to date and filled in correctly. There were separate arrangements for the storage and recording of any controlled drugs. There were no residents self - medicating. Details of staff training in respect of any invasive treatment procedures, such as insulin injections, were also maintained. Elmwood House Nursing Home DS0000002055.V302691.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 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 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home had an open and responsive approach to listening to any concerns or complaints. The safety and protection of residents was actively promoted with staff. EVIDENCE: The Home had a comprehensive complaints policy displayed and this is also referred to in the service user guide. The policy has been adapted for resident use with good pictorial representations developed to assist understanding. The Home kept detailed records of any concerns and also maintained an incident file. Independent advocacy for residents is available and several residents spoken to indicated that they would raise any issues if they were unhappy. The Commission has not received any complaints since the last inspection. Two anonymous complaints have been made and recorded, one to the Environmental Health Officer and one to the R.S.P.C.A. Neither was substantiated. The Home has relevant abuse and protection policies in place and maintain ongoing links with the local social services for the provision of training. All staff interviewed confirmed that they had received input in this area and demonstrated a good awareness of the issues. They also confirmed that they had undertaken training concerning challenging behaviour and had a satisfactory awareness of processes in this respect. The Home has had one protection referral since the last inspection, involving an incident between two residents. Local interagency protocols were followed and a plan for ensuring Elmwood House Nursing Home DS0000002055.V302691.R01.S.doc Version 5.2 Page 16 resident safety was developed and put into practice. However, The Commission was not informed of the incident in a timely manner. Elmwood House Nursing Home DS0000002055.V302691.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy a generally safe and comfortable environment, which is kept clean and is adapted to their needs EVIDENCE: Most parts of the premises were viewed during this inspection and the overall environment is well – maintained and hygienic with a rolling maintenance programme in place. It was stated that an environmental assessment is done monthly, with a lead person for each house, and any maintenance or hazards are reported to the manager. During the tour of the premises there were several matters that were seen to require attention, such as re carpeting in some places such as the entrance area in the Cottage, the lounge in the Villa, and the bathroom floor surface in the Lodge. The lounge area in The Penthouse was in need of freshening up and redecorating. Communal areas were generally bright and appropriately furnished, though there were parts that received a lot of ongoing ‘wear and tear’ from residents. Some areas including certain resident bedrooms were somewhat sparse due to issues around behavioural patterns though attempts were made to get over this problem through the use of items such as plastic mirrors. Generally bedrooms were of Elmwood House Nursing Home DS0000002055.V302691.R01.S.doc Version 5.2 Page 18 an appropriate size, suitably furnished and personalised by individual residents. The Home was well – resourced with bathroom and toilet facilities, which had aids and adaptations for those residents with mobility difficulties. These areas were generally clean and hygienic. The Home has a member of staff who takes a lead roll in infection control matters and staff confirmed that they have received training in this area. The Home has a well - organised and equipped central laundry area with 2 staff employed to manage the service. The dress and appearance of service users was observed to be satisfactory and age appropriate. Externally there were several accessible sitting areas for residents, which are used for barbeques, and the grounds, including the areas for growing produce and keeping the hens and geese, were well - maintained. Elmwood House Nursing Home DS0000002055.V302691.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ interests are enhanced through the Home’s satisfactory recruitment practices and a well - developed and relevant training programme for staff. EVIDENCE: Staffing levels at the Home remain satisfactory and in line with the needs of residents, with a degree of flexibility to promote individual activities. There were no current vacancies. The manager stated that they are now introducing new recruitment procedures, which include the formal involvement of residents in the interviewing process. Two staff files were examined in detail and these were in good order with appropriate interviewing records evident and CRB checks and references taken up. The Home has recently had an auditing check from the Criminal Records Bureau and though no report has been received as yet, it was stated that no issues of concern were raised at the time. The Home has established practices for the induction of staff using the ‘Skills for Care’ framework. The training coordinator for the Home was on leave at the time of the visit though training programmes and records were seen. These were suitably structured and included a wide range of relevant training opportunities, including the basic mandatory care courses such as moving and handling and food hygiene. Staff also confirmed that other areas such as Elmwood House Nursing Home DS0000002055.V302691.R01.S.doc Version 5.2 Page 20 infection control and working with challenging behaviour were provided. NVQ training is also suitably promoted with the staff group, including domestic workers. Staff indicated that they felt supported and thought that the management at the Home were approachable and willing to listen to suggestions. They stated that they received annual appraisals and one to one time on an informal basis. Records for staff supervision showed that this was done on a reactive basis by the nursing staff, if an issue came up, rather than in any formalised or structured manner. Elmwood House Nursing Home DS0000002055.V302691.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a home that is well –organised and were there is a structured approach to their health and safety. EVIDENCE: The manager has relevant practice and managerial experience, nursing qualifications and has completed the NVQ level 4 in care and management. There is also a deputy manager, who together with other qualified nursing staff, takes on clearly defined lead responsibilities in such areas as staff development, health and safety, medicine administration and infection control practice. The Home has annual aims and objectives and the manager produces an annual report on the running of the Home. Questionnaire surveys are undertaken with both staff and residents on a regular basis. The manager also Elmwood House Nursing Home DS0000002055.V302691.R01.S.doc Version 5.2 Page 22 meets with the providers and other managers in the organisation on a weekly basis. Monthly monitoring visits to the Home by the owners’ representatives, in this case managers from other Homes are now undertaken with reports completed, though only one copy of these has been sent to The Commission. The Home’s Health and Safety policies and practices were examined at the last inspection, earlier in the year, together with the servicing of utilities and equipment, and were found to be satisfactory. Fire safety records were seen on this occasion and were up to date and complete with regular fire drills taking place. Fire safety training for staff was provided on a six monthly basis. The Fire Officer had inspected the Home in January 2006 and there were no requirements or recommendations stemming from his report. Elmwood House Nursing Home DS0000002055.V302691.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 X 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Elmwood House Nursing Home DS0000002055.V302691.R01.S.doc Version 5.2 Page 24 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA36 Regulation 18 Requirement The Home must ensure that a structured system for the individual supervision of staff is established Timescale for action 30/09/06 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 YA24 YA39 Good Practice Recommendations Items of maintenance, as detailed in the main body of the report, should be attended to as soon as is practicable. The monthly monitoring reports of the Providers’ representatives should be sent to the Commission. Elmwood House Nursing Home DS0000002055.V302691.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Elmwood House Nursing Home DS0000002055.V302691.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. 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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