Inspection on 09/08/06 for Ferndale Court Nursing & Residential Home

This inspection was carried out on 9th 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 but made no statutory requirements on the home.

Other inspections for this house

Ferndale Court Nursing &... 10/04/08

Ferndale Court Nursing &... 03/07/07

Ferndale Court Nursing &... 28/02/06

Ferndale Court Nursing &... 24/08/05

Ferndale Court Nursing &... 01/11/04

Ferndale Court Nursing &... 24/05/04

Ferndale Court Nursing &... 15/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Ferndale Court Nursing & Residential Home Ferndale Court Nursing & Residential Home St Michaels Road Widnes Cheshire WA8 8TF Lead Inspector June Shimmin Key Unannounced Inspection 09:00 9th August 2006 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 Ferndale Court Nursing & Residential Home DS0000005172.V298249.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. Ferndale Court Nursing & Residential Home DS0000005172.V298249.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ferndale Court Nursing & Residential Home Address Ferndale Court Nursing & Residential Home St Michaels Road Widnes Cheshire WA8 8TF 0151 257 9111 0151 420 0210 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) www.schealthcare.co.uk Southern Cross Healthcare Services Limited Tamara Flanagan Care Home 57 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (57), of places Physical disability (5) Ferndale Court Nursing & Residential Home DS0000005172.V298249.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 57 service users to include:* Up to 57 service users in the category of OP (Old age, not falling within any other category) * Up to 5 service users in the category of PD(Physical disability under 65 years of age) * Up to 1 service user in the category of DE(E) (Dementia over 65 years of age) * Within the 57 beds up to 33 service users requiring nursing care may be accommodated 28th February 2006 Date of last inspection Brief Description of the Service: Ferndale Court is a care home providing personal care and accommodation for 57 people. Of those 57, up to 33 may be older people in receipt of nursing care, up to 5 may have a physical disability and 1 may have dementia. The home is located in the Ditton area of Widnes, close to local shops and churches. It was opened in 1997 and is a two-storey purpose built home. All the bedrooms are single with en-suite facilities. The home also has several lounges and dining rooms. A passenger lift is available for access to the first floor. The home shares the same site as Ferndale Mews care home, both homes being set in private grounds with parking and gardens. The current weekly fees range from £318.22 to £430 for residents receiving personal care only and from £340.04 to £520 for residents receiving nursing care. Further details regarding fees are available from the manager. Ferndale Court Nursing & Residential Home DS0000005172.V298249.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit was part of the service`s first key inspection. It was carried out on 9th and 11th August, 2006 by June Shimmin, regulatory inspector and lasted eleven hours. During the inspection conversations were held with residents, relatives, management and staff. 7 residents/relatives returned written comment cards. A GP and care professional also returned comment cards. A partial tour of the building was also carried out. Various documentation including assessments, care plans, medication charts, recruitment and fire safety records were seen. There were 53 residents living at the home on the day of inspection, 24 of whom were receiving nursing care and 29 personal care only. What the service does well: Staff are highly regarded and comments were made such as “We`re quite happy with the staff and their attitude - like an extended family. Residents and relatives are given information about the home to help them decide if the home will meet their needs. All prospective residents are assessed before admission to ensure that the home can meet their needs. Residents enjoy a good quality of life in terms of activities and food. Visitors are made welcome. The home is clean, tidy and well maintained and offers a pleasant and comfortable living environment for its residents. The home carries out audits to make sure that standards are being maintained. Ferndale Court Nursing & Residential Home DS0000005172.V298249.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ferndale Court Nursing & Residential Home DS0000005172.V298249.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ferndale Court Nursing & Residential Home DS0000005172.V298249.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Information is provided for residents and relatives to help them make a decision about the home. Contracts are only provided between the home and privately funded residents, which means that residents funded by social services do not receive the same information. New residents are assessed before admission to ensure that the home can meet their needs. EVIDENCE: Ferndale Court has a Statement of Purpose and Service User Guide (information leaflets), which describe the services and facilities provided. These are on display at the entrance together with a copy of the latest inspection report. The registered manager also gives residents and relatives a copy of the Southern Cross Times and the home brochure. The CSCI registration certificate was displayed. Ferndale Court Nursing & Residential Home DS0000005172.V298249.R01.S.doc Version 5.2 Page 9 Contracts are in place between privately funded residents and Ferndale Court. These explain the terms and conditions of residency. Similar contracts are not provided for residents funded by social services. This means that those residents may not be fully aware of their rights and the terms and conditions at the home. The registered manager, her deputy, or the unit manager of the floor where non-nursing residents are admitted, assess prospective residents before admission to the home. The assessment documentation of three recently admitted residents were looked at. The content of the assessments was good. However, there was very little recorded about the family history of residents or their social and leisure care needs. The registered manager ensures that, if a resident`s needs change, or if the home is no longer able to meet their needs, that a reassessment of need is carried out. The home does not provide intermediate care but can offer respite care if there are vacancies. Ferndale Court Nursing & Residential Home DS0000005172.V298249.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care needs of residents are mainly identified and met. Medication is well managed. The staff members respect the privacy and dignity of residents. EVIDENCE: Four care plans were looked at, including a care plan for a resident admitted for respite care. These included various risk assessments. Overall the standard of care planning was good. Where possible, the staff members ask the residents to sign the care plan to show that they have understood and agreed to the care provided. Some minor issues were identified. The first care plan had been reviewed every month but had not identified some care needs. For instance, there was no advice about good diabetic care, regarding foot care, eye checks and blood pressure monitoring. There was no reference to the resident`s blood sugars in the review. A care plan for elimination needed to be more detailed. There was a care plan for dementia Ferndale Court Nursing & Residential Home DS0000005172.V298249.R01.S.doc Version 5.2 Page 11 which acknowledged that the resident needed a lot of support when talking about family and past and could get upset easily. However, the review did not evaluate the resident`s mood. There was also no care plan for a new health care need. There was evidence that various health professionals had been involved in the resident`s care. The care plan of the second resident identified that the resident had pressure sores on admission to the home. The staff members had managed to heal one and the others were improving and the home is commended for this. A specialist “tissue viability” nurse had been consulted about the pressure sores. The risk assessments and care plans had mostly been reviewed but the content of some of the care plans did not evaluate whether care delivery had been effective. For instance the evaluation of a care plan for a wound and prevention of further pressure sores stated dressing renewed to foot” rather than detailing the degree of wound healing and whether other pressure areas were intact. The resident had developed another health problem and was taking antibiotics, but there was no plan for this. The resident had been reviewed by a number of health care professionals. The third care plan included all identified risks and care needs. The resident had again been admitted with pressure sores and these had improved since admission. The care plans had been reviewed every month and the content of the review was good. A communication care plan was well written. The review of a care plan for diabetes did not refer to blood sugar levels and if they were satisfactory. Progress records indicated that the resident had developed an infection but there was no care plan for this. The fourth care plan was well written. There was reference to input from health professionals and the care plans had been reviewed every month. There was a record of the resident`s social history which helps staff to understand more about the resident. However, as with the third care plan there was little reference in the daily records to the resident`s psychological needs and most emphasis on their physical care needs. A care plan for oral hygiene was needed. Ferndale Court has a medication room on both floors. The upstairs room was very hot and the home was taking measures to reduce the room temperature by the use of fans. Sometimes the room temperature was registering between 29 and 34 degrees. Staff members said that they were awaiting the installation of air conditioning. Records for the administration of medication were looked at for the ground floor. These were found to be accurate and up to date. There were however, many instances of residents refusing medication. Reasons for refusal needed to be documented and discussed with the GP to see if some medications could be discontinued or an alternative sought. The home was managing controlled drugs well. Ferndale Court Nursing & Residential Home DS0000005172.V298249.R01.S.doc Version 5.2 Page 12 Residents said that they were happy with the way in which staff approached them. Comments such as “they knock on the door” and “treated with respect” were made. Staff members interacted in a kind and sensitive manner with residents. Ferndale Court Nursing & Residential Home DS0000005172.V298249.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 in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to keep in contact with family and friends. They are offered a range of social activities at the home. They are able to express choice in their daily lives. They receive a healthy and varied diet. EVIDENCE: Ferndale Court employs an activity coordinator who works 30 hours a week between Monday and Friday. During the morning there had been balloon games with 10 residents joining in. There was bingo in the afternoon, which was enjoyed by residents and several visitors. The activities coordinator keeps a record of the activities enjoyed by individual residents on a one to one basis or in groups. These included: keep fit, 121, bowls, friendship club, ie get together, arts & crafts, friendship club, exercises, hand massage and reminiscence. The activity coordinator has attended a 6 week course in dementia, accredited by the University of Stirling and is also doing an in-house 2 day “yesterday, today and tomorrow” course the following week. The activities coordinator said that she always reads about the social history of residents before entering this kind of therapy. The home held a recent Ferndale Court Nursing & Residential Home DS0000005172.V298249.R01.S.doc Version 5.2 Page 14 awareness day for Action against Elder Abuse, which was attended by the local mayor. Photos of this were displayed. A summer fair was recently held. The activities coordinator keeps newspaper clippings of these events. There had been a recent trip to Blackpool by coach. The home also uses Halton community transport. A Tea dance was being arranged for the coming week at a nearby club. They also invite people from sheltered accommodation and were hoping up to 30 would attend. A number of visitors said that they were made to feel welcome and were happy with the standards of care at Ferndale Court. Residents are able to exercise choice in their daily lives, for instance they can choose when to get up and go to bed and whether they wish to stay in their own room or join with other residents in communal areas. They also have a choice of meals. Ferndale Court has a number of small dining rooms which are homely. Residents can also take their meals in their room. Residents said that they considered the quality of food to be good. There is always an alternative and the alternative pureed diet the day before had been either liver and onions or smoked fish. The home provided information about menus before the inspection. These demonstrated choice and variety. The lunch was roast pork, roast potatoes, carrot & swede, sprouts, gravy and sage and onion stuffing followed by chocolate sponge and custard, yoghourt or ice cream. A salad was the alternative. Records were kept of what individual residents had eaten. The evening meal is served at 4 30pm and was cold meat salad, soft corned beef hash, or soup and sandwiches (mixed cheese, tuna, ham, egg mayonnaise, corned beef). There is a hot and cold choice for the evening meal. Hot and cold drinks are available at all meals and during the morning and afternoon. Supper is provided between 7 and 11pm. Ferndale Court Nursing & Residential Home DS0000005172.V298249.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 in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents and relatives are aware of how to complain. Residents are protected from possible abuse. EVIDENCE: Ferndale Court has a complaints procedure, which is displayed in the entrance to the home and is also included within the information leaflets about the home. The home has a complaints book. Information provided by the home before the inspection indicated that the home had received three complaints, one of which was substantiated. Halton Borough Council Adult Protection procedures and the Department of Health guidance, No Secrets, were available in the home. 13 staff members have recently attended training in this subject. Remaining staff should undertake this training. The home follows the correct procedure when an allegation of adult abuse is made, so that residents are protected. A recent allegation was proven. The staff member was given a final written warning. A further allegation of misconduct of a member of staff was recorded in the supervision records of another member of staff. This was not notified to CSCI. Ferndale Court Nursing & Residential Home DS0000005172.V298249.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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Ferndale Court provides a pleasant, comfortable and well-maintained living environment for its residents. EVIDENCE: During a tour of the building all communal areas and a number of bedrooms were seen. The premises were clean, tidy and hygienic and no unpleasant odours detected. Steps had been taken to prevent the spread of infection in the home. The corridors were spacious allowing for easy access of equipment. The home provided a range of aids and adaptations suitable for use by residents with a disability. The home employs a maintenance man from Monday to Friday to carry out basic maintenance and decoration work. Ferndale Court Nursing & Residential Home DS0000005172.V298249.R01.S.doc Version 5.2 Page 17 The home usually redecorates rooms as they become vacant. The heating and lighting were good. Externally there are well kept gardens. There is adequate parking. Ferndale Court Nursing & Residential Home DS0000005172.V298249.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 is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels are adequate. Staff members are given opportunities to undertake training but not many have achieved the minimum training standard, NVQ level 2. Recruitment practices are mainly satisfactory. EVIDENCE: The home has a number of staff vacancies. The registered manager has been actively trying to recruit new staff to cover these vacancies. Several relatives commented that they considered that staffing levels were not always satisfactory, for instance, “at times they seem very busy and could do with more staff. On the day of inspection there were two first level registered nurses (RGN) and four carers on duty on the nursing unit and the unit manager and three carers on the ground floor unit for residents requiring personal care only. The registered manager was supernumerary. In the afternoon there is one RGN on duty. At night there is one RGN on duty together with two carers on the first floor and two on the ground. Agency staff useage was quite high due to staff sickness. Cleaning and kitchen staffing levels are adequate. The registered Ferndale Court Nursing & Residential Home DS0000005172.V298249.R01.S.doc Version 5.2 Page 19 manager said that staff will cover extra shifts. A new weekend laundry assistant was due to start work following satisfactory references. Care staff are highly regarded by residents and relatives. For instance a comment such as “I`m much better here than at home alone, I get all the help I need” was typical. Four staff have achieved NVQ level 3. Two more have signed up with an external training organisation and seven are waiting to be signed up. Other recent training included a session on foot care for nine staff and training in adult protection. The induction record of a nurse was seen and had been signed and dated. The recruitment records of four staff were seen. These were satisfactory, except for one where there were two personal references on file and none from a previous employer. The registered manager had obtained a preliminary security check (POVA first) for all staff and all staff worked under supervision until the full security check (enhanced disclosure from the Criminal Records Bureau) was obtained. Ferndale Court Nursing & Residential Home DS0000005172.V298249.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. 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Ferndale Court is well managed. It monitors its performance through an effective quality assurance system. EVIDENCE: The manager of the home has become registered with the CSCI since the last inspection. She is a first level registered nurse and has worked at the home initially as a registered nurse, then deputy manager and now as registered manager. The registered manager is currently working towards the registered manager`s award and expects to complete this by September 2006. Although the registered manager is supernumerary she occasionally works with other staff to monitor practice and assess residents` progress. Staff described the manager as being approachable and supportive. Ferndale Court Nursing & Residential Home DS0000005172.V298249.R01.S.doc Version 5.2 Page 21 Records were checked for the monies held by the home on behalf of two residents. These were kept on a computer and were accurate. The registered manager also said that a regional administrator for Southern Cross audits these records on a regular basis. The registered manager carries out audits into various aspects of the management of the home every two months and records of this are kept. A senior manager of Southern Cross visits the home every month and also assesses the management and care delivery of the home. A copy of this report is made available to the CSCI. Relatives said that they had attended meetings about the home. However, several staff members said that there had been no staff meetings for some time. The registered manager said that the last meeting for residents was only attended by two residents. Fire safety logs indicated that fire drills had been carried out on a regular basis but it was difficult to track whether all members of staff had taken part in a fire drill as there was no training matrix. All other fire safety records were checked and found to be correct and up to date. The registered manager provided the CSCI with information about the home before the inspection. This indicated that equipment and installations at the home had been maintained and serviced on a regular basis. Several maintenance records were checked and found to be accurate and up to date. Ferndale Court Nursing & Residential Home DS0000005172.V298249.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 3 2 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 3 Ferndale Court Nursing & Residential Home DS0000005172.V298249.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 OP2 Regulation 5a Requirement The registered person must ensure that all residents receive a statement of terms and conditions within 24 hours of admission to the care home. The registered person must notify the CSCI without delay of any incident affecting the wellbeing of residents. The registered person must increase the number of staff training for an NVQ Level II in Care. (Previous timescale of 30/09/05 not met) The registered person must obtain two written references, one of which must relate to the person`s most recent employment. Timescale for action 09/10/06 2. OP18 37 09/09/06 3. OP28 18(1) 30/11/06 4. OP29 19(4) (b&c) Schedule 2 09/10/06 Ferndale Court Nursing & Residential Home DS0000005172.V298249.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. Refer to Standard OP3 OP7 OP7 OP9 OP18 OP33 Good Practice Recommendations The assessment of new residents should include details about their family history, social interests, hobbies, religious and cultural needs. Care plans should be written for further care needs, such as infections, which develop following admission to the home. The review of care plans should evaluate care delivery and state whether care has been effective. Reasons for refusal of medication should be documented and discussed with the GP. Remaining staff should undertake refresher training in the protection of vulnerable adults. Staff meetings should be held for all staff groups. Ferndale Court Nursing & Residential Home DS0000005172.V298249.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Ferndale Court Nursing & Residential Home DS0000005172.V298249.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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